COVID-19 symptoms can range from mild to severe. Most adults with a mild case of COVID-19 can treat their symptoms at home and recover in a few days. Managing symptoms at home means resting at home, taking pain-relief and cough medicines and keeping hydrated.

But for some people, this may not be enough.

If you're one of the estimated 4.5 million adult Australians who has risk factors that may make you very sick if you get COVID-19, you may be eligible for oral COVID-19 antiviral treatments.

These oral medicines may lower the chance of some people with COVID-19 getting very sick and needing to go to hospital.

What is COVID-19 antiviral medication?

Antivirals are medicines that help stop a virus from infecting healthy cells that can make you sick. COVID-19 antiviral treatments stop the SARS-CoV-2 virus (the coronavirus which causes COVID-19) from multiplying and causing severe illness in people. These medicines help your immune system to fight off the infection.

COVID-19 medications are not a substitute for vaccination against COVID-19. You should get vaccinated against COVID-19 if you are able to.

What oral COVID-19 antiviral medications are available in Australia?

The Therapeutic Goods Administration (TGA), the Australian Government agency which regulates medicines and medical devices, has approved 2 oral COVID-19 antiviral medicines for use in Australia: Lagevrio and Paxlovid.

Lagevrio and Paxlovid are available by prescription only and are listed on the Pharmaceutical Benefits Scheme (PBS). The PBS subsidises medications, so they are affordable for people.

If you're prescribed these medicines by your doctor, you won't need to go to hospital to have them. They come in a capsule form, so you can take them in the comfort of your own home.

Lagevrio and Paxlovid are for treating adults with COVID-19 who don't need oxygen, but who are at increased risk of hospitalisation or death.

For more information on these oral treatments, you can read the Lagevrio® (molnupiravir) and Paxlovid® (nirmatrelvir + ritonavir) medicine information sheets.

Who is eligible for oral COVID-19 antiviral medication in Australia?

According to the National COVID-19 Clinical Evidence Taskforce clinical guidelines, and the relevant eligibility criteria from the PBS and Department of Health and Aged Care, you may be eligible for oral COVID-19 antiviral treatments if:

• you have mild or moderate COVID-19 confirmed with a PCR or RAT test (although, if you’re aged 70 years or older and asymptomatic, but you’ve confirmed that you have COVID-19 with a PCR test or RAT, you may still be eligible for treatment)
• you don’t require oxygen (however, you may already be on home oxygen therapy for an existing underlying condition. If you don’t need to increase oxygen levels due to COVID-19, you may be eligible for treatment)
• you start taking the antiviral treatments within 5 days since symptoms began (these treatments need to be started as soon as possible for them to be effective)

AND

• you’re 18 years or older and moderately to severely immunocompromised regardless of your vaccination status OR
• you’re 70 years or older with or without symptoms OR
• you’re 50 years or older and you have 2 or more of the risk factors listed below or you’ve had a COVID-19 infection resulting in hospitalisation OR
• you’re 30 years or older and an Aboriginal or Torres Strait Islander person and you have 1 or more of the risk factors below or you’ve had a COVID-19 infection resulting in hospitalisation OR
• you’re 50 years or older — or, 30 years or older and an Aboriginal or Torres Strait Islander person — and you’ve had less than 3 doses of a COVID-19 vaccine OR
• you’ve had less than 3 doses of a COVID-19 vaccine and you have at least 1 of the risk factors for severe illness listed below

The risk factors for severe illness include:

• a body mass index (BMI) that’s 30 or greater
• diabetes (type 1 or 2) requiring medication
• some chronic conditions, such as chronic kidney disease, liver disease and lung disease
• serious heart conditions
• neurodevelopmental disorders
• neurological conditions
• medical-related technological dependence
• active cancer
• immunocompromising conditions or immunosuppressive therapy
• living remotely with reduced access to higher-level healthcare
• being pregnant
• past COVID-19 infection resulting in hospitalisation

The healthdirect COVID-19 Symptom and Antiviral Eligibility Checker will show if you may be eligible for antiviral medication.

How do I get oral COVID-19 antiviral medication?

Your doctor can prescribe you Lagevrio or Paxlovid for treatment at home. But first they must assess if either of these treatments are suitable for you. If you’re at higher risk of severe illness and eligible for oral COVID-19 antiviral treatments, you should contact your doctor as soon as possible.

You can make a telehealth appointment to see your doctor or an appointment at a GP respiratory clinic to see a doctor in person or via telehealth. Telehealth appointments are when you speak to the doctor over the phone or via a video call.

Healthdirect Australia is working with state government health departments to help people at higher risk to access antivirals.

If you live in Queensland, New South Wales, South Australia or Victoria, you can call the National Coronavirus Helpline on 1800 020 080 for an initial assessment of your eligibility for COVID-19 antiviral medication. The helpline will help connect you to your doctor for further assessment and prescription.

People in other states and territories can visit the website of their state or territory’s health department for more information.

If you're a doctor, learn about treating your patients with oral COVID-19 antiviral medication from the Australian Government’s Department of Health and Aged Care, National COVID-19 Clinical Evidence Taskforce and The Royal Australian College of General Practitioners (RACGP).

When must I start taking oral COVID-19 antiviral medication?

You need to start taking Lagevrio or Paxlovid within 5 days of you testing positive for COVID-19. This is because these treatments work best if you start taking them as soon as possible after learning you have COVID-19. Speak to your doctor as soon as you can after testing positive for COVID-19.

Who shouldn't take oral COVID-19 antiviral medication?

If you have severe kidney or liver disease, you shouldn't have Paxlovid COVID-19 treatment. Talk to your healthcare provider about alternative oral treatments.

Certain treatments are not recommended during pregnancy, in women of childbearing potential not using contraception, or in women who are breastfeeding. Talk to your healthcare provider if you're planning a pregnancy, pregnant or breastfeeding.

Can I take antibiotics to treat COVID-19?

Antibiotics are not used to treat COVID-19. This is because a virus, not bacteria, causes COVID-19. Antibiotics are for treating some infections and diseases caused by bacteria.

Medicines such as ivermectin, doxycycline, zinc and hydroxychloroquine are not effective against the coronavirus that causes COVID-19. The Australian Government has not approved them for the treatment of COVID-19 in Australia.

For more information

• Contact your doctor. If you have COVID-19 symptoms, you can book a telehealth appointment. This is when you speak to your doctor over the phone or online.
• For the latest news on COVID-19 antivirals in Australia, visit the Australian Government Department of Health website.
• Call the National Coronavirus Helpline (1800 020 080) to get answers to questions about isolation, symptoms, restrictions, vaccines, testing and access to antiviral treatments. The helpline is open 24 hours a day.

This post was originally published on 27 June 2022 and has been updated to include the most recent details on this topic.