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Treatment Options for COVID-19

There are more treatment options available today for COVID-19 patients than there were at the beginning of the pandemic. As the FDA continues to authorize new drugs, healthcare providers are able to assess and recommend the right therapy options for their patients based on risk and their COVID-19 symptoms.

Availability of COVID-19 treatments may differ depending on efficacy, how they are administered, the risk profile of the patient, and whether the treatment is authorized by the FDA for adults only or adults and pediatric patients.

Current availability at Reid Health

Reid Health receives allocations of some COVID-19 therapeutics from the Indiana Department of Health. Below is the current availability of these medications at Reid.

Treatment
name
Adequate supply Limited supply Very limited None available
Monoclonal antibodies (bebtelovimab) x
Evusheld x
Paxlovid x

As of 7/1/22

Monoclonal Antibody Treatment

Monoclonal antibodies are a treatment designed to help your immune system fight viruses. They can restore, enhance, or imitate the immune system's attack on cells, blocking the virus that causes COVID-19 from attaching to your cells and making it more difficult for the virus to reproduce and cause harm.

The FDA has given Emergency Use Authorization for their use in treating those who are at high risk for severe COVID-19. For those who qualify, monoclonal antibodies can be used to treat mild to moderate symptoms of COVID-19. Treatment can be provided up to 10 days after the onset of symptoms, but it's most effective when administered within no more than four days.

If you meet the criteria for a monoclonal antibody infusion, don't wait until you feel poorly to talk with your physician. Once you qualify for hospital admission, you no longer meet the requirements for monoclonal antibody treatment.

Referring physicians: Fax this form to Reid Central Scheduling at (765) 983-7983 (must complete high risk criteria prior to sending fax).

Download Monoclonal Antibody Referral Form

Download and print these additional resources.

Evusheld

Evusheld is the only monoclonal antibody treatment that helps prevent COVID-19 infection in certain people ages 12 years and older who do not currently have COVID-19 and have not recently been exposed to someone with COVID-19.

You might be eligible for this treatment if you are moderately to severely immunocompromised and might not get an adequate immune response from vaccination or have a history of severe adverse reactions to a COVID-19 vaccine and/or component(s) of the vaccines and are unable to get vaccinated.

Evusheld is not a substitute for vaccination in those for whom the vaccines are recommended. It can be administered as two separate, consecutive injections at a healthcare facility.

Referring physicians: Fax this form to Reid Central Scheduling at (765) 983-7983 (must complete high risk criteria prior to sending fax).

Download Evusheld Referral Form

Download Evusheld Consent Form

Download and print these additional resources.

Criteria for Monoclonal Antibody Treatment

Monoclonal antibody treatments can be recommended by providers for COVID-positive patients who are high-risk and need additional immunity support.

Criteria for classification of high-risk:

  • Body Mass Index (BMI) greater than 25
  • Pregnancy
  • Age greater than or equal to 65 years
  • High-risk conditions - see list of conditions

Paxlovid

An oral antiviral medication called Paxlovid is now available under Emergency Use Authorization by the FDA for treating mild-to-moderate COVID-19 in those ages 12 years and older, who weigh at least 88 pounds, and are at high risk for developing severe illness. During clinical trials, the medication reduced severe outcomes (hospitalization or death) by 88%.

Paxlovid is to be taken twice daily for 5 days, and treatment should begin within 5 days of symptoms first appearing. It is not recommended for those with certain medical conditions and could interact with other prescribed medications.

Referring physicians: Fax this form to Reid Health Pharmacy at (765) 983-3018 (must complete screening criteria prior to sending fax).

Download Paxlovid Referral Form

Download and print these additional resources.

Molnupiravir

Molnupiravir is an oral antiviral medication now available under Emergency Use Authorization by the FDA for treating COVID-19 in those 18 years and older with mild to moderate symptoms who are at high risk for developing severe illness and for whom alternative COVID-19 treatment options are not accessible or clinically appropriate. During clinical trials, it reduced the risk of hospitalization or death among patients with COVID-19 by 30%.

Molnupiravir is to be taken every 12 hours for 5 days with treatment beginning within the first 5 days after developing symptoms. Do not stop taking it before you complete the full 5 days of treatment, even if you feel better.

It's not recommended for use during pregnancy as it could cause fetal harm when given to pregnant individuals. Those of childbearing age should use a reliable method of birth control correctly and consistently during treatment and for four days after the final dose. People of reproductive potential who are sexually active with those of childbearing age should use a reliable method of birth control correctly and consistently during treatment and for at least three months after the final dose.

Molnupiravir is available by prescription only through some Walmart and CVS pharmacies.

Download and print these additional resources.

FAQs

What is an Emergency Use Authorization (EUA)?

Under section 564 of the Federal Food, Drug & Cosmetic Act, the FDA may, pursuant to a determination and declaration by the HHS Secretary, authorize an unapproved product or unapproved uses of an approved product for emergency use. In issuing an EUA, the FDA must determine, among other things, that the product may be effective in diagnosing, treating, or preventing a serious or life-threatening disease or condition caused by a chemical, biological, radiological, or nuclear agent; that the known and potential benefits outweigh the known and potential risks for the product; and that there are no adequate, approved, and available alternatives. Emergency use authorization is NOT the same as FDA approval or licensure.

How is high risk defined under the EUA?

High risk for progressing to severe COVID-19 and/or hospitalization is defined as patients who meet at least one of the following criteria

What is a monoclonal antibody?

Monoclonal antibodies are laboratory-produced molecules made to serve as substitute antibodies that can restore, enhance, or mimic the immune system's attack on cells. They are designed to block viral attachment and entry into human cells, thus neutralizing the virus. They are designed to limit viral replication and may be effective for the treatment of COVID-19 in patients who are at high risk for progressing to severe COVID-19 and/or hospitalization.

When should monoclonal antibodies be administered to a patient?

It's recommended they be administered as soon as possible after a positive test for COVID-19 and within 10 days of symptom onset. Monoclonal antibodies are most effective when administered within no more than four days after symptoms begin.

If you meet the criteria for a monoclonal antibody infusion, don't wait until you feel poorly to talk with your physician. Once you qualify for hospital admission, you no longer meet the requirements for monoclonal antibody treatment.

Are there side effects of monoclonal antibody treatment?

Possible side effects include:

  • Allergic reactions: Allergic reactions can happen during and after infusion. Tell your healthcare provider right away if you get any of the following signs and symptoms of allergic reactions: fever; difficulty breathing; low oxygen level in your blood; chills; tiredness; fast or slow heart rate; chest discomfort or pain; weakness; confusion; nausea; headache; shortness of breath; low or high blood pressure; wheezing; swelling of your lips, face, or throat; rash including hives; itching; muscle aches; dizziness; feeling faint; and sweating.
  • The side effects of getting any medicine by vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the infusion site.

Are there side effects of using Paxlovid?

Possible side effects include:

  • Liver problems: Tell your healthcare provider right away if you have any of signs and symptoms of liver problems, including loss of appetite, yellowing of your skin and the whites of eyes (jaundice), dark-colored urine, pale-colored stools and itchy skin, stomach-area (abdominal) pain.
  • Resistance to HIV medicines: If you have an untreated HIV infection, Paxlovid might lead to some HIV medicines not working as well in the future.
  • Other possible side effects include an altered sense of taste, diarrhea, high blood pressure, and muscle aches.

Are there side effects of using molnupiravir?

Molnupiravir may cause serious side effects, including harm to your unborn baby. It's not known if it will harm your baby if you take it during pregnancy.

  • It's not recommended for use in pregnancy.
  • Molnupiravir has not been studied in human pregnancy, but when given to pregnant animals, molnupiravir caused harm to their unborn babies.
  • You and your healthcare provider may decide you should take molnupiravir during pregnancy if there are no other COVID-19 treatment options authorized by the FDA that are accessible or clinically appropriate for you.
  • If you and your healthcare provider decide you should take molnupiravir during pregnancy, you and your healthcare provider should discuss the known and potential benefits and the potential risks of taking molnupiravir during pregnancy.

Other possible side effects include:

  • Diarrhea
  • Nausea
  • Dizziness

Is there a requirement for providers to report side effects as part of the EUA?

Yes. As part of the EUA, the FDA requires health care providers to report all medication errors and serious adverse events considered to be potentially related to treatment through FDA's MedWatch Adverse Event Reporting program. Providers can complete and submit the report online or download and complete the form, then submit it via fax at (800) FDA-0178.

Do patient outcomes need to be reported under the EUA?

No, reporting of patient outcomes is not required under the EUA. However, reporting of all medication errors and serious adverse events considered to be potentially related to treatment is required.