Well, it was a good run without ever getting Covid -- about three years since the nasty virus came to the United States in early 2020.
After I had trouble sleeping last Saturday night, feeling on edge for no discernible reason, I took a rapid Covid test Sunday morning, which came back negative, even though my voice was a bit hoarse.
But Monday morning I had some nasal congestion and increased hoarseness, so I tested again. Yikes! A positive result.
That kicked off a flurry of phone calls. First, I called my Salem Health family physician's office. I talked with someone who described my treatment options after I told her that I'd like to get Paxlovid given my age (74) and understandable desire to avoid a serious case of Covid.
She explained that a complication was that Paxlovid interacted with several prescription medications that I was taking. OK, I told her, no problem. I just won't take the medications while on the five-day Paxlovid course of treatment.
I then was told that they use the Salem Health pharmacy and that I'd be getting a call from a pharmacist. Probably the same day. Around 2:30 in the afternoon I got that call.
The Salem Health pharmacist was wonderfully clear.
He had me repeat what the person in my doctor's office had told me (which probably was in my chart): stop taking all of my other prescription medications for the five-day Paxlovid treatment, plus three days afterward, waiting another two days to restart the most problematic medication, Lovastatin (10 mg).
Again I said, no problem. I told the pharmacist I wasn't going to suffer much, if at all, from not taking the other medications. I'd much rather shorter the course of my Covid infection and lower the risk of getting Long Covid, which a VA study indicates is about a 25% risk reduction.
Laurel, my wife, picked up the no-cost Paxlovid prescription for me. I took my first dose of three pills late Monday afternoon on the same day I tested positive for Covid. So I felt good that it was possible to get going with Paxlovid so soon (Paxlovid needs to be started within five days of having Covid symptoms).
Paxlovid is an antiviral therapy that consists of two separate medications packaged together. When you take your three-pill dose, two of those pills will be nirmatrelvir, which inhibits a key enzyme that the COVID virus requires in order to make functional virus particles. After nirmatrelvir treatment, the COVID virus that is released from the cells is no longer able to enter uninfected cells in the body, which, in turn, stops the infection. The other is ritonavir, a drug that was once used to treat HIV/AIDS but is now used to boost levels of antiviral medicines.
As a COVID-19 treatment, ritonavir essentially shuts down nirmatrelvir’s metabolism in the liver, so that it doesn’t move out of your body as quickly, which means it can work longer—giving it a boost to help fight the infection.
At the moment I'm 3 1/2 days into the 5-day treatment. Starting today, Thursday, I'm almost symptom free.
My nasal congestion is just about gone. I cough occasionally, but way less than before. The only annoying side effect is some diarrhea, along with a bit of a metallic taste in my mouth for several hours after taking a dose.
Regarding the oft-heard Paxlovid "rebound effect," where Covid symptoms recur after going away, the Salem Health Pharmacist told me that this isn't due to Paxlovid, but to Covid. I believe he's right, after some Googling of this subject. For example, see here and here.
Not everyone with Covid is eligible to get Paxlovid. Based on my experience, I recommend that if you have Covid, ask if you can be prescribed Paxlovid.
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