Antivirals – your questions answered

Antivirals are medicines that help stop a virus infecting healthy cells or multiplying in the body.

We now have antivirals that work against COVID-19. They work best when taken as soon as possible within 5 days from when your symptoms start.

They are available as tablets or capsules to be taken by the mouth or in a needle (directly into the bloodstream).

COVID-19 antivirals do not work against other viruses like the flu. Antivirals are only prescribed to eligible people who have tested positive to COVID-19 through a rapid antigen test (RAT) or PCR (nose and throat swab) test.

Read the Australian Government’s updated eligibility for antivirals.

Antiviral medicines 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 inside 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 know 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). Both are 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 other options available, including 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)

People who are eligible for antiviral medicines include:

• Everyone aged over 70
• People aged 50 years and older with two or more risk factors for severe disease
• Aboriginal or Torres Strait Islander people aged 30 years and older with one or more risk factors for severe illness
• Immunocompromised people over 18 may also be eligible.

If you test positive to COVID-19, have symptoms but do not require hospitalisation, and are at higher risk of severe illness from COVID-19, you may also be eligible for antivirals.

Find advice on the eligibility criteria on the Department of Health website.

Talk to your GP now so you know which  COVID-19 test you should do if you get sick and if you need antiviral medicines. Your doctor can fill out an antiviral pre-assessment form and you can discuss which treatment best suits you.

If you test positive for COVID-19, your GP will still need to provide a prescription for antiviral medicines but knowing which antiviral medicine is right for you will help you access it more quickly and easily.

See the antiviral pre-assessment form for people at higher risk of severe illness or the antiviral pre-assessment form for residents of aged care facilities. These forms can only be completed by a doctor (ideally your GP).

COVID-19 antivirals are only prescribed to eligible people who have tested positive to COVID-19 through a rapid antigen test (RAT) or PCR (nose and throat swab) test.

Although registering a RAT test is no longer mandatory, voluntarily registering your result helps you access antiviral medicines if you are eligible.

Steps for accessing antivirals:

1. If you test positive to COVID-19 or register a positive rapid antigen test, you’ll receive a survey link from NSW Health via SMS.
2. 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 result
• completed the survey you receive from NSW Health
• been identified as being at higher risk of severe illness.

3. Call your GP immediately to discuss antivirals (usually via telehealth). Antivirals work best when taken as soon as possible and within 5 days from the start of symptoms.

4. If your GP says you are eligible for antivirals, they will send you a prescription (online or paper copy). 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 very sick from COVID-19 and have not received the NSW Health survey or cannot get in touch with your GP, contact the NSW Health COVID-19 and Flu Care at Home Support Line on 1800 960 933 or the National Coronavirus Helpline on 1800 020 080 who are able to check if you are eligible for antivirals.

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 needing antivirals. Antivirals may help people who are at higher risk of developing severe illness, depending on their circumstances.

You can use the COVID-19 Symptom and Antiviral Eligibility Checker to find out if you may be eligible for antiviral medication.

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.

For people who are eligible under the PBS, COVID-19 oral antiviral treatments cost less than $10 for concession card holders, or around $45 for other people who are eligible.

Please read more information on oral antivirals on NPS Medicinewise.