Paxlovid vs Ivermectin
PaxlovidIvermectin
Antiviral (Protease Inhibitor Combination)Drug ClassAntiparasitic (Avermectin class)
Treatment of mild-to-moderate COVID-19 in high-risk patients to prevent severe diseaseApproved UsesTreatment of parasitic infections (e.g., onchocerciasis, strongyloidiasis)
None officially endorsedOff-Label/Controversial UsesInvestigated but not recommended for COVID-19 treatment by WHO, FDA, and CDC
Nirmatrelvir inhibits SARS-CoV-2 protease, preventing viral replication; ritonavir boosts nirmatrelvir levels by slowing its metabolismMechanism of ActionBinds to parasite nerve and muscle cells, causing paralysis and death of the parasite
Oral tablets (co-packaged)FormulationOral tablets, Topical formulations
5-day regimen: Nirmatrelvir 300 mg + Ritonavir 100 mg twice dailyDosageBased on parasitic infection; varies (e.g., 150–200 mcg/kg single dose for certain infections)
Altered taste, diarrhea, high blood pressure, muscle achesCommon Side EffectsNausea, diarrhea, dizziness, rash
Liver toxicity, drug interactions with CYP3A4 substrates, hypersensitivitySevere Side EffectsNeurological effects (in rare cases), liver injury
Proven effective in reducing hospitalization and death in high-risk patientsEfficacy for COVID-19Not proven effective; major health agencies advise against use for COVID-19
Limited data, not recommended unless benefit outweighs riskPregnancy CategoryGenerally considered safe for parasitic infections during pregnancy but not for COVID-19
Significant (CYP3A4 inhibitors/inducers, anticoagulants, anticonvulsants, etc.)Drug InteractionsLimited, but may interact with other drugs metabolized by P-glycoprotein
Emergency Use Authorization (EUA) for COVID-19Approval StatusFDA-approved for parasitic infections but not for COVID-19
Must start within 5 days of symptom onset for COVID-19; not suitable for severe renal or hepatic impairmentSpecial ConsiderationsOveruse or misuse in COVID-19 has led to toxicity cases; not endorsed by health authorities for viral infections
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