5 Paxlovid Side Effects You Should Know About

Paxlovid (nirmatrelvir / ritonavir) has been a life-saver for many people with COVID-19. This antiviral medication is FDA approved for adults at high risk of developing severe illness from COVID. It’s considered the first-choice option for treating mild to moderate COVID in this group of people.

But as with all medications, Paxlovid has some side effects. While some are common, others are more unique. Let’s take a look at five Paxlovid side effects and how to manage them.

1. Taste changes (“Paxlovid mouth”)

Loss of smell or taste is a well-known symptom of COVID. But this side effect is different from that. As Paxlovid became more widely available, many people began reporting taste changes as a side effect. This experience was coined “Paxlovid mouth” by many news outlets. Those who experience it describe it in different ways, a couple being a bitter or metallic taste. But they all agree on one thing — it’s gross.

These taste changes were expected when Paxlovid was initially FDA authorized in 2021. In fact, it was the most commonly reported side effect during clinical trials. It’s also a common side effect of ritonavir (Norvir) — one of the two antivirals in Paxlovid. But even though it’s typical, that doesn’t mean it’s pleasant.

Thankfully, this side effect is temporary and relatively mild for many. It should go away once you stop treatment with Paxlovid, which usually only lasts 5 days. In the meantime, sucking on mints or strongly flavored candies may be helpful. If these taste changes are causing you to throw up, contact your healthcare provider.

2. Diarrhea

Diarrhea is a common side effect of many medications. While uncommon, loose stools are possible with Paxlovid. About 3% of clinical trial participants reported this side effect. But keep in mind, diarrhea is also a symptom of COVID. A similar number of people taking a placebo (a pill with no medication in it) also reported it.

Diarrhea with Paxlovid can typically be managed at home. Be sure to drink plenty of fluids and watch for symptoms of dehydration. You may also find a bland diet sits better with you. If your diarrhea doesn’t clear up after finishing Paxlovid, reach out to your healthcare provider.

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3. High blood pressure

It’s not unusual for a medication to raise blood pressure. And this can be a concern if you already have high blood pressure or other heart conditions. Small numbers of people who took Paxlovid have reported this side effect.

Your blood pressure should return to normal after finishing Paxlovid. But your healthcare provider may ask you to check your blood pressure at home while taking it. Let them know if your blood pressure is still high after finishing the medication.

4. Headache

Headaches are no fun and can make it difficult to complete your usual activities. Paxlovid may cause headaches for some people who take it. But it’s relatively rare with the medication.

Headaches from Paxlovid should be mild. But if you find them bothersome, over-the-counter pain relievers may help. Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are two options that don’t interact with Paxlovid.

EXPERT PICKS: WHAT TO READ NEXT

• What it feels like: Three people share their experiences with Paxlovid, which can be beneficial for many people at high risk from COVID.

• Bad taste in the mouth: Paxlovid commonly produces a bitter or bad taste (sometimes called “Paxlovid mouth”). Find out why this side effect happens and how to manage it.

• Interactions with other meds: Paxlovid interacts with hundreds of other medications. But many of these interactions can be managed with dosage adjustments.

5. Liver damage

As mentioned earlier, Paxlovid contains the medication ritonavir. Ritonavir is known to contribute to liver damage. This side effect is more likely to happen in people who already have liver problems.

Liver damage wasn’t reported in Paxlovid’s clinical trials. But because of what experts know about ritonavir, Paxlovid is not recommended for people with severe liver problems. Make sure your healthcare provider knows if you have a history of liver issues before you start taking it.

When should I contact my healthcare provider about Paxlovid side effects?

Most Paxlovid side effects are mild and should go away on their own. But if you find anything to be excessive, reach out to your healthcare provider. They can let you know if further care is needed.

Seek immediate help if you experience any symptoms of liver damage:

• Yellowing of the skin or eyes (jaundice)

• Right-sided stomach pain

• Dark urine

• Nausea

• Swelling in the stomach area

You should also let your provider know if you think you’re having an allergic reaction to Paxlovid. Medication allergies can range from mild to life-threatening. Call 911 if you’re having breathing difficulties or swelling of the lips, mouth, or throat. These may be symptoms of a serious allergic reaction and need emergency care.