Table 4e. Characteristics of Antiviral Agents, Including Antibody Products
Last Updated: March 6, 2023
- This table contains drugs and products that have shown antiviral activity against SARS-CoV-2, including small-molecule antiviral drugs, CCP, and IFNs.
- RDV is the only antiviral drug that is approved by the FDA for the treatment of COVID-19.
- RTV-boosted nirmatrelvir, MOV, and CCP have received EUAs from the FDA for the treatment of COVID-19.
- For drug-drug interaction information, please refer to product labels, EUA fact sheets, and Drug-Drug Interactions Between Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Concomitant Medications.
- For the Panel’s recommendations on using the drugs listed in this table, refer to the individual drug sections, Therapeutic Management of Nonhospitalized Adults With COVID-19, Therapeutic Management of Hospitalized Adults With COVID-19, Therapeutic Management of Nonhospitalized Children With COVID-19, or Antiviral Agents, Including Antibody Products.
|Drug Name||Dosing Regimens||Adverse Events||Monitoring Parameters||Drug-Drug Interaction Potential||Comments|
|Anti-SARS-CoV-2 Antiviral Drugs (Small-Molecule Antivirals)|
|Ritonavir-Boosted Nirmatrelvir (Paxlovid)|
Authorized under an FDA EUA for the treatment of mild to moderate COVID-19 in high-risk individuals aged ≥12 years and weighing ≥40 kg.
Dose Recommended in FDA EUA1
Severe Hepatic Impairment (Child-Pugh Class C)
Approved by the FDA for the treatment of COVID-19 in individuals aged ≥28 days and weighing ≥3 kg.
Dose for Adults and Children Weighing ≥40 kg
Dose for Children Aged ≥28 Days and Weighing 3 kg to <40 kg
Total Treatment Duration
Authorized under an FDA EUA for the treatment of mild to moderate COVID-19 in high-risk individuals aged ≥18 years.
Dose Recommended in FDA EUA
|COVID-19 Convalescent Plasma|
|High-Titer COVID-19 Convalescent Plasma|
Authorized under an FDA EUA for the treatment of COVID-19 in patients who are immunocompromised or who are receiving immunosuppressive treatment.
|Dose Recommended in FDA EUA |
Not approved by the FDA and not recommended by the Panel for the treatment of COVID-19. Currently under investigation in clinical trials.
Key: AE = adverse event; ALT = alanine transaminase; AST = aspartate aminotransferase; CBC = complete blood count; CCP = COVID-19 convalescent plasma; CHF = congestive heart failure; CYP = cytochrome P450; eGFR = estimated glomerular filtration rate; EUA = Emergency Use Authorization; FDA = Food and Drug Administration; HSR = hypersensitivity reaction; IFN = interferon; IV = intravenous; MATE = multidrug and toxin extrusion protein; MOV = molnupiravir; NG = nasogastric; OATP = organic anion transporting polypeptide; OG = orogastric; OTC = over-the-counter; the Panel = the COVID-19 Treatment Guidelines Panel; P-gp = P-glycoprotein; PO = oral; RDV = remdesivir; RTV = ritonavir; SBECD = sulfobutylether-beta-cyclodextrin; TACO = transfusion-associated circulatory overload; TRALI = transfusion-related acute lung injury; ULN = upper limit of normal
- Food and Drug Administration. Fact sheet for healthcare providers: Emergency Use Authorization for Paxlovid. 2022. Available at: https://www.fda.gov/media/155050/download.
- (CTC) BCTC, COVID Therapy Review and Advisory Working Group (CTRAWG). Therapeutic brief: crushing nirmatrelvir/ritonavir (Paxlovid). 2022. Available at: http://www.bccdc.ca/Health-Professionals-Site/Documents/COVID-treatment/Crushing_Paxlovid.pdf.
- Remdesivir (Veklury) [package insert]. Food and Drug Administration. 2022. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/214787Orig1s015lbl.pdf.
- Food and Drug Administration. Fact sheet for healthcare providers: Emergency Use Authorization for Lagevrio (molnupiravir) capsules. 2022. Available at: https://www.fda.gov/media/155054/download.
- Marano G, Vaglio S, Pupella S, et al. Convalescent plasma: new evidence for an old therapeutic tool? Blood Transfus. 2016;14(2):152-157. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26674811.