This page includes quick summaries of the available therapeutics.
Providers must review the respective medication Fact Sheets.
Provider Resources
- Do you have a clinical question about therapeutics? Email COVIDRxProviders@cdph.ca.gov.
- Want to receive frequent updates?
- Register to attend CDPH weekly Provider webinars on Fridays at 9:00 a.m.
- Sign up here to recieve email updates from CDPH.
- Click Here for Important COVID-19 Outpatient Therapeutics Updates
- COVID-19 Treatments Communication Tools
- CDPH Therapeutics Best Practices
- CDPH COVID-19 Treatments Webpage for Providers
- HHS Therapeutics Clinical Implementation Guide
- Pharmacists Resources
- Electronic Data Transmission Prescriptions – Frequently Asked Questions – California State Board of Pharmacy
- The Emergency Use Authorization (EUA) for Paxlovid allows pharmacists to prescribe Paxlovid under specific circumstances. For more details, please see the California Board of Pharmacy Order Waiving Restrictions on Pharmacists Independently Initiating and Furnishing Paxlovid to Individual Patients. The Department of Healthcare Services (DHCS) will reimburse pharmacists for prescribing and dispensing Paxlovid by the California Board of Pharmacy Waiver and the Food and Drug Administration’s EUA.
Variants & Efficacy
- The Ventura County Variants report provides aggregate whole genome sequencing results for local COVID-19 cases.
- For help navigating this report, watch this video.
- The California COVID Assessment Tool (CalCAT) website includes nowcasts, forecasts, scenarios, and variants.
- The Centers for Disease Control (CDC) Variant Proportions webpage reflects up-to-date variant monitoring, links to nowcasts, and categorizes variant proportions by region.
- The National Institutes of Health/National Center for Advancing Translational Sciences (NIH/NCAT) Open Data Portal on variant therapeutics offers a summary of findings from recent studies, with a table allowing for comparison of resistance profiles of different variants.
- Variant Therapeutic in vitro Activity Visualization
- CDPH Variant Tracking
Oral Treatment
Paxlovid
Pfizer’s Paxlovid
Type: Oral antiviral – protease inhibitor.
Administration Route: By mouth (PO) – twice daily for five days.
Timing: As soon as possible after diagnosis of COVID-19 and within five days of symptom onset.
Target Population: COVID-19 patients 12 years of age and older weighing at least 40 kg at high risk for progression to severe COVID-19 symptoms. Many drug-drug interactions.
- Paxlovid EUA Letter
- Paxlovid Fact Sheets
- Paxlovid Resources
- Sample Prescription
- Sample Standing Order
- Information Sheet: Paxlovid Eligibility and Effectiveness (hhs.gov)
- FAQs on the EUA for Paxlovid 07062022 (fda.gov)
- PAXLOVID Patient Eligibility Screening Checklist and Drug Interaction Tool 08262022 (fda.gov)
- Information on Viral Rebound
- Nirmatrelvir and the Risk of Post-Acute Sequelae of COVID-19 | medRxiv
- Recurrence of Symptoms Following a 2-Day Symptom-Free Period in Patients With COVID-19 | Infectious Diseases | JAMA Network Open | JAMA Network
- Nirmatrelvir–Ritonavir and Viral Load Rebound in Covid-19 | NEJM
- Real-World Effectiveness of Nirmatrelvir/Ritonavir in Preventing Hospitalization Among Patients With COVID-19 at High Risk for Severe Disease in the United States: A Nationwide Population-Based Cohort Study | medRxiv
- Game Changer: Paxlovid Reduces Hospitalizations and Saves Lives l Epic Research
- CDC Morbidity and Mortality Weekly Report (MMWR):
- COVID-19 rebound after Paxlovid and Molnupiravir during January-June 2022 | medRxiv
- Rebound Phenomenon after Nirmatrelvir/Ritonavir Treatment of Coronavirus Disease-2019 in High-Risk Persons – PMC (nih.gov)
- CDC Health Advisory: COVID-19 Rebound After Paxlovid Treatment
Lagevrio (Molnupiravir)
Merck and Ridgeback’s Molnupiravir
Type: Oral antiviral – nucleoside analog.
Administration Route: By mouth (PO) – every 12 hours for five days
Timing: As soon as possible after diagnosis of COVID-19 and within five days of symptom onset.
Target Population: COVID-19 patients 18 and older at high risk for progression to severe COVID-19 symptoms. It is NOT recommended in pregnancy.
- Molnupiravir EUA Letter
- Molnupiravir Fact Sheets
- Molnupiravir Resources
- FAQs on the EUA
- Information Sheet: Lagevrio Eligibility and Effectiveness (hhs.gov)
- Real-world clinical outcomes of treatment with molnupiravir for patients with mild-to-moderate coronavirus disease 2019 during the Omicron variant pandemic | SpringerLink
- Effectiveness of Molnupiravir in High-Risk Patients: A Propensity Score Matched Analysis | Clinical Infectious Diseases | Oxford Academic
Intravenous Antiviral Therapy
Remdesivir
Gilead’s Veklury (Remdesivir)
Type: nucleotide analog RNA polymerase inhibitor
Administration Route: Intravenous (IV) infusion over 30 to 120 minutes
Timing: For nonhospitalized patients, as soon as possible after diagnosis of COVID-19 and within seven days of symptom onset. See Patient Information for initiation of treatment in hospitalized patients and the duration of treatment for hospitalized and nonhospitalized patients.
Target Population: Adults and pediatric patients (28 days of age and older and weighing at least 3 kg) with positive results of direct SARS-CoV-2 viral testing who are hospitalized or not hospitalized and have mild-to-moderate COVID-19 and are at high risk for progression to severe COVID-19, including hospitalization or death.
- Dear Healthcare Provider Letter
- Prescribing Information
- Patient Information
- Veklury Resources
COVID-19 Convalescent Plasma (CCP)
- COVID-19 Convalescent Plasma EUA Letter
- COVID-19 Convalescent Plasma Provider Fact Sheet
- Recommendations for Investigational COVID-19 Convalescent Plasma | FDA
- FDA issued an EUA to permit the emergency use of the unapproved product, COVID-19 convalescent plasma with high titers of anti-SARS-CoV-2 antibodies, for the treatment of COVID-19 in patients with immunosuppressive disease or receiving immunosuppressive therapy, in either the outpatient or inpatient setting. COVID-19 convalescent plasma is not authorized to treat immunocompetent patients with COVID-19.
- Given that the clinical evidence in patients with immunosuppressive disease or receiving immunosuppressive treatment remains limited, data from additional randomized, controlled trials are needed.
- FDA has authorized other treatments for emergency use for the treatment of COVID-19 in adults and pediatric patients in the outpatient setting. These products have more consistently demonstrated clinical benefit in this population and do not carry some of the risks associated with transfusion of blood components.
- COVID-19 Treatment Guidelines: Convalescent Plasma and Immune Globulins | NIH
- Based on the available data, the Panel revised the recommendation language for using CCP in immunocompromised patients. There is currently insufficient evidence for the Panel to recommend either for or against the use of high titer CCP for the treatment of COVID-19 in hospitalized or nonhospitalized patients who are immunocompromised. Some Panel members would use CCP to treat an immunocompromised patient with significant symptoms attributable to COVID-19, signs of active SARS-CoV-2 replication, and inadequate response to available therapies. In these cases, clinicians should attempt to obtain high titer CCP from a vaccinated donor who recently recovered from COVID-19, likely caused by a SARS-CoV-2 variant similar to the variant causing the patient’s illness.
Telehealth
How to obtain COVID-19 Therapeutics
Paxlovid and Molnupiravir: When prescribing these medications to your patients, providers should visit the HHS Therapeutics Locator to find pharmacies with a current supply. Patients may also be advised of the HHS Test to Treat (T2T) program and the HHS T2T Locator map.
Remdesivir: Veklury (Remdesivir) is commercially available through Gilead Pharmaceuticals and multiple distributors. For additional purchasing information or how to access Remdesivir, Providers may email remdesivir@amerisourcebergen.com, call 1-800-746-6273, or reach out directly to your AmerisourceBergen, Cardinal, or McKesson representative.
Funding & Reimbursement
Reporting Requirements
Click here to view the CDPH HPoP Reporting and Transfer instructions.
Need more information?
General inquiries: COVIDTherapeutics@ventura.org
Clinical questions: COVIDRxProviders@cdph.ca.gov
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