Paxlovid stays in your system for around 24–30 hours after you take your final dose. It is important to understand how long the medication can remain in your body to help avoid drug interactions.
Medically reviewed by Alyssa Peckham, PharmD, BCPP
Paxlovid is a medication that helps stop SARS-CoV-2, the virus that causes COVID-19, from growing inside your body.
It is made up of two medications. One medication directly stops the virus, while the other helps the first medication stay in your body longer so it can be more effective.
This helps prevent symptoms from getting worse, especially in people who have a higher risk of serious health conditions from COVID-19.
How long will Paxlovid last in the system?
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Paxlovid is meant to reduce symptom severity and prevent hospitalization during an active infection. Unlike a vaccine, it does not offer long-term protection against COVID-19.
Typically, Paxlovid will fully eliminate COVID-19 in a healthy adult in about 1 to 1.5 days (24–30 hours).
Due to the risk of serious drug interactions, you must stop taking some medications before taking Paxlovid. This includes drugs like:
You must wait 5 days after you have finished taking Paxlovid to begin taking some of these medications again.
Other drug dosages may need adjusting as well. A doctor or healthcare professional will offer the best advice on this when they prescribe you Paxlovid.
How does it work?
Paxlovid stops the COVID-19 virus from growing inside your body. It is made up of two medications:
Nirmatrelvir: to prevent the virus from replicating
Ritonavir: which helps the first part stay in your body longer to be more effective
This combination helps prevent your symptoms from worsening.
You may start to feel better during or after the treatment. Paxlovid can reduce your risk of severe illness from COVID-19 by over 50%, possibly up to 89% if you are unvaccinated.
However, depending on the severity of your symptoms and how your body responds to the medication, you may still be contagious after completing a standard 5-day Paxlovid course.
Always check with a healthcare professional and follow public health guidelines to know when COVID-19 is no longer contagious and it is safe to be around others again.
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Paxlovid is an antiviral medication. Antiviral drugs treat infections caused by viruses, such as the flu, herpes, hepatitis, HIV, and COVID-19.
These drugs work in different ways, such as by:
preventing viruses from entering cells
stopping viruses from replicating
boosting the immune system’s ability to fight the virus
It is important to use them correctly to prevent the development of drug resistance, which can make viruses harder to treat.
Who is it for?
Paxlovid is for adults and children ages 12 years and older who weigh at least 88 pounds and are at high risk of developing severe COVID-19 symptoms.
This includes people with specific medical conditions or factors that increase their risk for serious illness.
The goal is to treat COVID-19 once symptoms begin to prevent them from getting worse.
Always consult a healthcare professional to determine whether Paxlovid is the right treatment option based on your health needs and circumstances.
Are there any risks?
Taking Paxlovid does have some potential risks and downsides. The medication comes with a boxed warning, highlighting the importance of careful management to ensure safety.
An important consideration is that Paxlovid can interact with many other medications you might be taking, leading to serious or even life threatening reactions.
To avoid harmful drug interactions, you must inform a doctor or healthcare professional about all medications, over-the-counter (OTC) drugs, and herbal supplements you are using.
If you have liver or severe kidney conditions, you should take caution. Paxlovid might not be suitable for you, or you may need a different dosage.
What are the side effects?
The most commonly reported side effects of Paxlovid are taste disturbances (anecdotal evidence suggests you may notice a metallic taste) and diarrhea.
Less common side effects can include:
headache
vomiting
abdominal pain
nausea
high blood pressure
feeling generally unwell
Monitoring your health and reporting any unexpected or severe symptoms to a healthcare professional is important. Remember that individual reactions to medication can vary, and not everyone will experience these side effects.
Rare but serious side effects
You should seek immediate medical attention if you experience any signs or symptoms of:
Allergic reactions, including:
rash
itching
swelling of the face, lips, tongue, or throat
difficulty breathing
severe dizziness
Symptoms of liver damage, including:
yellowing of your skin and the whites of your eyes
loss of appetite
dark-colored urine
pale-colored stool
itchy skin
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Paxlovid requires a prescription from and doctor or healthcare professional. It is important to act quickly if you test positive for COVID-19 and are eligible for treatment.
You must start taking the medication within the first 5 days of your symptoms, as early treatment makes Paxlovid more effective.
In certain areas, designated test-to-treat sites, including some pharmacies, can provide on-the-spot access to Paxlovid after a positive COVID-19 test and evaluation.
Timing: start as soon as possible but within 7 days of symptoms
Administration: intravenous (IV) infusions at a healthcare facility, for 3 consecutive days
molnupiravir (Lagevrio)
Suitable for: adults only
Timing: start as soon as possible but within 5 days of symptoms
Administration: taken orally, at home
The choice between these medications and Paxlovid depends on factors like age, symptom severity, underlying health conditions, and treatment accessibility.
Always consult a healthcare professional to determine the most appropriate treatment based on your needs.
Summary
How long Paxlovid stays in your body will depend on factors such as your age, metabolism, and kidney health. It should be gone from your body within 1 to 1.5 days, or 24–30 hours.
Paxlovid works best if you can access treatment early, usually within 5 days of symptoms.
You may need to temporarily adjust or stop taking some regular medications while you take Paxlovid, so be sure to let a doctor or healthcare professional know about the drugs you are taking, including OTC medications and herbal supplements.
Alternatives are available if Paxlovid is unsuitable for you. Discussing your needs with a healthcare team will ensure you get the right medication.
Fact sheet for patients, parents, and caregivers: Emergency use authorization (EUA) of Paxlovid for coronavirus disease 2019 (COVID-19). (2024). https://www.fda.gov/media/155051/download
