Key takeaways:
Paxlovid (nirmatrelvir/ritonavir) is an oral medication prescribed to treat mild to moderate COVID-19 symptoms.
It’s taken two times a day for 5 days. A bitter or bad taste in the mouth is a common side effect of Paxlovid.
Paxlovid needs to be started within 5 days of developing COVID symptoms, and it’s typically prescribed only to those at high risk for developing a severe infection.
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Over the past few years, scientists have developed an arsenal of tools to fight COVID-19. One of them is a medication called Paxlovid (nirmatrelvir/ritonavir). It's designed to keep people who have mild to moderate symptoms of COVID from getting so sick that they need to be hospitalized.
People with mild to moderate COVID symptoms may be eligible for Paxlovid if they’re at a heightened risk of severe illness — for example, if they have a weakened immune system. The medication must be started within 5 days of developing symptoms, and it’s taken twice a day for 5 days.
Below, three people who recently took Paxlovid describe what the experience was like.
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Bad taste in your mouth? Try Hot Tamales
Amy Levy, who’s 54 and works in public relations in Los Angeles, tested positive for COVID in November 2022. She had just spent two weeks visiting Israel. On the plane ride back to the U.S., her entire body ached. And when she landed, she had trouble carrying her luggage. She called her doctor right away and told him she had COVID.
Amy takes three immune-suppressing medications that increase her risk of having a severe COVID infection. So her doctor prescribed her Paxlovid.
“For the first 24 hours, I pretty much just slept,” Amy says.
She also experienced a side effect that has been reported by other people who have taken the medication: a bitter or metallic taste (“Paxlovid mouth”) that lingers in the mouth for hours. But she found a creative way to cope with it.
To help Amy combat Paxlovid mouth, her friend dropped off two boxes of Hot Tamales for her. The cinnamon candies helped conceal the bad taste. And, she says, “The minute I stopped taking the Paxlovid, the bad taste went away.”
Amy’s husband and daughter both tested positive for COVID, too, but they didn’t take Paxlovid. “They’re not as immunocompromised as me,” Amy explains.
Looking back, she’s glad she took Paxlovid and credits it with helping her make a full recovery. She didn't experience a repeat infection, and she’s now healthy.
“I took the Paxlovid as directed for 5 days, and I was a lot better,” she says. “I felt that it definitely worked.”
Relief for the worst-ever sore throat
Lynda LaMonte, who’s 59, took Paxlovid in September 2022 when she was diagnosed with COVID.
“My inclination was initially to power through it, because it was very flu-like,” says Lynda, the director of communications for an economic consulting firm in Larchmont, New York. “But the thing that pushed me over the edge was the sore throat. It was worse than any strep throat that I had ever had in my life.”
On her third day of feeling sick, Lynda went to an urgent care center. She discussed the possibility of taking Paxlovid with one of the doctors, who warned her about the chance of rebound COVID symptoms after she finished treatment. So Lynda asked if there was a 75% chance that she would test positive again.
“She said, ‘No, it’s not like that,’” Lynda says, recalling her conversation with the doctor. “And I’m, like, ‘Well, then, give me the Paxlovid.’”
Paxlovid pills are large, and swallowing them with a sore throat was difficult. But Lynda’s throat began to feel better within a few hours of taking the medication. “It absolutely worked; it was effective, she says. “Within 24 hours, [my symptoms were] in a tolerable state.”
Lynda did experience some side effects during the 5 days that she took Paxlovid. She had a “foul” taste in her mouth, gastrointestinal issues, and general malaise. Still, she felt like it was worth it because it helped with her COVID symptoms so much.
“I would tell people that you should take it if you absolutely need it,” she says. “But you have to be prepared for some of the other issues.”
Hoping to prevent long COVID
In the days leading up to Thanksgiving 2022, Joi Louviere tested positive for COVID for the first time. She recalls feeling very ill. “I couldn't even get enough strength to get out of bed and walk to the bathroom or reach for water,” she says.
It was a weekend, so Joi, a 34-year-old Dallas resident who works in communications, called her doctor’s emergency line. After a telehealth visit, her doctor sent in a prescription for Paxlovid. (She has asthma, which means she was at an elevated risk of getting very sick from COVID.)
Joi documented her experience with COVID by sending texts to her sister.
“Before I took it, at 4AM, I was saying, ‘I’m so nauseous, like deliriously nauseous,’” she recalls. “And then I took it, and I don’t remember feeling like that again. So that was good.” Her cold and flu symptoms, including feeling achy all over, also vanished.
Joi lost her sense of taste while she had COVID. So, while she did detect the bitterness of the Paxlovid, she didn’t really mind it.
“Sometimes tasting the pill wasn’t that bad. It was, like, ‘I’m feeling something,’” she says, recalling that it was a reminder that her sense of taste would soon return in full.
Some research suggests that taking Paxlovid is associated with a decreased risk oflong COVID — an umbrella term for symptoms that linger for weeks or months after the initial infection. That aspect of Paxlovid appealed to Joi.
“My reason for starting it in the first place wasn't just how bad I was feeling. [It was also] because of my asthma,” she says. “I was worried about having long COVID, and I heard that this could combat that. So I was, like, ‘OK, I’ll try anything not to have trouble breathing.’”
Life with long COVID: A self-described “long hauler” shares what it’s like to navigate years of COVID symptoms.
Possible side effects: Learn about five of the most common Paxlovid side effects — from headaches to changes in taste — and how to manage them.
When to expect relief: How long does it take Paxlovid to work? And how effective is it? Pharmacists answer some of the most common questions about the COVID treatment.
What does the pharmacist say?
Christina Aungst, PharmD
Pharmacy Editor
Paxlovid is a combination of two antiviral medications that are taken together. It works by preventing the COVID-19 virus from making copies of itself in the body. Paxlovid is the first-choice treatment for mild to moderate COVID in people with a higher risk of severe illness. In initial clinical studies, it was about 90% effective at preventing COVID-related hospitalization and death.
While serious side effects are rare, Paxlovid can cause a bitter or bad taste in your mouth while you’re taking it. This should resolve once you’re done taking the medication. And sucking on cinnamon candies, chewing gum or ice, and drinking plenty of fluids are all ways to lessen this side effect.
Paxlovid should be started within 5 days of developing symptoms. A positive COVID test is no longer required to get a prescription for the medication. And pharmacists now have the ability to prescribe it directly. So you can get access to the medication even faster than before.
It’s possible to experience a return of COVID symptoms after finishing treatment with Paxlovid. This isn’t a side effect of the medication, but rather the illness running its course.
Studies suggest “Paxlovid rebound” is uncommon, affecting only about 4% of people who take it. That’s compared to around 30% of people who don’t receive any treatment for COVID and experience worsening symptoms after they initially improve.
If you think you have COVID, talk to your healthcare provider or pharmacist. They’ll review your medical history and medication list to see if Paxlovid is right for you.
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