PAXLOVID may be right for certain patients at high risk
According to the Centers for Disease Control and Prevention (CDC), the risk of progressing to severe COVID-19 may be increased if:
- The patient has one or more of the common high-risk factors below
- The patient is unvaccinated or not up to date with vaccinations against
COVID-19 - They experience healthcare access inequities due to race, ethnicity, disability, or where they live or work
Current evidence suggests that children with medical complexity, with genetic, neurologic, or metabolic conditions, or with congenital heart disease can be at increased risk for getting very sick from COVID-19.
Like adults, children with obesity, diabetes, asthma or chronic lung disease, sickle cell disease, or who are immunocompromised can also be at increased risk for getting very sick from COVID-19.
The risk may also be increased by other factors not listed on this page, so be sure to discuss all health conditions and lifestyle factors with a healthcare professional.
People with one of the high-risk factors below and mild-to-moderate COVID-19 for 5 days or fewer may be able to take PAXLOVID, so you or the patient should talk to a healthcare professional.
Physical Diseases and Conditions
Blood disorders
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Sickle cell disease or thalassemia
Cancer
Cerebrovascular disease
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Stroke
Chronic kidney problems
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People with moderate kidney disease will need a different dose of PAXLOVID
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PAXLOVID is not recommended for people with severe kidney disease
Chronic liver diseases
- Cirrhosis (or scarring of the liver)
- Non-alcoholic fatty liver disease
- Alcohol-related liver disease
- Autoimmune hepatitis
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PAXLOVID is not recommended for people with severe liver disease
Chronic lung diseases
- Moderate-to-severe asthma
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Bronchiectasis (thickening of the lungs’ airways)
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A chronic lung disease affecting newborns called bronchopulmonary dysplasia. PAXLOVID is not authorized for children younger than 12 years old
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Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis
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Damaged or scarred lung tissue known as interstitial lung disease (including idiopathic pulmonary fibrosis)
- Pulmonary embolism (blood clot in the lungs)
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Pulmonary hypertension (high blood pressure in the lungs)
Cystic fibrosis
Diabetes type 1 and type 2
Heart conditions
- Heart failure
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Coronary artery disease (damage or disease in the heart's major blood vessels)
- Cardiomyopathies (heart muscle diseases)
- Possibly high blood pressure (hypertension)
Infections and other contagious illnesses
- Human immunodeficiency virus (HIV)
- Tuberculosis
Neurological conditions
- Dementia
Weakened immune system, which may be caused by:
- Solid organ or blood stem cell transplant
- Corticosteroids, chemotherapy, or other medicines that reduce immune function
- Primary immunodeficiency
Weight
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Having a BMI in the 95th percentile or higher is a risk factor for children*
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Don’t know the patient’s BMI? Calculate it here†
*PAXLOVID is only authorized for children 12 years of age and older who weigh at least 88 pounds (40 kg).
†By clicking this link, you will be redirected to a website that is neither owned nor controlled by Pfizer. Pfizer is not responsible for the content or services of this site.
Pregnancy
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The risk is increased if the patient is pregnant or was pregnant within the last 6 weeks. It’s not known if PAXLOVID is safe to use during pregnancy, so be sure to tell a healthcare professional if the patient is pregnant or has been pregnant within the last few months
Mental Health Conditions
Mental health conditions increase risk, including:
- Mood disorders, such as depression
- Schizophrenia spectrum disorders
Lifestyle Factors
- Doing little or no physical activity
- Current or former smoker
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Substance use disorders (such as alcohol, opioid, or cocaine use disorders)
Disabilities
Some mental, physical, and developmental disabilities increase risk, including those that:
- Limit mobility
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Reduce a person’s ability to follow preventive measures, like hand washing
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Require close contact with those who may be infected, such as a caregiver or family member
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Reduce a person’s ability to communicate their symptoms
These disabilities put the patient at risk:
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Attention-Deficit/Hyperactivity Disorder (ADHD)
- Autism
- Cerebral Palsy
- Charcot Foot
- Chromosomal Disorders
- Chromosome 17 and 19 Deletion
- Chromosome 18q Deletion
- Cognitive Impairment
- Congenital Hydrocephalus
- Congenital Malformations
- Deafness/Hearing Loss
- Disability Indicated by Barthel Index
- Down Syndrome
- Fahr’s Syndrome
- Fragile X Syndrome
- Gaucher Disease
- Hand and Foot Disorders
- Learning disabilities
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Leber’s Hereditary Optic Neuropathy (LHON) or Autosomal Dominant Optic Atrophy (ADOA)
- Leigh Syndrome
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Limitations with self-care or activities of daily living
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Maternal Inherited Diabetes and Deafness (MIDD)
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Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS) and Risk Markers
- Mobility Disability
- Movement Disorders
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Multiple Disability (referred to in research papers as “bedridden disability”)
- Multisystem Disease
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Myoclonic Epilepsy with Ragged Red Fibers (MERRF)
- Myotonic Dystrophy
- Neurodevelopmental Disorders
- Neuromuscular Disorders
- Neuromyelitis Optica Spectrum Disorder (NMOSD)
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Neuropathy, Ataxia, and Retinitis Pigmentosa (NARP)
- Perinatal Spastic Hemiparesis
- Primary Mitochondrial Myopathy (PMM)
- Progressive Supranuclear Palsy
- Senior-Løken Syndrome
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Severe and complex disability (referred to in research papers as “polyhandicap disability”)
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Spina Bifida and Other Nervous System Anomalies
- Spinal Cord Injury
- Tourette Syndrome
- Traumatic Brain Injury
- Visual Impairment/Blindness
- Wheelchair Use
Additional information to share with a
healthcare professional when discussing PAXLOVID
Be sure to let a healthcare professional know if the patient has any allergies
They should not take PAXLOVID if they are allergic to nirmatrelvir, ritonavir, or any of the ingredients in PAXLOVID.
Bring a list of all the medicines the patient is taking
Including all prescription and over-the-counter medicines, vitamins, and herbal supplements. PAXLOVID can interact with other medicines causing severe or life-threatening side effects or death. Be sure to tell a healthcare professional about all the medicines being taken when discussing PAXLOVID.
PAXLOVID may affect how oral contraceptives work
If the patient is able to become pregnant, they should discuss birth control with a healthcare professional. They may need to use a different or additional form of contraception.
Tell a healthcare professional if the patient has liver or kidney problems or has HIV infection
If they have any recent blood test results, bring them for a healthcare professional to review. PAXLOVID isn't for people with severe liver or kidney disease. PAXLOVID may lead to some HIV medicines not working as well in the future.
Tell a healthcare professional if the patient is pregnant, plans to become pregnant, is breastfeeding, or plans to breastfeed
It is not known if PAXLOVID can harm their unborn baby. Tell a healthcare professional right away if they are or become pregnant. It is unknown if PAXLOVID can pass into breast milk, so discuss the best way to feed the baby during treatment.