How can I get Rx for Paxlovid when I don't have COVID (yet)? (NYC)
July 7, 2023 11:56 AM Subscribe
I'm 72 and have hypertension. I haven't had COVID yet because I've been very (some might say absurdly) careful. However, I'm being somewhat less careful now, visiting some people in their homes, going on train rides, etc (I still wear a mask a lot, but not in those people's homes, and went to a restaurant indoors once, etc.)
I'd like to get a prescription for Paxlovid, fill, it, and have it around just in case. My internist will not write me a prescription (he says he doesn't think it's a great drug (?))
I don't want to start with a whole new internist just for this (recently had my annual physical).
is there any way to get a prescription for Paxlovid without having COVID? I'm in Manhattan, New York City.
When I tested positive for COVID in February, I went to an urgent care clinic the next morning and walked out with a box of Paxlovid. I started taking it immediately and never got actually sick -- just a few days of fatigue and a slight fever. I was also quadruple-vaxxed including the bivalent booster.
Pharmacists at places like CVS can give you Paxlovid on the spot -- the FDA has authorized pharmacists to prescribe and provide it if you are in a high risk group (which you are, due to age).
I'm not sure you need to preemptively have a filled prescription, since you can now get Paxlovid in a matter of hours after a positive test in multiple ways.
posted by erst at 12:08 PM on July 7, 2023 [3 favorites]
Pharmacists at places like CVS can give you Paxlovid on the spot -- the FDA has authorized pharmacists to prescribe and provide it if you are in a high risk group (which you are, due to age).
I'm not sure you need to preemptively have a filled prescription, since you can now get Paxlovid in a matter of hours after a positive test in multiple ways.
posted by erst at 12:08 PM on July 7, 2023 [3 favorites]
Do you see any specialists who would *file* a prescription with your pharmacy, in case you tested positive over a weekend?
Alternately, telehealth doc or pharmacist: A positive COVID test is no longer required to qualify for Paxlovid. If you meet the other criteria listed above, you can still get the medication. A healthcare provider or pharmacist can determine if you likely have the illness based on your symptoms. They’ll also take into account any recent exposures you may have had to others who are sick.
posted by Iris Gambol at 12:13 PM on July 7, 2023
Alternately, telehealth doc or pharmacist: A positive COVID test is no longer required to qualify for Paxlovid. If you meet the other criteria listed above, you can still get the medication. A healthcare provider or pharmacist can determine if you likely have the illness based on your symptoms. They’ll also take into account any recent exposures you may have had to others who are sick.
posted by Iris Gambol at 12:13 PM on July 7, 2023
So here in Seattle, Ms. Windo finally got COVID. She is 57. We have insurance and good doctors and stuff, and they would not give her Paxlovid...
And I'm hiding out downstairs, because I am on blood thinners, I am pretty sure they won't give it to me either. Good luck in your search
posted by Windopaene at 12:26 PM on July 7, 2023
And I'm hiding out downstairs, because I am on blood thinners, I am pretty sure they won't give it to me either. Good luck in your search
posted by Windopaene at 12:26 PM on July 7, 2023
Hey, Windopaene - When I got covid, my doctor started to say that I wasn't in a vulnerable group, then I explained why I was vulnerable and the doctor changed her mind.
What I'm saying is: if it's not too late, (have Ms. W) send the doctor a note and insist.
Doctors have to make judgment calls all the time; they are the front lines for deciding how to make sure treatments get to people who really need them and aren't consumed and made unavailable by people who don't really need them.
Last time I checked, Paxlovid wasn't being used _enough_, but some doctors were treating it like the Covid vaccine in the early days - assuming it's scarcer than it is, and defaulting to saying no unless someone seemed on death's door.
A gentle push back might get you what you need, especially if the doctor might not know you are vulnerable since he sees your wife, or might not know how much Paxlovid is at your local pharmacy (you can check with them if you want to send that info too).
posted by amtho at 12:32 PM on July 7, 2023 [1 favorite]
What I'm saying is: if it's not too late, (have Ms. W) send the doctor a note and insist.
Doctors have to make judgment calls all the time; they are the front lines for deciding how to make sure treatments get to people who really need them and aren't consumed and made unavailable by people who don't really need them.
Last time I checked, Paxlovid wasn't being used _enough_, but some doctors were treating it like the Covid vaccine in the early days - assuming it's scarcer than it is, and defaulting to saying no unless someone seemed on death's door.
A gentle push back might get you what you need, especially if the doctor might not know you are vulnerable since he sees your wife, or might not know how much Paxlovid is at your local pharmacy (you can check with them if you want to send that info too).
posted by amtho at 12:32 PM on July 7, 2023 [1 favorite]
Best answer: Paxlovid has a relatively short shelf life. If you get your prescription filled right now, and they hand you one that is not expired but expires in the next six months, would you really want to keep and/or use possibly-ineffective medication after those six months?
The Paxlovid they gave me when I was infected last year expired in five months (and is currently expired). I think there's been an extension, but this means it expires next month.
posted by meowzilla at 12:41 PM on July 7, 2023 [4 favorites]
The Paxlovid they gave me when I was infected last year expired in five months (and is currently expired). I think there's been an extension, but this means it expires next month.
posted by meowzilla at 12:41 PM on July 7, 2023 [4 favorites]
Response by poster: I would like to take the medicine with me WHILE traveling. I didn't say that. I should have. But it's good to hear that it's so easy to get a prescription if you get sick.
posted by DMelanogaster at 12:44 PM on July 7, 2023 [1 favorite]
posted by DMelanogaster at 12:44 PM on July 7, 2023 [1 favorite]
You might want to consider a new internist. Paxlovid reduces severe disease, hospitalization and death by at least 80%. Any doctor who is not keeping up with actual research and is instead basing decisions on popular media gestalt isn’t someone you should be trusting with your health. What other modern medical practices are being dismissed that you don’t know about? I would be looking for someone who follows the science, not their gut.
posted by Bottlecap at 12:58 PM on July 7, 2023 [2 favorites]
posted by Bottlecap at 12:58 PM on July 7, 2023 [2 favorites]
If you'd be open to lying, I think going to an urgent care clinic, saying "I've been exposed to a covid case in the last 24 hours and I'm planning to travel in the next week; I would like to have paxlovid on hand so that I can isolate in the hotel room if I need to, rather than trying to find a doctor and pharmacy in an unfamiliar place while feeling unwell" seems like it would probably be a convincing rationale for a lot of doctors. But like every damn thing with covid, it's so individual - some doctors are big paxlovid boosters and others are quite reluctant to prescribe.
posted by potrzebie at 1:02 PM on July 7, 2023 [2 favorites]
posted by potrzebie at 1:02 PM on July 7, 2023 [2 favorites]
This hotline makes it easy to get a prescription if you get sick.
posted by metasarah at 1:14 PM on July 7, 2023 [1 favorite]
posted by metasarah at 1:14 PM on July 7, 2023 [1 favorite]
Any doctor who is not keeping up with actual research and is instead basing decisions on popular media gestalt isn’t someone you should be trusting with your health.
Exactly, which is why many American doctors are hesitant to write a script Paxlovid just because of a positive COVID test, and entire counties health care systems (like the NHS in the UK) won't prescribe it all unless the patient has an extremely suppressed immune system in which COVID is likely to be fatal.
That is the actual research. The shoveling it at everyone because "why not?" is the "popular media gestalt".
Paxlovid can extend the length you are contagious by weeks. It can extend your symptoms by weeks. You can get sick, test negative for a week or so, and then have worse symptoms again for an even longer period than the initial one.
However, your symptoms will likely be lessened than they would be without Paxlovid. If the non-Paxlovid edition of the sickness would put you in the hospital and/or kill you, then yeah, all those side-effects are worth it.
But, if Paxlovid is just going to turn a week of moderate symptoms into up to 5-6 weeks of slightly-less moderate symptoms, it's probably not worth it.
Anyway, listened to your doctor, not random people on the internet. And think real hard about just looking for doctors that are going to tell you want to hear, rather than a doctor that is telling you what you need to hear.
posted by Back At It Again At Krispy Kreme at 1:55 PM on July 7, 2023 [16 favorites]
Exactly, which is why many American doctors are hesitant to write a script Paxlovid just because of a positive COVID test, and entire counties health care systems (like the NHS in the UK) won't prescribe it all unless the patient has an extremely suppressed immune system in which COVID is likely to be fatal.
That is the actual research. The shoveling it at everyone because "why not?" is the "popular media gestalt".
Paxlovid can extend the length you are contagious by weeks. It can extend your symptoms by weeks. You can get sick, test negative for a week or so, and then have worse symptoms again for an even longer period than the initial one.
However, your symptoms will likely be lessened than they would be without Paxlovid. If the non-Paxlovid edition of the sickness would put you in the hospital and/or kill you, then yeah, all those side-effects are worth it.
But, if Paxlovid is just going to turn a week of moderate symptoms into up to 5-6 weeks of slightly-less moderate symptoms, it's probably not worth it.
Anyway, listened to your doctor, not random people on the internet. And think real hard about just looking for doctors that are going to tell you want to hear, rather than a doctor that is telling you what you need to hear.
posted by Back At It Again At Krispy Kreme at 1:55 PM on July 7, 2023 [16 favorites]
Anecdata, but when my entire family got COVID during a family event there was a mix on whose doctors would prescribe paxlovid. My father did a telehealth to get it when his internist wouldn’t. He had blood work pulled a few weeks after recovering and he had new, minor kidney impairment. It resolved over time without intervention and just but his internist explained that one of his hesitancies to prescribe was because he’s seen a number of her patients have impaired renal function after taking paxlovid. He’s seen some other abnormalities too, and that’s why he’s very selective about who he will prescribe it for. My other family members didn’t have any reason to have blood work post infection so who knows what their kidneys did, but no one was clinical for renal impairment.
posted by OsoMeaty at 2:33 PM on July 7, 2023 [2 favorites]
posted by OsoMeaty at 2:33 PM on July 7, 2023 [2 favorites]
Some Paxlovid expiration dates have been extended; Pfizer site to check product expiration dates, HHS's Paxlovid Expiration Date Extension by Batch Number list. Info for Canada. If it helps with physician discussions: FDA Grants Full Approval to Paxlovid, COVID-19 Antiviral Treatment (June 2023)
posted by Iris Gambol at 4:58 PM on July 7, 2023 [1 favorite]
posted by Iris Gambol at 4:58 PM on July 7, 2023 [1 favorite]
Data point, fwiw... Hypertensive myself, and just got through a moderate bout of Covid. I was given a Paxlovid rx and... I'm not convinced it did much to help, since I was still very sick with 101+ fever, all-body ache, and violent coughing for a few days (unless without it I would have ended up in the hospital, which I guess is a possibility).
After the 5 days of paxlovid, I also experienced a rebound second wave of less-severe but still unpleasant symptoms (milder fever and less intense cough), so even with the anti-viral I was out of commission the better part of 2 weeks. The co-worker who infected me at the work event ("Sorry! I just thought I was tired and had bad allergies..."), who had just flown home, as it turns out, from Las fucking Vegas, where among other things she went unmasked to a crowded pop concert, is indefinitely on my shit list.
Eager for an updated formula of booster. I feel that masks and boosters are what kept me from getting the thing for the last 3 years despite family and other obligations requiring me to be in the presence of folks who weren't masking, distancing, or vaxing.
posted by aught at 6:51 AM on July 8, 2023 [1 favorite]
After the 5 days of paxlovid, I also experienced a rebound second wave of less-severe but still unpleasant symptoms (milder fever and less intense cough), so even with the anti-viral I was out of commission the better part of 2 weeks. The co-worker who infected me at the work event ("Sorry! I just thought I was tired and had bad allergies..."), who had just flown home, as it turns out, from Las fucking Vegas, where among other things she went unmasked to a crowded pop concert, is indefinitely on my shit list.
Eager for an updated formula of booster. I feel that masks and boosters are what kept me from getting the thing for the last 3 years despite family and other obligations requiring me to be in the presence of folks who weren't masking, distancing, or vaxing.
posted by aught at 6:51 AM on July 8, 2023 [1 favorite]
Contrary to what Back At It Again At Krispy Kreme said above, the latest research shows that Paxlovid DOES NOT significantly increase the risk of COVID rebound. That idea was based entirely on anecdotal evidence; when an actual rigorous study was done, it was found to be untrue.
The fact that this comment with wrong info about Paxlovid has been favorited more than any other in this thread so far is honestly making me feel slightly ill. I don't blame people for not knowing that the science has changed on this because the major non-medical media entities have basically stopped reporting on COVID news because "no one wants to hear about that anymore," but please do take note of this development. Paxlovid is already underprescribed and underused. I really, really do not want anyone in this thread to fail to take a medication that has been proven effective because of anecdotal rumors about it that have been debunked.
posted by BlueJae at 10:09 AM on July 8, 2023 [21 favorites]
The fact that this comment with wrong info about Paxlovid has been favorited more than any other in this thread so far is honestly making me feel slightly ill. I don't blame people for not knowing that the science has changed on this because the major non-medical media entities have basically stopped reporting on COVID news because "no one wants to hear about that anymore," but please do take note of this development. Paxlovid is already underprescribed and underused. I really, really do not want anyone in this thread to fail to take a medication that has been proven effective because of anecdotal rumors about it that have been debunked.
posted by BlueJae at 10:09 AM on July 8, 2023 [21 favorites]
Paxlovid roughly halves your chances of getting long covid. That's in addition to reducing severity of the acute illness.
Both of these benefits are major, even if you can't see or sense them directly. And even if you do get symptom rebound. I will absolutely take it when I get covid.
posted by Dashy at 9:09 AM on July 9, 2023
Both of these benefits are major, even if you can't see or sense them directly. And even if you do get symptom rebound. I will absolutely take it when I get covid.
posted by Dashy at 9:09 AM on July 9, 2023
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