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Antiviral Agents, Including Antibody Products

Last Updated: February 29, 2024

Remdesivir and ritonavir-boosted nirmatrelvir (Paxlovid) are approved by the Food and Drug Administration for the treatment of COVID-19.

Molnupiravir and high-titer COVID-19 convalescent plasma (CCP) are available only under Food and Drug Administration Emergency Use Authorizations for the treatment of COVID-19.

Summary Recommendations

Recommendations for Treating Nonhospitalized Adults

  • The COVID-19 Treatment Guidelines Panel (the Panel) recommends the following anti-SARS-CoV-2 therapies as preferred treatments for COVID-19. These drugs are listed in order of preference:
    • Ritonavir-boosted nirmatrelvir (Paxlovid) (AIIa)
    • Remdesivir (BIIa)
  • The Panel recommends molnupiravir as an alternative therapy when neither of the preferred therapies are available, feasible to use, or clinically appropriate (CIIa).
  • For more information on using these agents in nonhospitalized adults, see Therapeutic Management of Nonhospitalized Adults With COVID-19

Recommendations for Treating Nonhospitalized Children

Recommendations for Treating Hospitalized Adults or Children

Antiviral Treatments With Insufficient Evidence

  • There is 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. 
  • There is insufficient evidence for the Panel to recommend either for or against the use of high-titer CCP for the treatment of COVID-19 in nonhospitalized patients who are immunocompetent. 

Antiviral Treatments That the Panel Recommends Against

  • The Panel recommends against the use of the following drugs for the treatment of COVID-19, except in a clinical trial:
    • Interferon alfa or beta in nonhospitalized patients (AIIa)
    • Systemic interferon alfa in hospitalized patients (AIIa)
    • Nitazoxanide (BIIa)
  • The Panel recommends against the use of the following drugs for the treatment of COVID-19:
    • Anti-SARS-CoV-2 monoclonal antibodies (AIII)
    • Chloroquine or hydroxychloroquine and/or azithromycin in hospitalized patients (AI) and nonhospitalized patients (AIIa)
    • CCP in hospitalized patients who are immunocompetent (BIIa)
    • Lopinavir/ritonavir and other HIV protease inhibitors in hospitalized patients (AI) and nonhospitalized patients (AIII)
    • Interferon beta in hospitalized patients (AI)
Each recommendation in the Guidelines receives a rating for the strength of the recommendation (A, B, or C) and a rating for the evidence that supports it (I, IIa, IIb, or III). See Guidelines Development for more information.