Singapore — The Health Sciences Authority (HSA) announced on Thursday (Jan 3) that Paxlovid, Pfizer’s oral Covid-19 pill, has been approved for use. Interim authorization for the medicine was given on Jan 31, under the Pandemic Special Access Route.
“This is the first oral tablet approved in Singapore for the treatment of mild to moderate COVID-19 in adult patients who are at high risk of progression to severe disease, to reduce the risk of hospitalisation and death,” the HSA said in a statement.
Paxlovid is a combination of two medicines. One, nirmatrelvir, is an antiviral and the other ritonavir is a medication that maintains the blood level of nirmatrelvir to ensure its efficacy.
The pills are prescribed and prioritised for individuals with a higher risk of severe illness, such as the elderly and those with underlying medical conditions that would put them at high risk for severe Covid symptoms, including cancer and diabetes. Paxlovid needs to be taken for five days, twice a day.
Patients who qualify under those conditions must take the medication “as soon as possible after a diagnosis has been made, within 5 days of the onset of COVID-19 symptoms,” HSA added.
Paxlovid has been found to reduce the risk of Covid-19 related hospitalisation or death by 88.9 per cent when taken within three days after the onset of symptoms and 87.8 per cent when given within five days of onset of symptoms.
The medicine has been approved for use in the US, UK and the EU. Pfizer’s fact sheet for Paxlovid for Singapore patients may be viewed here.
Paxlovid vs. Molnupiravir
In October of last year, pharmaceutical company Merck announced that it had entered into an agreement with the government of Singapore to buy a supply of Molnupiravir, its oral Covid-19 antiviral drug.
Merck said on Oct 6 that Molnupiravir will be made available in Singapore after authorisation and approval for its use have been given.
Molnupiravir, which has not been granted authorization from the HSA yet, was said to be effective against the known variants of Covid-19 at that time when the Delta variant was the dominant strain in many countries.
In November, Merck said that based on the full results of its drug trials, its drug decreased the chance of hospitalisation or death by around 30 per cent in patients at risk of severe Covid who had received the medication within five days of showing symptoms. The company did not release data concerning patients who had been given molnupiravir within three days.
“Trial data provided by the two companies suggest that Pfizer has the more effective pill,” Reuters reported on Jan 31.
Warning Label
While seemingly more effective, at least one physician has warned that Paxlovid needs to be administered with care, especially for those who are taking multiple medications.
In a Feb 3 opinion piece for The Philadelphia Inquirer, US cardiologist David Becker pointed out Paxlovid’s high efficacy, but warned that it cannot be a substitute for vaccination “because not everyone should take this powerful medicine.”
He explained why. “Some of the preexisting conditions that make a COVID infection especially dangerous – such as high blood pressure, diabetes, heart failure and arrythmias – often are treated with multiple medicines that could also make Paxlovid dangerous.”
The ritonavir component of Paxlovid may interfere with other medications that patients are taking, which means that Covid patients who qualify for the use of Paxlovid must tell their doctor all the other medicines they are taking before they take the drug.
“The drug interferes with so many medications that are used for chronic medical conditions that it needs to be used carefully.
I would be very reluctant to recommend its use for patients taking multiple medications, all of which should be checked for interactions prior to use. It is not a panacea. Getting vaccinated to reduce the risk of life-threatening complications and hospitalization seems a much safer option,” Dr Becker added. /TISG
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Singapore to buy anti-COVID drug Molnupiravir, said to be effective against all variants