COVID-19 FAQs: Medications and Treatments
Get the facts about medications and treatments for COVID-19, including how arthritis medications may impact infection risk and outcomes.
News, scientific understanding and guidelines about COVID-19 are continually evolving. As such, please note that some information on this page may have changed since its original publication date.
Question: What are monoclonal antibodies and who qualifies for them to treat and prevent COVID-19?
A: Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off viruses. They are given by infusion or injection.
The FDA has granted EUA to a few monoclonal antibody treatments for people 12 years and older, weighing at least 88 pounds. However, due to high demand, monoclonal antibodies have two authorized uses:
- To treat or stop COVID-19 progression in a high-risk person
- To prevent COVID-19 in a high-risk person
According to the FDA, patients who are “high-risk” include those who are 65 years or older, have high blood pressure, heart disease, chronic kidney disease, sickle cell disease, diabetes, lung disease, a neurodevelopmental disorder, a BMI higher than 30, take immunosuppressant drugs and are pregnant. However, the FDA acknowledges risk factors aren't limited to those listed, and cite the CDC for more information regarding severe disease risk factors.
For high-risk people who have been infected, monoclonal antibodies are most effective in the earlier stages of disease. They may not provide much help to patients already hospitalized with severe disease.
If you are immunocompromised and have spent at least 15 minutes or longer within 6 feet of someone who has tested positive, you also likely qualify for preventative antibodies. Unvaccinated people who do not have a history of severe vaccine reactions or who are not considered to be immunocompromised are not authorized to receive preventative antibodies.
Monoclonal antibodies may be less effective against new virus variants and mutations, and evidence shows that some treatments may be ineffective against Omicron. If you’ve been infected with COVID-19 or have been exposed to the virus, talk to your doctor.
However, another monoclonal antibody drug, Evulsheld, can help prevent COVID-19 in the first place. It consists of two injections administered every six months to offer maximum protection. The FDA has issued EUA to Evulsheld for individuals 12 and older who are immunocompromised or on immunosuppressive drugs that prevent a strong vaccine response or who are allergic to ingredients in vaccines. It is NOT a substitution for COVID-19 vaccination – everyone who qualifies for vaccination should do so before receiving Evulsheld.
Access to Evulsheld varies state to state. For more information about where to find Evulsheld or if you qualify, talk to your doctor.
Question: Should I stop or reduce my arthritis drug if I have COVID-19?
A: Certain medications may need to be temporarily stopped if you have a confirmed infection, have been exposed to someone with a COVID-19 infection or are experiencing common COVID-19 symptoms such as fever, dry cough and shortness of breath.
Never stop or change medication dosage without calling your doctor. This is especially important with corticosteroids, which should never be stopped suddenly.
If you have any symptoms of COVID-19 or have been exposed to the virus, contact your doctor immediately. Your doctor will help you decide the best course of action.
Question: How is COVID-19 treated?
A: There is no cure for COVID-19, but doctors may prescribe various treatments to speed up recovery, including:
Antiviral drugs. Remdesivir is the only FDA-approved treatment for COVID-19. Evidence suggests that it may modestly speed up recovery time.
However, two more antiviral treatments from Pfizer (Paxlovid) and Merck (Molnupiravir) have received emergency-use authorization from the FDA. Both treatments are pill regimens that people take for five days after testing positive for COVID-19. Experts expect them to be effective in reducing severe disease outcomes, including against the Omicron variant.
So far, Pfizer’s treatment appears to be safer and more effective. In a research trial, it reduced the risk of hospitalization and death by 89 percent, versus Merck’s version, which reduced the risk of severe outcomes by 30 percent.
Monoclonal antibodies. Certain high-risk patients may qualify for monoclonal antibodies as a measure to either treat or prevent COVID-19 after exposure. This includes the pre-exposure prophylaxis drug, Evulsheld. (For more information, see question above.."What are monoclonal antibodies...?")
Convalescent plasma. The FDA granted EUA to convalescent plasma, or antibodies found in blood, to certain hospitalized patients who have early-stage disease and to people who cannot make their own antibodies. However, studies about its effectiveness, especially among patients with severe COVID-19, are mixed.
Dexamethasone. The commonly used steroid has been shown to reduce deaths among critically ill patients on ventilators and receiving oxygen. However, it’s less likely to help, and may even harm, some patients with earlier-stage infections.
Ultimately, the decision to treat COVID-19 with any drug depends on the judgment of the physician and the health status of the patient. In general, doctors will proceed with caution if patients have poor liver or kidney function unless the potential benefits of using the drug outweigh the potential risks.
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