Key takeaways:
Xocova (ensitrelvir) is an oral medication that can prevent infection in people ages 12 and older who were recently exposed to someone sick with COVID-19.
The typical Xocova dosage for adults and children is 3 tablets (375 mg) by mouth as a single dose on Day 1. Then take 1 tablet (125 mg) by mouth once daily on Days 2 through 5.
You should start Xocova within 72 hours (3 days) of being exposed to someone who’s sick with COVID.
You don’t need to take a different Xocova dosage if you have liver or kidney disease. But you shouldn’t take it if you’re pregnant or take certain medications that interact with Xocova.
Save on related medications
Xocova (ensitrelvir) is a medication that’s FDA approved to prevent infection if you were recently exposed to someone sick with COVID-19. Xocova works by preventing the virus that causes COVID from making copies of itself.
If you’ve been prescribed Xocova, it’s important to take it as directed. This helps it work its best to prevent infection. Below are details on recommended Xocova dosages for adults and children ages 12 and older.
What’s the typical Xocova dosage for adults?
Xocova comes in a blister pack with 7 tablets for a 5-day course. Each tablet contains 125 mg of ensitrelvir. The recommended Xocova dosage is to take it once a day by mouth for 5 days. But your dose on the first day will be higher than on Days 2 to 5.
Here’s the standard Xocova dosage schedule:
Day 1: Take 3 tablets (375 mg) by mouth as a single dose with or without food.
Days 2 to 5: Take 1 tablet (125 mg) by mouth once daily with or without food.
Each day’s dose of Xocova is clearly marked on the blister pack. This helps make it easy to know how many pills you should take each day.
Timing is important when starting Xocova. You should take your first dose within 72 hours (3 days) of being exposed to someone who’s sick with COVID.
The manufacturer doesn’t say whether you can cut Xocova tablets in half. So it’s best to swallow them whole. If you have trouble swallowing pills, tell your prescriber. They may have tips to help you take your doses.
What’s the typical Xocova dosage for children?
Xocova is also approved for children ages 12 and older. The recommended children’s Xocova dosage is the same as for adults:
Day 1: Take 3 tablets by mouth as a single dose with or without food.
Days 2 to 5: Take 1 tablet by mouth once daily with or without food.
Make sure your child starts Xocova within 72 hours of being exposed to a person sick with COVID.
Xocova tablets should be swallowed whole. If your child has trouble swallowing pills, tell their prescriber. Xocova doesn’t come in a liquid form, and the pills can’t be dissolved in water.
Are there Xocova dosage adjustments for health conditions?
There are no recommended Xocova dosage adjustments for certain health conditions, such as liver or kidney disease. But researchers haven’t sufficiently studied the medication in people with severe liver disease. So your prescriber may want to monitor you more closely while taking Xocova if you’re living with this condition.
If you’re pregnant, you shouldn’t take Xocova. This medication may harm a fetus. You should also avoid nursing while taking Xocova and for at least 2 weeks after your last dose.
Xocova interacts with many other medications. Some interactions can raise your risk of serious side effects. In some cases, you may need to temporarily stop another medication you take until you finish Xocova. In other cases, you may not be able to take Xocova.
Share a complete medication list with your prescriber and pharmacist before taking Xocova. Make sure this list includes over-the-counter medications and supplements you take. Your healthcare team can review it to make sure Xocova is safe for you to take.
What happens if you miss a dose of Xocova?
If you miss a dose of Xocova and it’s the same day, take it as soon as you remember. Then take your next dose at its usual time. If you realize you forgot a dose the day after you missed it, skip the missed one and take your next dose at its usual time. Don’t take 2 doses on the same day. And be sure to finish all the tablets in your dose pack.
What should you do if you take too much Xocova?
Taking an extra dose of Xocova by accident is unlikely to cause serious harm. But you may be more likely to experience side effects, such as headache or diarrhea.
What’s more, if you take extra pills by mistake you won’t have enough medication left to finish the full 5-day course. Researchers studied only 5-day courses of Xocova. They didn’t study how well shorter treatment lengths worked. So if this happens, you should ask your prescriber whether you’ll need to take additional tablets.
Contacting your prescriber is a good first step if you accidentally take too much Xocova. You can also call Poison Control at 1-800-222-1222 for guidance. But if anything seems severe or life-threatening, call 911 or go to the ER.
The bottom line
Xocova (ensitrelvir) is an oral medication that can prevent infection in people ages 12 and older who were recently exposed to someone sick with COVID-19.
The typical Xocova dosage is 3 tablets (375 mg) by mouth as a single dose on Day 1. Then take 1 tablet (125 mg) by mouth once daily on Days 2 to 5. This dosage is the same for adults and children. You should start Xocova within 72 hours (3 days) of being exposed to someone who’s sick with COVID.
There are no Xocova dosage adjustments for people with certain health conditions. But you shouldn’t take it if you’re pregnant. If you take certain medications, you may not be able to take Xocova either. Ask your prescriber whether this COVID prevention medication is right for you.
Why trust our experts?
References
Drugs and Lactation Database (LactMed). (2026). Ensitrelvir. National Institute of Child Health and Human Development.
Poison Control. (n.d.). Get Poison Control help online now. National Capital Poison Center.
Shionogi. (2026). Xocova- ensitrelvir tablet [package insert]. DailyMed.
