COVID, Paxlovid and other treatments for COVID

Just diagnosed with Paxlovid rebound, after about 6 days being off the anti-viral. Same symptoms as before…but also loss of taste & smell. Was told that I would not take more Paxlovid, and to continue with nasal care (sprays, nasal wash) I hope this rebound of infection will clear soon! Paxlovid worked amazingly during my initial treatment. Within 24 hours of taking it, I felt 80% better with most symptoms improving very quickly. I felt fully recovered until the rebound happened. I’m hoping my sense of smell & taste will resolve quickly.

Hi @gdcm, I thought you might appreciate this information from the CDC about:
- COVID-19 Rebound After Paxlovid Treatment https://emergency.cdc.gov/han/2022/pdf/CDC_HAN_467.pdf

Thank goodness that the Paxlovid reduced your initial symptoms and kept you from serious illness and possible hospitalization. According to the CDC, rebound infection is usual mild, but it does mean that you can transmit the infection to others and should follow precautions.

I, too, hope that your sense of smell and taste resolve quickly. Are you experiencing any other side effects? How are you feeling today?

Hi Colleen, I am feeling much better. CIM put me on a Zpac the day after my note which quickly resolved nasal infection & early bronchitis. I still have a cough (not as bad as before) but only coughing up clear mucous…and my fatigue has lessened a great deal. I have been doing the ‘Smell Training” and nasal washes, Prednisone sprays; (also on oral Prednisone for PsA flare) my smell and taste is much improved since Day 1 of my Rebound, when none of the scents in the smell kit smelled as they were supposed to. (I think my smell/taste is 75% improved..I can now taste vs just tasting cold/salt/sweet with nothing else.). I have been isolating at home. (Mayo Rheum stopped my Orencia infusions; next one in Sept….so maybe a better immune system for a short period will help clear the rebound…?.) I was wondering if I should take a COVID antigen test in a few days? I’m very pleased with Paxlovid, even with the rebound! So happy it is available for those at higher risk. (When do you think the FDA will fully approve Paxlovid, so that it is available by prescription like TamiFlu so that patients like me can carry it with them when traveling overseas, etc?). Thank you for your follow up. - Gretchen

Glad you are better. I had Covid in February one month after lung cancer surgery - despite my isolation. I had to take Molnupiravir because Paxlovid was out of stock. I had developed a congested cough, and it did help immediately. Now I too would like to travel to Europe this winter but am concerned that if I catch Covid I will not have access to Paxlovid and could develop more serious disease. I don't know when the FDA can fully approve Paxlovid, so that it is available for overseas travel. I did not have a serious case of Covid, never had a fever, however, it did slow my recovery from surgery a little. Interesting enough, I tested positive four months after my booster. For people at greater risk of severe disease it is hard not to have more freedom. I would at least like to be able to quantify my risk of serious disease.

For @jam5 and anyone else interested in the comprehensive list of meds considered at this time to be safe to use with Paxlovid, along with others which are contraindicated or require monitoring, this National Institute of Health site has tables with categorized drugs which might be of some help in identifying your meds for use with Paxlovid.

I’ve posted the tables below but make sure you also go to this site to read the entire disclaimers.
https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ritonavir-boosted-nirmatrelvir--paxlovid-/paxlovid-drug-drug-interactions/

This is great Lori. Thank you , I have added it to my reference list!

i tested positive for covid and am taking paxlovid. can i also take acetaminophen to bring down fever?

Hi @ristan and welcome to Mayo Clinic Connect. Because you are discussing COVID 19 and Paxlovid, I moved your post to this conversation:
- COVID, Paxlovid and other treatments for COVID https://connect.mayoclinic.org/discussion/covid-and-paxlovid/
So you can connect with other people having the same issues.
Did you consult with your doctor about taking over the counter medications with Paxlovid?

thank you. i went ahead and took two tylenol following the paxlovid to no bad effect. my dr was not available at the time i felt i had to make a decision. any advice from other people would be helpful.

We might be experiencing the same thing -- can you point to any references about the connection between Paxlovid and yeast infections? This comment came up as a top google search result but still looking for published references. thanks