Antivirals – your questions answered

Antivirals are medicines that help stop a virus infecting healthy cells or multiplying in the body.  Fortunately, we have antivirals that work against COVID-19. They work best when taken as soon as possible, usually within five days from when your symptoms start.

They come in either pill form to be taken by the mouth or can be given intravenously (directly into the bloodstream).

COVID-19 antivirals do not work against other viruses like the flu. They are only prescribed to eligible people who have tested positive to COVID-19 through a RAT or PCR test.

Antiviral treatments target the virus (SARS-CoV-2) that causes COVID-19 to prevent it infecting healthy cells in your body and multiplying. This helps stop the spread of the virus through your body and helps your immune system to fight off the infection.

By reducing how severe the illness is, you are less likely to go to hospital, develop breathing difficulties, need assistance with oxygen or intensive care treatment, or die from COVID-19. It’s important to note that antivirals are not a substitute for vaccination.

The Therapeutic Goods Administration (TGA) has approved two oral antiviral treatments for COVID-19 in Australia called Lagevrio® (molnupiravir) and Paxlovid® (nirmatrelvir + ritonavir). They are both available in NSW.

Most people who are eligible for antivirals will be prescribed oral antivirals, which come in tablet or capsule form, so you can take these medicines at home rather than needing to go to hospital for treatment. There are some other options available such as antiviral injections and in those cases your doctor may advise you to go to a hospital or clinic to receive your antiviral treatment intravenously. Your GP will let you know the best treatment option for you.

For more information on antivirals available in NSW read the below medicine information sheets:

• Lagevrio® (molnupiravir)
• Paxlovid® (nirmatrelvir + ritonavir)

If you test positive to COVID-19, have symptoms, are at higher risk of severe illness from COVID-19 but do not require hospitalisation, you may be eligible for antiviral or other early treatment for COVID-19.

Those at higher risk of severe illness from COVID-19 are:

• People aged 60 years and older.
• Pregnant women.
• Aboriginal, Torres Strait Islander and Pacific Islander people (from age 35 years and over).
• People with obesity, diabetes, serious cardiovascular disease, chronic lung disease (including severe asthma requiring hospitalisation in last 12 months), severe chronic liver or kidney disease, active cancer or who are immunocompromised.
• Some people with a disability including those with a disability that affects their lungs, heart or immune system.
• Residents of aged care and disability care facilities.
• People aged 18 years and older who are unvaccinated.

If you identify as being higher risk, plan ahead. Speak to your doctor (GP) now about antiviral or other early treatment for COVID-19 so you understand your options if you get COVID-19.

If you test positive to COVID-19 or register a positive rapid antigen test, you’ll receive a survey link and some questions from NSW Health via SMS.

We are working with Healthdirect Australia, the national government-funded virtual health provider, to help people at higher risk to access antivirals. If you’re identified as higher risk after completing the survey, you will receive a SMS from Healthdirect Australia about discussing antivirals with your GP.

You will only be sent a SMS from Healthdirect Australia if you have:

• received a positive COVID-19 test result or registered a positive rapid antigen test
• completed the survey you receive from NSW Health
• been identified as being at higher risk of severe illness.

Please call your GP to discuss antivirals or other early treatments, as soon as you have tested positive to COVID-19.  Antivirals work best when taken early and within 5 days from when your symptoms start.

If your GP says you are eligible for oral antivirals, they will send you a prescription (online or paper copy) so you can get the medication from a pharmacy or hospital clinic.

If you are prescribed antivirals, it's recommended you ask your pharmacy to arrange home delivery for your medication or ask someone to collect it on your behalf and drop it off.

If you believe you are at high-risk of getting seriously ill from COVID-19 and have not received the NSW Health survey and not been able to get in touch with your GP, you can contact Healthdirect on 1800 022 222 and/ or NSW Health’s COVID and Flu care at home support line on 1800 960 933. Nurses on the line will be able to assist you with your inquiry.

Antivirals can only be used in the early stages of infection and are not suitable for everyone. Most people can manage COVID-19 safely at home without the need for antivirals. They may be beneficial to people who are at higher risk of progressing to severe illness, depending on their circumstances.

All medicines can potentially have side effects but most will disappear with time or when you stop treatment.

Antiviral side effects vary depending on what medicine you are being treated with. Please read the medicine information sheets below for more information on side effects:

• Lagevrio® (molnupiravir)
• Paxlovid® (nirmatrelvir + ritonavir)

As antiviral medicines are new, information about how well they work is still being collected. That’s why it is important to speak to your doctor and see if you are eligible for the treatments. Your doctor will tell you if they are safe for you to use.

Each antiviral medication is different, so it’s important to read the medicine information sheet before treatment to see if you are suitable. You can access the information here:

• Lagevrio® (molnupiravir)
• Paxlovid® (nirmatrelvir + ritonavir)

Oral antivirals, Lagevrio® and Paxlovid® are available on the Pharmaceutical Benefits Scheme (PBS) in Australia and are heavily subsidised. There are specific PBS eligibility criteria for antivirals and if you meet the criteria you can access antivirals at a minimal cost.  You doctor or pharmacist can advise you.

Please read more information on oral antivirals on NPS Medicinewise.