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Paxlovid vs Lagevrio

Nirmatrelvir/ritonavir  ·  Molnupiravir

Both are COVID-19 antivirals. Here is how Paxlovid and Lagevrio compare on class, mechanism, dosing, approval and supply.

At a glance

PaxlovidNirmatrelvir/ritonavir
LagevrioMolnupiravir
Brand name
Paxlovid
Lagevrio
Drug class
Antiviral
Antiviral nucleoside analogue
Route
Not listed
Oral
Marketed by
Pfizer
Merck Sharp & Dohme
First FDA approval
25 May 2023
Not listed
US shortage
Not listed
Not listed

Key differences

What each one treats

PaxlovidNirmatrelvir/ritonavir

PAXLOVID is indicated for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. PAXLOVID which includes nirmatrelvir, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease (M pro : also referred to as 3CL pro or nsp5 protease) inhibitor, and ritonavir, an HIV-1 protease inhibitor and CYP3A inhibitor, is indicated for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. ( 1 ) Limitations of Use PAXLOVID is not approved for use as pre-exposure or post-exposure prophylaxis for prevention of COVID-19. ( 1 ) Limitations of Use PAXLOVID is not approved for use as pre-exposure or post-exposure prophylaxis for prevention of COVID-19 [see…

LagevrioMolnupiravir

An oral short-course antiviral capsule used to treat mild-to-moderate COVID-19 in high-risk adults.

How each one works

PaxlovidAntiviral

12.1 Mechanism of Action Nirmatrelvir is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antiviral drug [see Microbiology (12.4) ]. Ritonavir is an HIV-1 protease inhibitor but is not active against SARS-CoV-2 M pro . Ritonavir inhibits the CYP3A-mediated metabolism of nirmatrelvir, resulting in increased plasma concentrations of nirmatrelvir.

LagevrioAntiviral nucleoside analogue

12.1 Mechanism of Action Molnupiravir is a prodrug with antiviral activity against SARS-CoV-2. It is metabolized to the cytidine nucleoside analogue, NHC which distributes into cells where NHC is phosphorylated to form the pharmacologically active ribonucleoside triphosphate (NHC-TP). NHC-TP incorporation (as NHC-monophosphate [NHC-MP]) into SARS-CoV-2 RNA by the viral RNA polymerase (nsp12) results in an accumulation of errors in the viral genome leading to inhibition of replication. The mechanism of action (known as viral error catastrophe or viral lethal mutagenesis) is supported by biochemical and cell culture data, studies of SARS-CoV-2 infection in animal models, and analyses of SARS-…

Related comparisons

Paxlovid VS Veklury Veklury VS Lagevrio

Read more

Paxlovid profile Lagevrio profile COVID-19 Antivirals All comparisons
This is not medical advice, and not a recommendation of one drug over the other.

Which medicine is right for a given person depends on their diagnosis, other conditions, other medicines, kidney and liver function, pregnancy, and cost or reimbursement — none of which this page knows. Two drugs in the same class are not automatically interchangeable. Never start, stop or switch a prescription medicine on the basis of a web page; that decision belongs to you and your clinician or pharmacist.

Class and summary text is written by the Priya Life Science editorial team. Label, mechanism, route, manufacturer and approval data come from the U.S. FDA via the openFDA API; shortage status from the FDA Drug Shortage Database. Approvals, indications and brand names differ between the US, EU/Ireland (EMA/HPRA) and other regions — a drug approved in one may not be approved, or may carry a different name, in another.