10 Things you should know about the Covid-19 oral drugs

The Hong Kong government has recently ordered two Covid-19 oral drugs – MSD’s Molnupiravir and Pfizer’s Paxlovid.

The first batch of Paxlovid arrived in Hong Kong on March 14 and was distributed to the Hospital Authority the following day (March 15). Further shipments of Paxlovid are expected to arrive in Hong Kong in the next two to three months.

Due to confidentiality reasons, the exact quantity and cost of the drugs cannot be revealed. Though the authorities have emphasised that "the Government has procured an appropriate amount of Covid-19 oral drugs and will continue the procurement and stockpiling of these drugs."

Local sources have quoted LegCo member Michael Tien saying that around 50,000 doses were shipped in for the first batch of Paxlovid.

Molnupiravir and Paxlovid cannot be purchased over the counter, but the recent shipments have already been dispatched to places such as designated clinics, care homes for the elderly, the San Tin isolation facility, and Queen Mary Hospital. The drugs will also be distributed to private hospitals that admit Covid-19 patients.

Patients at higher risk will be given priority to the medicine, including anyone over the age of 70, those who suffer from chronic diseases such as diabetes, obesity (30≦BMI), kidney failures, cancer, as well as immuno-compromised individuals. Patients who have yet to get their second (BioNTech) or third (Sinovac) vaccine are also considered to be at high risk.

Molnupiravir is not suitable for women who are pregnant or breastfeeding as well as kids under the age of 18, while those with weak kidney or liver functions are not suited to take Paxlovid. Individuals who are unable to stop taking medication such as antibiotics and blood thinners for five days are also not suitable to take Paxlovid.

The medication should be given to patients within the first five days of symptom onset and should be taken for five consecutive days, twice daily.

There are some common side effects to taking Paxlovid, which may include diarrhoea, higher blood pressure, and muscle pain. For Molnupiravir, possible side effects include diarrhoea, headaches, skin irritation, and nausea.

The Hospital Authority had stated that Paxlovid is slightly more effective, but as mentioned above, not all are suited to take the drug. According to the New England Journal of Medicine, those treated within three days of symptom onset with Paxlovid can reduce the risk of hospitalisation or death by 89 percent. Meanwhile, those who take Molnupiravir within the first five days can reduce the risk of death by 30 percent.

The government's expert health advisor Professor Yuen Kwok-yung suggests that those with mild symptoms should stay at home and rest, drink water, and take appropriate medication such as Panadol for any pain relief.