If you are eligible, Paxlovid, an oral COVID-19 medication, can be prescribed by state-licensed pharmacists in the U.S. The pharmacist will need certain health records from the past year, such as your kidney and liver function lab tests, as well as a list of your current medications.

Your lab work may be available online through your healthcare provider or the company that provides your lab work and test results. In addition, your doctor or nurse may be able to send your lab results electronically to your pharmacist.

If you do not have access to this information, your pharmacist can contact your primary health care provider, or you can get a Paxlovid prescription from your doctor, an urgent care center, or via a virtual telehealth visit.

Paxlovid treatment must be started within 5 days of COVID-19 symptom onset, so do not delay in gathering this information, or have it on hand in case of a need.

Learn More: Paxlovid dosing (in more detail)

Who can get Paxlovid treatment?

Paxlovid (nirmatrelvir / ritonavir) is an oral antiviral medication used in people 12 years of age and older and weighing at least 40 kg (88 lb) who have mild-to-moderate symptoms of COVID-19, have recently tested positive for COVID-19, and are at high risk for severe disease or hospitalization. COVID-19 symptoms may appear 2-14 days after exposure to the virus.

Paxlovid may be prescribed if you have mild-to-moderate symptoms that started within the last 5 days. Mild-to-moderate COVID-19 symptoms do not usually require hospitalization.

Mild-to-moderate symptoms include:

• Fever
• Chills
• Cough
• Sore throat
• Feeling tired or fatigued
• Headache
• New loss of smell or taste
• Congestion or runny nose
• Muscle pain or body aches
• Nausea or vomiting
• Diarrhea

Am I at high risk for severe COVID-19?

Risk factors for severe COVID-19 may include:

• Age over 50 years, with risk increasing substantially if 65 years or older
• Cancer
• Diabetes
• Heart disease
• Kidney or liver disease
• Impaired immune system (immunocompromised)
• Asthma, COPD or another chronic lung disease
• Obesity or overweight
• Sickle cell disease
• Being unvaccinated or not being up to date on COVID-19 vaccinations
• Being a resident of a long-term care facility.

If you are at high risk for COVID-19 complications and have tested positive, contact your healthcare provider right away. In studies, high-risk patients who were treated with Paxlovid saw an 89% reduction in the risk of severe disease and/or hospitalization. Mild symptoms may progress quickly with COVID-19.

Clinical judgment from your healthcare provider or pharmacist is needed to accurately assess a person’s risk for severe COVID-19 on a case-by-case basis.

Emergency warning signs or symptoms for COVID-19 may include:

• Trouble breathing or shortness of breath
• Pain or pressure in the chest
• Showing signs of confusion
• Inability to wake or stay awake
• Depending on skin tone, lips, nail beds and skin may appear pale, gray, or blue.

If someone is showing any of these signs, call 911 or call ahead to your local emergency room or facility. Tell the person on the phone that you are seeking care for someone who has or may have COVID-19.

If you are pregnant or breastfeeding and suspect you have COVID‑19, talk to your healthcare professional about whether Paxlovid treatment is right for you.

Your risk for severe outcomes may also be increased by other factors or circumstances not listed here, so be sure to discuss your medical history with a healthcare professional.

Why can’t my pharmacist prescribe Paxlovid?

Not everyone is eligible for Paxlovid treatment. Some of the reasons your pharmacist may NOT be able to prescribe Paxlovid include:

• It’s been longer than 5 days since your COVID-19 symptoms started.
• Your pharmacist is not able to determine your kidney and liver function from lab work from the last 12 months.
• Your symptoms may be too severe; for example, you may be having severe trouble breathing and may need hospitalization.
• You or your child are under 12 years of age or weigh less than 40 kg (88 lb).
• You may not be at high risk for progression to severe COVID-19.
• You may be taking medications (including prescription, over-the-counter drugs and dietary supplements) that may interact with Paxlovid treatment.
• Your lab work shows you have severe kidney or liver disease. People with moderate kidney disease will need a lower dose of Paxlovid.
• You have had a previous allergic reaction to Paxlovid.

If your pharmacist cannot prescribe Paxlovid, contact your doctor, urgent care, center emergency department or other healthcare provider right away for further evaluation. This is not a complete list of reasons why you may not be eligible for Paxlovid treatment.

Related questions

• Paxlovid side effects: 8 key things to know
• How fast does Paxlovid work?
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Can a pharmacist prescribe Paxlovid to a child?

Yes, a pharmacist may prescribe Paxlovid to children 12 years and older and weighing at least 40 kg (88 lb), when appropriate and after an assessment, under an Emergency Use Authorization (EUA) for Paxlovid.

Specifically, the EUA for Paxlovid authorizes treatment of children with mild-to-moderate COVID, 12 years of age and older and weighing at least 40 kg (88 lb), who are at high risk for progression to severe COVID-19, including hospitalization or death.

On May 25, 2023, FDA approved Paxlovid for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. Through the New Drug Application, the FDA has determined that Paxlovid is safe and effective when used in accordance with the FDA-approved labeling.

For adults, Paxlovid is prescribed as an approved product based on the current FDA labeling and no longer under an EUA.

What is an EUA?

Emergency use authorization (Section 564 of the Federal Food, Drug and Cosmetic Act) is NOT the same as FDA approval or licensure. FDA may authorize an unapproved product or unapproved uses of an approved product for emergency use.

The FDA issued the Paxlovid EUA based on available evidence that the product may be effective in diagnosing, treating, or preventing a serious or life-threatening disease, that known benefits outweigh risks and there are no adequate, approved, and available alternatives.

As of March 9, 2024, only FDA-approved Paxlovid that is manufactured and labeled as outlined in the New Drug Application (NDA), may be dispensed.

EUA-labeled Paxlovid is no longer authorized for emergency use, even though pediatric patients are still prescribed Paxlovid under an EUA. All EUA-labeled Paxlovid remaining in distribution should be returned to the manufacturer (Pfizer) or disposed of according to regulations.

How do I get Paxlovid if I can’t afford it?

Paxlovid is expensive and many people may not be able to afford it if they do not have insurance. The cash price for oral Paxlovid is around $1,539 for a supply of 20 or 30 tablets, depending on the pharmacy you visit and any coupons or copay cards you may have.

If you are unable to afford Paxlovid, or do not have insurance coverage, there are other options available.

Commercially-insured patients

The Pfizer Co-Pay Savings Program is available for eligible commercially-insured patients who may pay as little as $0 with the PAXCESS Co-Pay Savings Program.

Commercially-insured means you have private insurance your employer provides or you have bought on your own through the Healthcare.gov website.

Medicare, Medicaid, TRICARE

People with Medicare, Medicaid/CHIP, TRICARE, insurance through the Department of Veterans Affairs Community Care Network and uninsured patients can receive Paxlovid at no charge through December 31, 2024 with the U.S. Government Patient Assistance Program (USG PAP) operated by the manufacturer of Paxlovid (Pfizer).

Contact Pfizer for more information at 1‑8‍77‑C19‑PACK (1-877-219-7225) or discuss payment options with your healthcare provider or pharmacist.

To learn more about Paxlovid costs and copay assistance, visit:

• Drugs.com Price Guide for Paxlovid

This is not all the information you need to know about COVID-19 and Paxlovid (nirmatrelvir / ritonavir) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

References

• Paxlovid [prescribing information]. Revised May 2023. New York, NY. Pfizer Inc. Accessed August 26, 2024 at https://labeling.pfizer.com/ShowLabeling.aspx?id=19599
• Pharmacist Paxlovid Prescribing Guide. American Society of Health System Pharmacists (ASHP). 2023. Accessed August 26, 2024 at https://www.ashp.org/-/media/assets/COVID-19/docs/Paxlovid-Prescribing-Guide.pdf
• COVID-19. US Centers for Disease Control (CDC). June 25, 2024. Accessed August 26, 2024 at https://www.cdc.gov/covid/signs-symptoms/index.html
• Frequently asked questions about Paxlovid. Pfizer. Accessed August 26, 2024 at  https://www.paxlovid.com/faq
• Frequently asked questions on the emergency use authorization for Paxlovid treatment of COVID-19. US Food and Drug Administration (FDA). March 13, 2024. Accessed August 26, 2024.
• COVID-19 Treatment Clinical Care for Outpatients. Centers for Disease Control (CDC). July 12, 2024. Accessed August 26, 2024 at https://www.cdc.gov/covid/hcp/clinical-care/outpatient-treatment.html
• Symptoms of COVID-19. Centers for Disease Control (CDC). June 25, 2024. Accessed August 26, 2024 at https://www.cdc.gov/covid/signs-symptoms/index.html
• What Are the Possible Treatment Options for COVID‑19? HHS Administration for Strategic Preparedness and Response (ASPR). Accessed August 26, 2024 at https://aspr.hhs.gov/COVID-19/Treatments/Pages/Possible-Treatment-Options-for-COVID19.aspx#PAP

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• Side Effects of Paxlovid (detailed)
• Paxlovid user reviews (535)

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