How to Get Paxlovid in 2023

Paxlovid is an oral COVID-19 treatment approved by the Food and Drug Administration (FDA). It can treat mild to moderate COVID in adults at high risk of getting seriously ill. While they are not covered under the FDA’s full approval, the emergency use authorization (EUA) for Paxlovid states that children (12 years and older and weighing at least 40 kilograms/88 pounds) at high risk for severe COVID illness can be prescribed Paxlovid, too. 

How do you know if you can—or should—take Paxlovid? How and where can you get it now that the pandemic emergency is over and COVID care access and costs have changed? Here’s what you need to know about getting Paxlovid in 2023.

You Need a Prescription for Paxlovid

Paxlovid is only available by prescription. Any licensed healthcare provider who is authorized under state law to prescribe drugs can write a prescription for Paxlovid if a patient meets the criteria for it. 

David Boulware, MD, MPH, professor at the University of Minnesota Medical School, told Verywell that pharmacists with access to a patient’s electronic medical records (including blood tests) may also prescribe Paxlovid.

While the FDA allows state-licensed pharmacists to prescribe the drug under the conditions that are listed in the EUA, the professionals need to have enough information about a patient to determine whether the drug is safe for them to take. For example, they’ll need to look at a patient’s kidney and liver function, as well as review a current list of a patient’s medications.

A patient would be considered at high risk for progression to severe COVID illness—and therefore able to be prescribed Paxlovid—based on a provider’s assessment of their current health and medical history.

As of 2023, Boulware said that Paxlovid is available at no cost, regardless of whether a patient has insurance (a patient’s health maintenance organization or insurance plan can technically refuse to cover Paxlovid, but Boulware said this has not become an issue yet).

You Don’t Need a Positive COVID Test

The FDA recommends that providers test a patient for SARS-CoV-2 to diagnose COVID, but a positive test is not actually required before a provider can prescribe Paxlovid. You can also report a positive at-home rapid test to your provider. 

Leigh Anne Hylton Gravatt, PharmD, an Associate Professor and Vice-Chair of Education in the Department of Pharmacotherapy and Outcomes Sciences at the Virginia Commonwealth University School of Pharmacy, told Verywell that Paxlovid can be prescribed based on a patient’s symptoms and potential exposure—however, the drug is not recommended for the prevention of COVID.

It’s rare, but a provider could diagnose COVID in a patient who tests negative but has symptoms of infection and recent known exposure. If the patient is at high risk of progressing to severe illness, a provider might prescribe Paxlovid since all the conditions laid out by the drug authorization would have been met. 

When You Should Not Take Paxlovid

Gravatt said there are several factors that may prevent a patient from getting Paxlovid. For starters, Gravatt said that Paxlovid is approved for outpatient use only and can only be used within five days of symptom onset.

Patients who have severely impaired kidney function and those taking medications that would interact with Paxlovid also won’t be able to take it safely.

According to Gravatt, “multiple types of medications, including some common blood pressure medication, antiarrhythmics, blood thinners, and certain cholesterol medications,” can interact negatively with Paxlovid.

Boulware added that Paxlovid can only be used for the conditions outlined in its approval and authorization. For example, it can’t be used for post-exposure protection for COVID.

Why not? Pfizer, the drug’s manufacturer, did a large trial to look at using Paxlovid as a post-exposure prophylactic and found that it was not effective at reducing the risk of confirmed and symptomatic COVID in adults who were exposed to the virus by a household contact.

Overall, Gravatt said getting Paxlovid is basically the same for patients who are part of the approved population and the group authorized for its emergency use.

If your provider says you can’t take Paxlovid, they’ll talk to you about what you need to do to help your body heal, avoid COVID complications, and prevent the spread of the virus to others.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.