What are oral antivirals?
Oral antivirals are an at-home COVID-19 treatment option for those who are high risk of severe illness. These pills work to keep the SARS-Cov-2 virus from replicating properly, thereby reducing viral load, which can help reduce symptom severity.
Patients interested in receiving oral antivirals should contact their primary care provider.
What types of patients can benefit from treatment with oral antivirals?
Oral antivirals are a treatment option to consider for people who have met all the following criteria:
- A positive COVID-19 test.
- Within 5 days of symptom onset.
- At increased risk for severe COVID-19 or hospitalization (risks include age, vaccination status, or certain medical conditions).
In Ohio, a patient must have a prescription order to receive oral antivirals. These pills may only be prescribed for an individual patient by physicians, advanced practice registered nurses, and physician assistants. Providers are strongly encouraged to ensure compliance with requirements for oral antiviral ordering and administration under state law.
- Oral therapeutics are new and under emergency use authorization (EUA). A side-by-side comparison of all COVID-19 therapeutics is available on the ASPR website with links to Health Care Provider Fact Sheets, eligible populations and contraindications.
- Risk is generally based on age, specific comorbidities by age group (e.g., kidney disease, diabetes, cardiovascular disease, chronic respiratory disease, etc.) and/or a body mass index greater or equal to 25. Evaluating risk based upon these factors helps to ensure the treatments are being made available safely and to the Ohioans who need them the most.
- The Centers for Disease Control and Prevention (CDC) website provides a list of risk factors for severe illness from COVID-19 on the webpage Underlying Medical Conditions Associated with High Risk for Severe COVID-19. The likelihood of developing severe COVID-19 increases when a person has multiple comorbidities.
- Supplies of the treatments are limited.
Currently Authorized Oral Therapeutics
Clinicians who wish to consider or recommend use of these therapies should review the COVID-19 Treatment Guidelines published by the National Institutes of Health (NIH) as well as the FDA EUA for each therapy.
These treatments are intended for outpatient dispensing; clinicians and health systems should provide medication in a location and manner in which patients with COVID-19 can be safely managed.
Currently available oral antivirals include:
- PAXLOVID (nirmatrelvir and ritonavir) – Fact Sheet for Healthcare Providers
- MOLNUPIRAVIR – Fact Sheet for Healthcare Providers
The list of oral therapeutic options is subject to change as new research becomes available, and as the FDA provides EUAs for other therapeutics for the treatment of COVID-19.
Where can a patient find oral antivirals?
Once a high-risk individual is diagnosed, they need to know where they can get oral antivirals.
Many hospitals and health systems are available throughout the state and can provide oral therapeutics with a physician order or referral. Providers should check with their associated health systems to determine availability.
How can I become a provider who administers oral antiviral therapeutics?
Dispensing of oral antiviral therapeutics can occur across a select group of providers, including:
- Retail pharmacy within a health system
- Health systems (outpatient)
- Nursing Homes (SNF/LTCF)
Due to an extremely limited supply, oral antivirals are being released in phases to eligible providers. Providers interested in dispensing oral therapeutics should complete this provider enrollment form to enroll. Sites may also email firstname.lastname@example.org for additional information.