Which Medications Should You Take For COVID?

Most people who get a mild case of COVID-19 can recover at home. You have a few options for treating your symptoms, including over-the-counter (OTC) products you may already have in your medicine cabinet. However, there are also some prescription treatments, like Paxlovid and Veklury, that you can get from your provider.

These Food and Drug Administration (FDA)-approved prescription drugs can help keep people with COVID out of the hospital and prevent severe, even life-threatening, illness. They’re especially helpful for people at high risk of developing complications if they get COVID, Steve Mok, PharmD, a pharmacist and infectious disease specialist at Wolters Kluwer’s Health division, told Verywell.

Older adults, people who are not vaccinated or not up to date on COVID vaccines or boosters, and people with certain medical conditions, such as chronic lung disease, heart disease, or weak immune systems, are all at higher risk of getting seriously sick if they catch COVID, Mok said.

If you test positive for COVID or think you have it, here are the OTC and prescription medications that experts recommend.

Over-the-Counter Medications For COVID

Katherine Yang, PharmD, MPH, professor and infectious diseases clinical pharmacist at the UCSF School of Pharmacy, told Verywell that the same OTC products you’d probably use to manage symptoms of the common cold and flu can also be used for COVID symptoms. While OTC medications do not directly treat COVID and won’t make your illness shorter, they can relieve your symptoms.

Here are a few OTC products experts recommend if you’re treating COVID symptoms at home:

• Pain and fever relievers: These medications, which include Tylenol (acetaminophen) and Advil (ibuprofen), can reduce fever and relieve headaches and body aches, Mok said. Even though these OTC medications are generally safe, ask your provider about taking them if you have chronic health conditions like liver or kidney disease.
• Cough suppressants: These OTC products usually have dextromethorphan, which can help manage cough symptoms caused by the common cold, flu, and COVID.
• Antihistamines: You might think of them more for allergies, but these medications can relieve or lessen the nasal symptoms from COVID like runny nose and sneezing.
• Decongestants: OTC decongestants like pseudoephedrine or phenylephrine may relieve nasal congestion, but Yang said these products “haven’t been shown to work that well for cold and flu symptoms in general.”

Before you use any OTC product for COVID symptoms, make sure you read the instructions carefully and understand how (and when) to take a dose. If you’re not sure, ask a pharmacist or your provider.

“If one chooses to use a combination cold product that contains a fever reducer, cough medicine, and decongestant, be sure to follow the instructions,” Yang said. “Be careful when taking it with other cold products to prevent accidentally doubling up on any ingredients.”

Prescription Medications for COVID 

The FDA has approved several antiviral prescription medications to treat mild to moderate COVID in people at high risk of getting sick. These medications keep the COVID virus from making copies of itself (replicating) in the body, which helps the immune system fight it off, Yang said.

Paxlovid (nirmatrelvir-ritonavir)

Paxlovid is an oral antiviral prescription medication that is FDA-approved for adults. It’s designed for managing mild to moderate cases of COVID, Yang said. Paxlovid is available for high-risk people with COVID who are not in the hospital.

Studies on Paxlovid have shown varying levels of success in keeping the disease from progressing, keeping people out of the hospital, and preventing people from getting severely ill and dying from COVID, Luis Ostrosky, MD, chief of infectious diseases and epidemiology with UTHealth Houston and Memorial Hermann, told Verywell.

Paxlovid is approved for adults and children aged 12 years and older. It's a pill that is taken by mouth (orally). However, to make sure it's the most effective, it needs to be started within five days of when a person starts having COVID symptoms.

Mok said the patients who may benefit the most from Paxlovid treatment are adults aged 65 or older, people with moderate or severe conditions affecting their immune systems, people with more than one risk factor for severe disease (such as asthma, kidney disease, and liver disease), and unvaccinated people who are aged 50 years or older.

Yang said that it’s important to be cautious about potential drug interactions that can come with prescription medications like Paxlovid. Since these interactions can cause serious problems, Yang said that you should “always let your physician and pharmacist know all the prescription and OTC medications and herbal supplements that you are taking to make sure you can take Paxlovid safely.”

Lagevrio (monupiravir)

Lagevrio is another oral antiviral medication that has FDA emergency use authorization (EUA) for the treatment of mild to moderate COVID-19 illness, Yang said. The drug works by interrupting the replication of the COVID virus, potentially blocking its ability to spread in the body.

Lagevrio is not currently recommended by the National Institutes of Health (NIH) as a first-line treatment for COVID because it doesn’t appear to be as effective as the other options, according to Mok. The drug may cause birth defects, so it should not be taken by anyone who is pregnant, Yang said.

Lagevrio is a pill that can be taken by mouth. It’s meant for adults aged 18 years and older who are at high risk of developing severe COVID, needing hospitalization, and/or dying. Similarly to Paxlovid, it’s most effective when taken within five days of symptom onset.

Patients need a prescription for these medications, which they can get from a primary care provider, retail clinics, urgent care facilities, and federally-supported test-to-treat locations, Mok said.

“In general, antiviral medications for COVID are underutilized. For persons who are at higher risk for COVID-related complications, it is always good to have a plan in place,” Yang said. “Know who to call if you get sick and where to get medications, especially as we enter the holiday season.”

Medications for Severe COVID 

If someone is in the hospital with COVID, they may get other medications, depending on how sick they are. Most patients with severe COVID receive Veklury (remdesivir), an antiviral medication that can be used in adults and children who are hospitalized with COVID, Ostrosky said. It’s not a pill like the other medications—it has to be given as an intravenous (IV) infusion at a healthcare facility for three to five consecutive days.

Patients who need increasing amounts of oxygen or have signs of body-wide inflammation may need to be given anti-inflammatory medications such as steroids and immunomodulators, Ostrosky said.

Patients with severe COVID may also get anticoagulants such as heparin to reduce the risk of blood clots, Mok added. 

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.