Get to know Paxlovid, a drug that is claimed to be able to reduce the risk of severity due to Covid-19 infection – In addition to implementing health protocols and promoting vaccination programs, the world is also competing to find drugs to treat infections caused by Covid-19.

In December 2021, the United States Food and Drug Administration (FDA) approved an Emergency Use Authorization (EUA) for Paxlovid to treat Covid-19.

The availability of special oral therapy drugs for SARS-CoV-2 is urgently needed to minimize the effects of Covid-19 infection on the body and prevent hospitalization, as well as illness and death.

In clinical trials, the drug was 90 percent effective in preventing hospitalization and death of high-risk patients.

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In addition, paxlovid was also able to fight VOC Sars Cov-2, including Omicron. Paxlovid is also reported to be able to inhibit other types of coronaviruses including SARS and MERS.

Paxlovid Benefits and Contra Indications

Illustration of covid-19, symptoms of long covid in children (Pixabay)
Illustration of covid-19 (Pixabay)

As explained by Associate Professor, Department of Chemistry at Universiti Putra Malaysia, Bimo Ario Tejo, Ph.D, the drug is effective for all variants because the target is a viral protease enzyme whose mutation rate is much lower than the mutation in the spike part of the SARS-CoV-2 virus.

Paxlovid will be available in blister form containing two 150 mg Nirmatrelvir tablets and one 100 mg Ritonavir tablet.

Nirmaltrevir is derived from the drug candidate PF-00835231, which was created by the pharmaceutical company Pfizer to deal with the SARS outbreak in 2002. However, the production process for the drug was stopped because the SARS outbreak was brought under control quickly.

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The drug candidate PF-00835231 was only glimpsed after the emergence of Covid-19 caused by the SARS-CoV-2 virus which is a betacoronavirus, a group with the virus that caused the SARS outbreak 20 years ago.

The Pfizer research team modified the drug candidate PF-00835231 to increase its effectiveness against the SARS-CoV-2 virus. The result of this modification is named nirmaltrevir (PF-07321332).

Nirmaltrevir works by inhibiting the protease enzyme used by the SARS-CoV-2 virus to reproduce in the human body. The result is that the development of the virus is inhibited.

Because nirmaltrevir has the possibility to decompose in the human body (so its effectiveness is reduced), then ritonavir is added to maintain the stability of nirmaltrevir so that it does not break down easily.

The results of the Paxlovid clinical trial (nirmaltrevir and ritonavir) by Pfizer involving 2,246 people showed an 89 percent effectiveness in reducing the risk of hospitalization and death if given 3 days after symptom onset, or 88 percent if given 5 days after symptom onset.

In addition, in the Paxlovid clinical trial the Asian population was included in the clinical trial subjects. Its composition is 72 percent Caucasian, 5 percent African, and 14 percent Asian. So the effectiveness of Paxlovid against people of Asian race has been tested.

Paxlovid is safe for consumption by patients aged 12 years and over and weighing 40 kg or more. However, Bimo reminded that Paxlovid is not effective for Covid-19 patients who have severe symptoms and have been hospitalized.

This drug must also be given as soon as it is indicated positive for Covid-19, preferably within five days after the appearance of symptoms, and cannot be used for more than five consecutive days.

“Paxlovid can only be given with a doctor’s prescription and cannot be used to prevent Covid-19. So health protocols and vaccinations must still be carried out,” said Bimo, quoted from a press release, Sunday (27/3/2022).

He also reminded that before taking the drug, patients need to know whether they have a history of hypersensitivity to nirmaltrevir or ritonavir.

In addition, patients are not surprised that when taking Paxlovid they will experience dysgeusia (impaired sense of taste), diarrhea, hypertension, and muscle pain.

Paxlovid is also contraindicated when given with other drugs that interact with CYP3A such as alfuzosin, pethidine, propoxyphene, amiodarone, dronedarone, flecainide, propafenone, quinidine, colchicine, lovastatin, simvastatin, phenobarbital, rifampin, and others.

A complete list of drugs that have contraindications to Paxlovid is in fact sheet publications issued by the FDA. Therefore, it is important for patients to consult their doctor before taking this drug.

Bimo also explained that in general, comorbid patients may take Paxlovid as long as they are consulted with a doctor.

However, in patients with kidney problems (eGFR 30 to

However, Paxlovid should not be given to patients with renal impairment with an eGFR

Various countries are already using Paxlovid. In the east, South Korea became the first Asian country to have approved the use of Paxlovid.

Meanwhile, Indonesia has arrived for Paxlovid and is still waiting for a study on the efficacy, efficacy, and side effects of paxlovid conducted by the POM.