Effective Covid-19 treatment and hassle-free online care

Some people with Covid-19 experience no symptoms. Others become sick enough to require a hospital stay. The risk factors for severe Covid-19 include:

• Being 65 or older
• Pre-existing lung conditions (including asthma, lung cancer, chronic obstructive pulmonary disease or cystic fibrosis)
• Heart disease or cardiomyopathy
• Being identified as obese
• Having a weakened immune system due to organ transplants, cancer treatment or taking certain medications

Like Covid-19, influenza (flu) is a contagious respiratory condition that can cause symptoms including fever, cough, body aches, sore throat and shortness of breath. Because Covid-19 and flu can create similar symptoms, it can be difficult to tell the two conditions apart. If you’re experiencing serious symptoms, contact your medical provider.

Otherwise, here’s how to tell Covid-19 and flu apart:

• Flu usually causes symptoms within 1-4 days from the time of infection. Covid-19 may trigger symptoms anywhere from 2 to 14 days after infection.
• Flu typically doesn’t cause a temporary loss of smell or taste.
• Bacterial infections are a more common complication of flu.

Paxlovid and Molnupiravir are Covid prescription medications for high-risk patients with mild-to-moderate Covid-19 symptoms. Both Covid treatments are antivirals that help slow or stop the virus from replicating. They include a course of pills taken at home over 5 days.

The treatments must be started within the first 5 days of symptoms—which can be difficult for those who can’t easily access in-person care. Fortunately, Dr. B’s accessible health platform makes seeing an online doctor for Covid treatment within this vital 5-day window accessible and affordable.

The federal government will wind down its distribution of Paxlovid and Molnupiravir in November and December 2023, transitioning the responsibility to the commercial market. But if you have a prescription, you can still get the oral treatment for free while the government’s supplies last. Here’s how to anticipate your out-of-pocket cost:

Medicare, Medicaid and those without insurance: Patients will continue to receive the Covid treatment for free until 2024 through a U.S. government Patient Assistance Program (PAP) managed by Pfizer. Specific details about participating sites are not currently available, but more information should come in the near future.

Indian Health Service, the Department of Veterans Affairs (VA) or the Department of Defense: The U.S. Department of Health and Human Services (HHS) has indicated they will still get Paxlovid through the government's purchased supplies.

Private Insurance: If you have private insurance, your out-of-pocket expense will depend on your insurance provider and individual pharmacy prices (determined by a pharmacy benefit manager). Contact your insurance provider or speak with your pharmacist about insured costs.

Additionally, Pfizer has launched a Copay Savings Program to help minimize the expense for insured patients. If eligible, you can download a card to share at your pharmacy. For updates and questions, contact the program at (877) 219-7225 (1-877-C19-PACK).

Merck & Co Patient Assistance Program for Molnupiravir (Lagevrio): The U.S. Department of Health and Human Services (HHS) has shared that Merck will soon provide a "Patient Assistance Program" to offer Molnupiravir (Lagevrio) at no cost to patients who can't afford it on their own. (More information should come by November 17, 2023.) Learn more at merckhelps.com or call (800) 727-5400 if you have any questions.

Dr. B Drug Discount Card:  When you come to Dr. B for any treatment, we show you medication costs at local pharmacies so that you can choose the best option before your prescription gets sent out. Then, we email you a Dr. B Drug Discount Card to lock in that low cost. The same goes for Covid-19 prescription medications! Here’s more about how drug discount cards work.

You may be able to get Paxlovid online or Mulnopiravir online (after a Dr. B Covid online consultation) if you:

• Have experienced Covid-19 symptoms for 5 days or less
• Have taken a Covid-19 test and gotten a positive test result
• Are 18 or older
• Are a high-risk patient with a qualifying condition, including:
  • Asthma
  • Cancer
  • Chronic lung diseases
  • Diabetes
  • Disabilities
  • Heart conditions
  • Human immunodeficiency virus (HIV)
  • Mental health disorders
  • Obesity (BMI ≥25 kg/m2)
  • Smoking (both former and current)

Paxlovid and Molnupiravir are both oral medications (Covid pills) that must be taken within 5 days of initial Covid-19 symptoms. Paxlovid contains two medications—Nirmatrelvir and Ritonavir—which prevent the Covid-19 protein from replicating. Molnupiravir inserts itself directly into the Covid-19 virus' genetic material to stop it from replicating and growing.

For high-risk patients, Paxlovid can help decrease the risk of hospitalization or death by up to 89%. Molnupiravir is less effective. But it has fewer drug interactions, making it appropriate for patients who may not qualify for Paxlovid because of pre-existing conditions or medication conflicts.

In the early days of the pandemic, researchers noticed that some people experienced a return of symptoms 2-8 days after their initial recovery. This was assumed to be only related to Paxlovid use and was called “Paxlovid rebound.”

New studies show that it’s common to experience a brief return of symptoms whether or not you take Paxlovid. This suggests that rebound symptoms are a natural part of Covid-19. Paxlovid continues to be recommended as the most effective early-stage treatment of mild to moderate Covid-19 in high-risk patients.

The good news? If you’re at high risk for severe illness and have an active Covid-19 infection, you may be eligible to get a Paxlovid prescription online. Start a Dr. B Paxlovid online health assessment today.

Paxlovid contains Nirmatrelvir (2 pink pills) and Ritonavir (1 white pill). Patients take all 3 pills together 2 times a day (12 hours apart) for 5 days.

A dose of Molnupiravir contains 4 red-colored capsules. Patients take all 4 pills together 2 times a day (12 hours apart) for 5 days.

Even if symptoms improve within a few days, it’s crucial that you complete the entire prescribed amount of medication. Stopping treatment too soon may not entirely stop or slow the virus from replicating.

Paxlovid side effects are generally mild. They can include:

• Muscle aches
• Increased blood pressure
• Altered or impaired sense of taste
• Diarrhea

These common medications interact poorly with Paxlovid. Discuss alternative treatment options with your primary care doctor if you take:

Anti-coagulants: Apixaban (Eliquis), Dabigatran (Pradaxa), Edoxaban (Savaysa), Rivaroxaban (Xarelto), Ticagrelor (Brilinta), Warfarin (Coumadin, Jantoven)

Benign Prostatic Hyperplasia (BPH): Alfuzosin (Uroxatral), Doxazosin (Cardura), Silodosin (Rapaflo), Tamsulosin (Flomax), Terazosin (Hytrin)

Cardiac/Hypertension: Amiodarone (Cordarone, Nexterone, Pacerone), Amlodipine (Norvasc, Katerzia, Norliqva), Cilostazol (Pletal), Clopidogrel (Plavix), Digoxin (Lanoxicaps, Lanoxin), Diltiazem (Cardizem, Carter, Dilacor, Dilt-CD, Diltia, Matzim, Taztia, Tiadylt, Tiazac), Disopyramide (Norpace), Dofetilide (Tikosyn), Dronedarone (Multaq), Eplerenone (Inspra), Felodipine (Plendil), Flecainide (Tambocor), Ivabradine (Corlanor), Mexiletine, Nifedipine (Procardia, Adatta, Afeditab, Nifedica, Nifedical), Propafenone (Rythmol), Quinidine, Ranolazine (Ranexa, Aspurzyo), Sacubitril (Entresto), Valsartan (Diovan, Exforge), Verapamil (Calan, Covera, Isoptin, Verelan, Tarka)

Diabetes: Glyburide (DiaBeta, Micronase), Saxagliptin (Onglyza)

Immunosuppressants: Chemotherapeutic medications, Cyclosporine (Gengraf, Neoral), Dexamethasone (Decadron, Hemady, TaperDex), Everolimus (Zortress, Afinitor), Fedratinib (Inrebic), Ruxolitinib (Jakafi), Sirolimus (Rapamune), Tacrolimus (Astagraf, Envarsus, Hecoria, Prograf), Tofacitinib (Xeljanz), Upadacitinib (Rinvoq), Voclosporin (Lupkynis)

Medications for infections: Brincidofovir (Tembexa), Clarithromycin (Biaxin), Cobicistat (Tybost), Glecaprevir/Pibrentasvir (Mavyret), HIV medications, Isavuconazole, Itraconazole (Onmel, Sporanox, Tolsura), Ketoconazole, Maraviroc (Selzentry),Posaconazole (Noxafil), Rifabutin (Mycobutin), Rifampin (Rifadin), Rifapentine (Priftin), Voriconazole (Vfend)

Migraine: Almotriptan (Axert), Ergot derivatives (bromocriptine, Parlodel), Dihydroergotamine (Migranal), Ergotamine (Cafergot), and Pergolide (Permax), Zolmitriptan (Zomig)

Miscellaneous: Colchicine (Colcrys, Gloperba, Mitigare), Darifenacin (Enablex), Elexacaftor/ Tezacaftor/Ivacaftor (Trikafta), Eluxadoline (Viberzi), Finerenone (Kerendia), Ivacaftor (Kalydeco), Lumacaftor/Ivacaftor (Orkambi), Naloxegol (Movantik), Oxybutynin (Ditropan), Solifenacin (Vesicare), St. John’s wort, Tezacaftor/Ivacaftor (Symdeko), Tolvaptan (Jynarque, Samsca)

Neuropsychiatric and Sleep: Alprazolam (Xanax, Niravam), Aripiprazole (Abilify), Brexpiprazole (Rexulti), Buspirone (BuSpar), Cariprazine (Vraylar), Chlordiazepoxide (Librium), Clobazam (Onfi, Sympazan), Clonazepam (Klonopin), Clorazepate (Tranxene), Clozapine (Clozaril, FazaClo, Versacloz), Diazepam (Valium), Estazolam, Flurazepam (Dalmane), Haloperidol (Haldol), Iloperidone (Fanapt), Lumateperone (Caplyta), Lurasidone (Latuda), Midazolam (Versed, Seizalam), Mirtazapine (Remeron), Pimavanserin (Nuplazid), Pimozide (Orap), Quetiapine (Seroquel), Risperidone (Risperdal, Perseris), Trazodone (Desyrel, Oleptro), Ziprasidone (Geodon), Zolpidem (Ambien, Edluar, Intermezzo, Zolpimist)

Pain or Dependence: Buprenorphine (Belbuca, Buprenex, Sulocade, Subutex), Fentanyl (Sublimaze), Hydrocodone (Norco, Vicodin, Hysingla, Zohydro), Hydromorphone (Dilaudid, Exalgo), Methadone (Diskettes, Dolphin, Methadose), Morphine (Arymoa, Avinza, Duramorph, Infumorph, Kadian, Mitigo, Morphabond, MS Contin, Oramorph, Roxanol), Oxycodone (OxyContin, OxyFast, Oxaydo, Oxecta, Roxicodone, Roxybond, Xtampza), Tramadol (Ultram, ConZip, Odolo, Rybix, Ryzolt)

Pulmonary Hypertension and/or Sexual Dysfunction: Bosentan (Tracleer), Flibanserin (Addyi), Riociguat (Adempas), Sildenafil (Viagra, Revatio), Tadalafil (Cialis, Adcirca, Alyq), Vardenafil (Levitra, Staxyn)

Seizure: Carbamazepine (Tegretol, Carbatrol, Epitol, Equetro), Phenobarbital (Sezaby), Phenytoin (Dilantin, Phenytek), Primidone (Mysoline)

Molnupiravir side effects are also generally mild. They can include:

• Diarrhea
• Nausea
• Dizziness

Does Paxlovid need a prescription? Yes! Molnupiravir requires a prescription, too. But there's no need to trek to your doctor's office. If eligible, you can get an online Paxlovid prescription or Molnupiravir prescription through Dr. B’s virtual medical platform.

To get started, fill out an online health assessment. A licensed medical provider will review your health and medical history. If they recommend a prescription treatment, they will send it to your preferred pharmacy for pick-up.

Consultation: An online consultation costs $15, which is less than most doctor copays. Currently, we don’t submit medical consultation claims to insurance companies.

Medication: During the Covid-19 public health emergency, the U.S. government provided Covid-19 antiviral treatments for free at pharmacies nationwide. Now, these medications will remain free only while the federal government has them in supply. Afterward, your prescription cost will depend on whether or not you have insurance and where you fill your prescription.