COVID-19 Pill: What to Know About the Pfizer and Merck Treatments

Two at-home COVID-19 treatment pills should soon be available to Americans. Pharmaceutical companies say the treatments will reduce serious illness, hospitalizations and death in COVID-19 patients.

The treatments from both Pfizer and Merck are pill regimens that people take for five days at home after a positive COVID test. The treatment should begin within five days of the first COVID symptoms and must be prescribed by a doctor.

The FDA issued an emergency use authorization for Pfizer’s treatment, known as Paxlovid, on Dec. 22, 2021 for the treatment of mild to moderate cases of COVID-19 in adults and children ages 12 and up who are at high risk for progression to severe COVID-19, including hospitalization or death. 

A panel of independent advisers to the Food and Drug Administration recommended approval of the Merck treatment, called Molnupiravir, in a 13-10 vote Dec. 2. The vote puts the treatment on track for FDA approval.

How does it work?

Once a person tests positive for COVID-19, they should contact their doctor to determine if either of these medications are appropriate. Ideally, drug makers have said the treatment should begin within five days of the first COVID symptoms.

Merck’s Molnupiravir regimen is four pills twice a day for five days. Pfizer’s Paxlovid treatment calls for three pills twice a day for five days.

Clinical trials have shown Molnupiravir can reduce the risk of hospitalization or death by about 30%. In Paxlovid clinical trials, the risk was reduced by 89% among people who started it within three days of having symptoms.

When will the pills be available?

Merck said it will produce more than 10 million doses of Molnupiravir by the end of this year, and at least 20 million more in 2022. Pfizer has said it will produce enough doses to treat 20 million people in the first half of 2022 and another 60 million in the second half.

The federal government has said it will buy several million doses of each of the treatments.

Once the treatments get full FDA authorization, they will be available for use to qualifying patients. The FDA will ultimately decide which members of the population are eligible for the pill regimens.

What other COVID-19 treatments are available?

Currently remdesivir, sold under the name Veklury, is the only FDA-approved antiviral drug used to treat COVID-19 patients 12 and older. The drug is only administered in a hospital or in a healthcare setting.

Monoclonal antibody therapy is also used to treat patients in early disease. Monoclonal antibodies are administered via infusion or injection, and ideally given within the first three to four days of the onset of symptoms. They have been shown to be most effective when given in the first 10 days and to reduce hospitalization or death in non-hospitalized COVID patients by 70%.

Both treatments are available at Ochsner.

While the results from both the Merck and Pfizer trials for their at-home pill treatments are encouraging, health care providers still recommend vaccination as a first and best means of defense. The pills and other COVID-19 treatments are not a substitute for vaccination. 

All eligible patients should receive a COVID vaccine series, including booster doses, as quickly as possible.