Covid-19 Oral Treatments in Residential Aged Care Facilities

Working in partnership with the aged care sector, the Australian Government has pre-placed Lagevrio®, a prescription-only (S4) medicine that requires a prescription from a general practitioner, in residential aged care facilities as soon as possible, with the view to transition to PBS arrangements as supply continues to grow.

This will support timely administration to eligible patients, once prescribed by their usual doctor, until listing on the PBS can commence. It allows authorised prescribers can start giving the medication to eligible residents who have tested positive to COVID-19 as soon as possible.

Lagevrio® is taken as capsules. It works by blocking the ability of the COVID-19 virus to multiply in the human body. Lagevrio® capsules are taken twice a day for five days. Capsules should not be opened, broken or crushed. If you cannot swallow capsules whole, please consult with your treating doctor. The most common side effects reported in clinical trials of Lagevrio® were diarrhoea, nausea, and dizziness. If you start taking Lagevrio® you will be closely monitored for these side effects.

Your doctor and the clinical care team will work with you, and your loved ones, to decide whether an oral treatment such as Lagevrio® is suitable for you.

The oral treatment will be most beneficial for those who:

  • have mild to moderate COVID-19,

  • are aged 60 years and older, and

  • have significant medical conditions which make them more likely to become seriously unwell and end up in hospital after testing positive to COVID-19.

Besides Lagevrio®, Pfizer Australia Pty Ltd's oral COVID-19 treatment Paxlovid® (nirmatrelvir + ritonavir) was also granted provisional approval by The Therapeutic Goods Administration (TGA) on 18 January 2022. Paxlovid® has been granted provisional approval for the treatment of COVID-19 in adults 18 years of age and older, who do not require initiation of supplemental oxygen due to COVID-19 and are at increased risk of progression to hospitalisation or death. The two active substances of Paxlovid®, nirmatrelvir and ritonavir, which are given as separate tablets, must be taken together twice a day for 5 days.

The use of Paxlovid® is not recommended in pregnancy or breastfeeding, and for women of childbearing potential. It is recommended that sexually active women of childbearing potential use contraception. Unlike Lagevrio®, Paxlovid® is not safe to use with certain other medications either because for some medicines this may lead to potentially harmful increases in their blood levels, or in the case of some other medicines they may reduce the activity of Paxlovid®. It is also contraindicated in people with severe kidney or liver disease. That is why Lagevrio® has been preplaced in residential aged care facilities as a priority for older people.

Australians can be confident that the TGA's review processes of Lagevrio® and Paxlovid® were rigorous. The decision to provisionally approve the treatments was also informed by expert advice from the Advisory Committee on Medicines (ACM), an independent committee with expertise in scientific, medical and clinical fields including consumer representation.

Oral treatments should be administered as soon as possible after a diagnosis of COVID-19 and within 5 days of the start of symptoms. Both Lagevrio® and Paxlovid® are not intended to be used as a substitute for vaccination again COVID-19. Vaccinations, wearing masks and keeping your distance are still the best ways to protect yourself, your family, and the community from COVID-19.