16 ms·

And this was known to be a problem a year ago and Merck kept pushing it forward despite its low efficacy and risk for driving mutation. Meanwhile Paxlovid is un

And this was known to be a problem a year ago and Merck kept pushing it forward despite its low efficacy and risk for driving mutation. Meanwhile Paxlovid is underprescribed despite its effectiveness.

nikolay 4y ago
[flagged]
- thepangolino 4y ago
  What really bothers me with Ivermectin is that it used to be one of the cheapest and most available drugs yet it instantly became taboo to even talk about for in the context of covid. Why a known, safe, cheap and readily available drug couldn’t be used off label in the context of an unprecedented (at least in terms of social restrictions measures) global pandemic will always remain a mystery.
bawolff 4y ago
Well merck isn't without blame here, i feel like this is what the fda is for.
- logifail 4y ago
  It can be hard to believe the FDA is sufficiently independent when one reads about the revolving door straight to Big Pharma[0][1] [0] https://www.npr.org/sections/health-shots/2016/09/28/495694559/a-look-at-how-the-revolving-door-spins-from-fda-to-industry https://www.npr.org/sections/health-shots/2016/09/28/4956945... [1] https://thehill.com/blogs/congress-blog/politics/452654-for-big-pharma-the-revolving-door-keeps-spinning/ https://thehill.com/blogs/congress-blog/politics/452654-for-...
pixl97 4y ago
Other than the taste side effect I had, paxlovid was a miracle drug. Covid symptoms started disappearing very quickly after I took it.
- Spooky23 4y ago
  I went from post nasal drip to very hairy symptoms within 8 hours. Started paxlovid and was back to postnasal drip overnight and better by afternoon. Never have had that type of experience with any drug.
  - raymondh 4y ago
    Same here. I went from delirium to symptom free overnight.
  - latchkey 4y ago
    When I was living in SE Asia, I had really bad stomach issues quite often. One time was worse than ever. Went to a local pharmacy and they gave me some pill. Took it and literally hours later, I was fine. I remember looking it up and it was something developed in the 60's that wasn't used in the US any longer... but wow, it worked like magic.
    - ALittleLight 4y ago
      I was recently reading about a drug called ibogaine - which is apparently pretty effective at treating opioid addiction, but is illegal in the US. The drug is prescribed in New Zealand, and the studies I saw made it look like a miracle cure (for most but not all patients). Infuriating that, in the midst of the opioid crisis, the government wouldn't even consider permitting safe and effective treatment.
      - mofreelumch 4y ago
        You do a disservice to legalization efforts by ignoring the fact that you are discussing a powerful psychedelic. I am all for legalization efforts, but it is important to be clear and upfront about what we are talking about. Tangental to your point; I wonder if the US would currently be facing such an extreme and distressing methamphetamine epidemic if ephedra were still available (recognizing the obvious catch 22 here, as ephedrine is famously used in a variety of stimulant manufacture)
jyscao 4y ago
[flagged]
- loeg 4y ago
  > Ivermectin beats all these novel drugs developed specifically for covid out of the water. Yet it has largely been forbidden to be prescribed. No, it really, really doesn't. https://www.ema.europa.eu/en/news/ema-advises-against-use-ivermectin-prevention-treatment-covid-19-outside-randomised-clinical-trials https://www.ema.europa.eu/en/news/ema-advises-against-use-iv... https://ebm.bmj.com/content/27/3/156 https://ebm.bmj.com/content/27/3/156
  - jyscao 4y ago
    Ditto for hydroxychloroquine.
    - loeg 4y ago
      Yes, hydroxychloroquine is also ineffective at treating Covid.
      - gjsman-1000 4y ago
        We know that now, but in a major scientific misstep that I believe gives partial culpability to science for the widespread misbelief, is that first major study published in The Lancet showing hydroxychloroquine to be ineffective actually was full of statistical errors that were severe and it was retracted. https://www.nbcnews.com/health/health-news/lancet-retracts-large-study-hydroxychloroquine-n1225091 https://www.nbcnews.com/health/health-news/lancet-retracts-l... We now have better studies showing hydroxychloroquine to be ineffective, but the first study everyone went off of showing it to be useless... actually was bunk. And not just a little bunk, "A first-year statistics major could tell you about major flaws in the design of the analysis." This, of course, was a major help to conspiracies and confused doctors, as why would everyone be using such a flawed study to claim hydroxychloroquine is ineffective? I get why it would look political.
  - 4y ago
jasonhansel 4y ago
As I understand it, part of the issue is that Paxlovid interacts with a large number of other medications. This is a problem because people at high risk of dying from Covid tend to have preexisting medical conditions, and thus are more likely to take medications that interact with Paxlovid.
- DennisP 4y ago
  Also Paxlovid itself is hard on unhealthy kidneys, according to my doctor.
  - reureu 4y ago
    There are renal dosing standards for paxlovid. So if you have not-great kidneys, they just give you a different dose. Covid can also cause kidney damage, and kidney issues are associated with worse outcomes from covid. So, it's all a bit of a double edged sword.
- reureu 4y ago
  Most of the interactions can be managed, but I think the message got out among primary care docs there are drug interactions and so they get scared to prescribe it. There are relatively few meds that are absolutely contraindicated, while there's a large list of meds that require some dose adjustment or holding the med for a few days. This is an issue with the ritonavir in the paxlovid, which has been extensively used in HIV treatment -- so, this isn't a new issue that we know nothing about. And then I've heard from too many patients their doctor doesn't think they need it because they're not that sick, so it's not worth managing the drug interactions. Unfortunately, paxlovid needs to be started within five days of symptom onset, but most patients aren't going to be hospitalized within those first five days. Given the lack of monoclonal antibodies, the potential mutagenic effect of molupiravir, and the less-than-steller impact of remdesivir... if I or someone I loved got covid, I'd be jumping on paxlovid since there aren't many other options right now.
  - nradov 4y ago
    What if that someone you love is young and in good health? Paxlovid has some significant side effects and is only recommended for patients at high risk of severe COVID-19 due to advanced age or other risk factors. https://www.paxlovidhcp.com/ https://www.paxlovidhcp.com/
qbasic_forever 4y ago
Not to mention the original paxlovid trial was for a 10 day course of treatment but it was decided when approving the EUA that a 5 day course would be used to help spread out the limited doses. Yet today it just sits on shelves unused and people are still getting less effective half courses, many going on to 'rebound' and not clear the virus completely.
seydor 4y ago
Partly because of cases of covid rebound after paxlovid https://www.scientificamerican.com/article/what-is-paxlovid-rebound-and-how-common-is-it/ https://www.scientificamerican.com/article/what-is-paxlovid-...

nikolay 4y ago

[flagged]

thepangolino 4y ago
What really bothers me with Ivermectin is that it used to be one of the cheapest and most available drugs yet it instantly became taboo to even talk about for in the context of covid. Why a known, safe, cheap and readily available drug couldn’t be used off label in the context of an unprecedented (at least in terms of social restrictions measures) global pandemic will always remain a mystery.

bawolff 4y ago

Well merck isn't without blame here, i feel like this is what the fda is for.

logifail 4y ago
It can be hard to believe the FDA is sufficiently independent when one reads about the revolving door straight to Big Pharma[0][1] [0] https://www.npr.org/sections/health-shots/2016/09/28/495694559/a-look-at-how-the-revolving-door-spins-from-fda-to-industry https://www.npr.org/sections/health-shots/2016/09/28/4956945... [1] https://thehill.com/blogs/congress-blog/politics/452654-for-big-pharma-the-revolving-door-keeps-spinning/ https://thehill.com/blogs/congress-blog/politics/452654-for-...

pixl97 4y ago

Other than the taste side effect I had, paxlovid was a miracle drug. Covid symptoms started disappearing very quickly after I took it.

Spooky23 4y ago
I went from post nasal drip to very hairy symptoms within 8 hours. Started paxlovid and was back to postnasal drip overnight and better by afternoon. Never have had that type of experience with any drug.
- raymondh 4y ago
  Same here. I went from delirium to symptom free overnight.
- latchkey 4y ago
  When I was living in SE Asia, I had really bad stomach issues quite often. One time was worse than ever. Went to a local pharmacy and they gave me some pill. Took it and literally hours later, I was fine. I remember looking it up and it was something developed in the 60's that wasn't used in the US any longer... but wow, it worked like magic.
  - ALittleLight 4y ago
    I was recently reading about a drug called ibogaine - which is apparently pretty effective at treating opioid addiction, but is illegal in the US. The drug is prescribed in New Zealand, and the studies I saw made it look like a miracle cure (for most but not all patients). Infuriating that, in the midst of the opioid crisis, the government wouldn't even consider permitting safe and effective treatment.
    - mofreelumch 4y ago
      You do a disservice to legalization efforts by ignoring the fact that you are discussing a powerful psychedelic. I am all for legalization efforts, but it is important to be clear and upfront about what we are talking about. Tangental to your point; I wonder if the US would currently be facing such an extreme and distressing methamphetamine epidemic if ephedra were still available (recognizing the obvious catch 22 here, as ephedrine is famously used in a variety of stimulant manufacture)

jyscao 4y ago

[flagged]

loeg 4y ago
> Ivermectin beats all these novel drugs developed specifically for covid out of the water. Yet it has largely been forbidden to be prescribed. No, it really, really doesn't. https://www.ema.europa.eu/en/news/ema-advises-against-use-ivermectin-prevention-treatment-covid-19-outside-randomised-clinical-trials https://www.ema.europa.eu/en/news/ema-advises-against-use-iv... https://ebm.bmj.com/content/27/3/156 https://ebm.bmj.com/content/27/3/156
- jyscao 4y ago
  Ditto for hydroxychloroquine.
  - loeg 4y ago
    Yes, hydroxychloroquine is also ineffective at treating Covid.
    - gjsman-1000 4y ago
      We know that now, but in a major scientific misstep that I believe gives partial culpability to science for the widespread misbelief, is that first major study published in The Lancet showing hydroxychloroquine to be ineffective actually was full of statistical errors that were severe and it was retracted. https://www.nbcnews.com/health/health-news/lancet-retracts-large-study-hydroxychloroquine-n1225091 https://www.nbcnews.com/health/health-news/lancet-retracts-l... We now have better studies showing hydroxychloroquine to be ineffective, but the first study everyone went off of showing it to be useless... actually was bunk. And not just a little bunk, "A first-year statistics major could tell you about major flaws in the design of the analysis." This, of course, was a major help to conspiracies and confused doctors, as why would everyone be using such a flawed study to claim hydroxychloroquine is ineffective? I get why it would look political.
- 4y ago

jasonhansel 4y ago

As I understand it, part of the issue is that Paxlovid interacts with a large number of other medications. This is a problem because people at high risk of dying from Covid tend to have preexisting medical conditions, and thus are more likely to take medications that interact with Paxlovid.

DennisP 4y ago
Also Paxlovid itself is hard on unhealthy kidneys, according to my doctor.
- reureu 4y ago
  There are renal dosing standards for paxlovid. So if you have not-great kidneys, they just give you a different dose. Covid can also cause kidney damage, and kidney issues are associated with worse outcomes from covid. So, it's all a bit of a double edged sword.
reureu 4y ago
Most of the interactions can be managed, but I think the message got out among primary care docs there are drug interactions and so they get scared to prescribe it. There are relatively few meds that are absolutely contraindicated, while there's a large list of meds that require some dose adjustment or holding the med for a few days. This is an issue with the ritonavir in the paxlovid, which has been extensively used in HIV treatment -- so, this isn't a new issue that we know nothing about. And then I've heard from too many patients their doctor doesn't think they need it because they're not that sick, so it's not worth managing the drug interactions. Unfortunately, paxlovid needs to be started within five days of symptom onset, but most patients aren't going to be hospitalized within those first five days. Given the lack of monoclonal antibodies, the potential mutagenic effect of molupiravir, and the less-than-steller impact of remdesivir... if I or someone I loved got covid, I'd be jumping on paxlovid since there aren't many other options right now.
- nradov 4y ago
  What if that someone you love is young and in good health? Paxlovid has some significant side effects and is only recommended for patients at high risk of severe COVID-19 due to advanced age or other risk factors. https://www.paxlovidhcp.com/ https://www.paxlovidhcp.com/

qbasic_forever 4y ago

Not to mention the original paxlovid trial was for a 10 day course of treatment but it was decided when approving the EUA that a 5 day course would be used to help spread out the limited doses. Yet today it just sits on shelves unused and people are still getting less effective half courses, many going on to 'rebound' and not clear the virus completely.

seydor 4y ago

Partly because of cases of covid rebound after paxlovid https://www.scientificamerican.com/article/what-is-paxlovid-rebound-and-how-common-is-it/ https://www.scientificamerican.com/article/what-is-paxlovid-...