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1. Shard Calculation

Query:

Response:

Calculated Shard: 131 (from laksa185)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa131.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.drugs.com/medical-answers/you-paxlovid-covid-rebounds-3569972/\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.drugs.com/medical-answers/you-paxlovid-covid-rebounds-3569972/\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.drugs.com\/medical-answers\/you-paxlovid-covid-rebounds-3569972\/","crawl_time":1776161986,"first_indexed_time":1661793808,"http_code":200,"src_unparsed":"com,drugs!www,\/medical-answers\/you-paxlovid-covid-rebounds-3569972\/ s443","src_root_hash":"1816286668162245731","history_drop_reason":null,"meta_title":"Can you take Paxlovid twice if COVID rebounds?","meta_descriptions":["Official answer: No, a second round of Paxlovid treatment is not needed after the initial 5-day treatment if COVID rebound occurs. Case..."],"attrs_boilerpipe_text":"Official Answer\nby Drugs.com\nNo, a second round of Paxlovid treatment is not needed after the initial 5-day treatment if COVID rebound occurs. Case reports suggest that most people who develop COVID rebound after completing 5 days of treatment have either no symptoms or mild illness. To date, there is no association between Paxlovid treatment and COVID rebound.\nAn FDA analysis has stated that COVID rebound associated with symptoms and \/ or a positive viral test may occur as part of the natural course of the disease, whether or not you take Paxlovid.\nCOVID rebound has also been reported to occur with Lagevrio (molnupiravir), another COVID antiviral medicine, in people who have not taken any treatment, and those who are vaccinated or not vaccinated.\nAt this time, the original 5-day treatment period for Paxlovid is recommended in the product labeling and by the Centers for Disease Control and Prevention (CDC). In studies, Paxlovid has been shown to reduced hospitalizations and deaths due to COVID-19 by about 89%.\nMost clinicians agree that the use of Paxlovid in patients at high risk for severe disease far outweighs the potential risk of minor rebound symptoms. Severe complications due to rebound have been rarely reported.\nData from studies (EPIC-HR, EPIC-SR; both randomized placebo-controlled trials) showed that rebound in SARS-CoV-2 (RNA or virus) shedding or self-reported COVID-19 symptoms occurred in a subset of patients but happened at similar rates in patients receiving either Paxlovid or placebo. According to the FDA, no association between Paxlovid treatment and COVID-19 rebound has been proven.\nWhat symptoms occur with COVID rebound?\nCase reports suggest that people who develop COVID rebound after completing 5 days of treatment show either no symptoms or mild illness. Symptoms can vary but the most commonly include cough (44%), fatigue or tiredness (35%) and headache (35%).\nSymptoms typically return 2 to 8 days after finishing treatment but are transient and usually clear up in 1 to 3 days. There have been no reports of deaths related to COVID rebound.\nWhat does Paxlovid treat?\nPaxlovid\n(nirmatrelvir and ritonavir) is an oral antiviral treatment and is approved by the FDA to be used for early-stage treatment (within 5 days of symptoms onset) of mild to moderate COVID-19 in adults at high risk for progression to severe disease, hospitalization or death.\nPaxlovid treatment should begin\nas soon as possible\nand within 5 days of COVID symptom onset among persons eligible to receive the treatment.\nPaxlovid is also available under an Emergency Use Authorization (EUA) to treat patients 12 to 18 years old (weighing at least 40 kg) for mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death.\nSome medicines may interact with Paxlovid and can cause serious side effects. There are certain medicines you cannot take with this medicine.\nTell your healthcare provider about all the medicines you take, including over-the-counter medicines, vitamins and herbal products.\nHave your healthcare provider complete a\ndrug interaction review\nprior to starting treatment with Paxlovid.\nRelated questions\nPaxlovid side effects: 8 key things to know\nHow fast does Paxlovid work?\nDoes Paxlovid make you less contagious?\nDo I have to isolate if I have Paxlovid rebound?\nIf you test positive again after finishing Paxlovid you should restart isolation for at least 5 full days and contact your healthcare provider for further instructions. You may still be shedding virus and be contagious.\nYou can end your rebound isolation period after 5 days if your fever is gone for 24 hours (without the use of fever-reducing medication) and your symptoms (such as cough, body aches, shortness of breath) are improving.\nWear a mask for 10 days after your rebound symptoms start, even if you've ended the 5 day isolation period.\nSome people continue to test positive 10 days after COVID-19 rebound begins, but are much less likely to be contagious by this time.\nHow quickly does Paxlovid (COVID-19) rebound start?\nCOVID-19 rebound has been reported to begin between 2 and 8 days after initial recovery. You may develop a recurrence of COVID-19 symptoms and \/ or a new positive viral test 2 to 8 days after having tested negative.\nCase reports suggest that symptoms and positive test results improve or resolve most commonly within a 3 day period, but can be shorter or longer.\nThis rebound effect is not a new COVID infection or due to Paxlovid resistance. The CDC reported no other respiratory pathogens were identified among known cases.\nHow often does rebound occur with Paxlovid?\nThe exact incidence is not known. Rebound has been reported to occur in about 8% of people, but numbers could be greater because some people may never retest if they remain asymptomatic (without symptoms). In the EPIC-HR study, rebound was observed in 8.3% of people who took Paxlovid compared to 5.7% of people who took a placebo (inactive) treatment (p=0.04%)\nCOVID rebound was also reported in a retrospective study that looked back at the history of patients who took no COVID treatment.\nRebound associated with symptoms was reported in 26% of people in this study, most commonly 11 days after initial symptom onset.\nHowever, both symptoms rebound and high-level viral testing rebound was observed in only 3% of participants.\nThis is not all the information you need to know about\nPaxlovid\n(nirmatrelvir and ritonavir) for safe and effective use and does not take the place of your doctor’s directions. Review the full Paxlovid product information and discuss this information and any questions you have with your doctor or other health care provider.\nReferences\nFrequently Asked Questions on the Emergency Use Authorization for Paxlovid for Treatment of COVID-19. Revised: 11\/1\/2023. US Food and Drug Administration (FDA). Accessed Nov. 6, 2023 at https:\/\/www.fda.gov\/media\/155052\/download\nFDA Briefing Document. NDA# 217188. Drug name: nirmatrelvir tablets and ritonavir tablets copackaged for oral use. Applicant: Pfizer Inc. Antimicrobial Drugs Advisory Committee Meeting March 16, 2023. Accessed Aug 24, 2023 at\nhttps:\/\/www.fda.gov\/media\/166197\/download\nDeo R, Choudhary MC, Moser C, et al; ACTIV-2\/A5401 Study Team. Symptom and Viral Rebound in Untreated SARS-CoV-2 Infection. Ann Intern Med. 2023 Mar;176(3):348-354. doi: 10.7326\/M22-2381.\nFDA Approves Paxlovid (nirmatrelvir tablets and ritonavir tablets) for Adult Patients at High Risk of Progression to Severe COVID-19 Drugs.com May 25, 2023 at\nhttps:\/\/www.drugs.com\/newdrugs\/fda-approves-paxlovid-nirmatrelvir-ritonavir-adult-patients-risk-progression-severe-covid-19-6028.html\nCOVID-19 Rebound After Paxlovid Treatment. CDC Health Advisory. May 24, 2022. Accessed Aug 24, 2023 at\nhttps:\/\/emergency.cdc.gov\/han\/2022\/pdf\/CDC_HAN_467.pdf\nPeople with Certain Medical Conditions and COVID-19 risk factors. US Centers for Disease Control and Information (CDC). Updated June 24, 2024. Accessed Oct 24, 2024 at\nhttps:\/\/www.cdc.gov\/covid\/risk-factors\/\nCohen P (author). COVID-19: Management of adults with acute illness in the outpatient setting. Up to Date. Accessed Aug 24, 2023 at\nhttps:\/\/www.uptodate.com\/contents\/covid-19-management-of-adults-with-acute-illness-in-the-outpatient-setting#H777607805\nFact Sheet. EUA for Paxlovid for COVID-19. Pfizer. Updated 5\/2023. Accessed Aug 24, 2023 at\nhttps:\/\/www.fda.gov\/media\/155051\/download\nA Study to Learn About a Repeat 5-Day Treatment With the Study Medicines (Called Nirmatrelvir\/Ritonavir) in People 12 Years Old or Older With Return of COVID-19 Symptoms and SARS-CoV-2 Positivity After Finishing Treatment With Nirmatrelvir\/Ritonavir. ID# NCT05567952. Clinical Trials.gov.\nhttps:\/\/www.clinicaltrials.gov\/study\/NCT05567952\nEbell MH. Rebound Symptoms Common With COVID-19 Even After Placebo Treatment. Am Fam Physician. 2023 Apr;107(4):432-433. PMID: 37054427.\nPaxlovidinformation.com. Pfizer Inc.\nhttps:\/\/www.paxlovidinformation.com\/\nRead next\nHow effective is Paxlovid for COVID-19?\nPaxlovid is effective at lowering the risk of hospitalization or death by 86% for adult patients who are at high risk of COVID-19 progressing to severe illness when Paxlovid is started within the first 3 days of COVID-19 symptoms.\nContinue reading\nWhen should you take Paxlovid?\nIf you have been prescribed Paxlovid (nirmatrelvir and ritonavir), you should take it as soon as possible. Paxlovid works best if it is taken within 5 days of the start of COVID-19 symptoms.\nContinue reading\nHow do Paxlovid and molnupiravir compare for COVID-19?\nPaxlovid (nirmatrelvir and ritonavir) and Lagevrio (molnupiravir) are two oral treatment options for mild-to-moderate coronavirus disease 2019 (COVID-19) in people who are at high risk for severe COVID-19 disease. However, they have some key differences.\nContinue reading\nSee also:\nRelated medical questions\nDoes Paxlovid prevent Long COVID?\nCan pharmacists prescribe Paxlovid?\nShould I take Paxlovid after a Positive COVID-19 Test?\nWhat Drugs Prevent or Treat Serious COVID-19 Cases\nCan you have Covid without a fever?\nWhich breathing techniques help with COVID-19?\nHow effective is Lagevrio (molnupiravir) for COVID-19?\nIs Omicron worse than Delta?\nCan you become immune to COVID-19?\nIs obesity a major risk factor for Covid-19?\nCOVID-19 vaccines and variants: What you should know\nShould I wear a face mask to protect myself from COVID-19?\nCOVID-19: Why is social distancing so important?\nWhy do more men die from coronavirus?\nCan ivermectin be used to treat COVID-19?\nCan you take Ibuprofen if you have COVID-19 (coronavirus)?\nWhat antibiotics kill Covid-19 (coronavirus)?\nCOVID-19: What are the Stages and Causes of Death?\nWhat's the difference between Bacteria and Viruses?\nDoes Zinc protect you from Covid-19 or boost your immune system?\nWhat is the difference between Spikevax and mNEXSPIKE?\nHow do I Treat Nasal Congestion with COVID-19?\nDoes Losartan block COVID-19 Coronavirus Receptors?\nAn Update: Is hydroxychloroquine effective for COVID-19?\nDoes Tamiflu (oseltamivir) work on COVID-19?\nWhere can I buy an at-home test kit for COVID-19?\nCan vitamin C prevent or treat COVID-19 (coronavirus)?\nDoes Mucinex help with Covid?\nWhat are JAK inhibitors and how do they work?\nCan I take NyQuil with COVID or after the COVID vaccine?\nDrug information\nPaxlovid Information for Consumers\nPaxlovid prescribing info & package insert\n(for Health Professionals)\nSide Effects of Paxlovid\n(detailed)\nPaxlovid user reviews\n(541)\nRelated support groups\nPaxlovid\n(19 questions, 22 members)\nCOVID-19\n(103 questions, 92 members)\nMedical Disclaimer","attrs_markdown":"[Skip to main content](https:\/\/www.drugs.com\/medical-answers\/you-paxlovid-covid-rebounds-3569972\/#content)\n\n[![Drugs.com - Go to homepage](https:\/\/www.drugs.com\/img\/logo\/drugscom-logo.svg)](https:\/\/www.drugs.com\/)\n\n[Register](https:\/\/www.drugs.com\/account\/register\/) [Sign in](https:\/\/www.drugs.com\/account\/login\/)\n\nSite navigation\n\n- [**Upgrade to a Plus Plan** Remove ads and unlock more features.](https:\/\/www.drugs.com\/account\/plan\/?launch=ddc-tier-1)\n- [Register](https:\/\/www.drugs.com\/account\/register\/) [Sign in](https:\/\/www.drugs.com\/account\/login\/)\n- [Drugs A-Z](https:\/\/www.drugs.com\/drug_information.html)\n- [Pill Identifier](https:\/\/www.drugs.com\/pill_identification.html)\n- [Drug Interaction Checker](https:\/\/www.drugs.com\/drug_interactions.html)\n- [Compare Drugs](https:\/\/www.drugs.com\/compare\/)\n- [News](https:\/\/www.drugs.com\/news.html)\n- [Pro Edition](https:\/\/www.drugs.com\/professionals.html)\n- [More Resources](https:\/\/www.drugs.com\/sitemap.html)\n- [Help & Support](https:\/\/www.drugs.com\/support\/)\n\nClose\n\n1. [Home](https:\/\/www.drugs.com\/)\n2. [Paxlovid](https:\/\/www.drugs.com\/paxlovid.html)\n3. FAQ\n\n# Can you take Paxlovid twice if COVID rebounds?\nMedically reviewed by [Leigh Ann Anderson, PharmD](https:\/\/www.drugs.com\/support\/editor\/14\/leigh-ann-anderson-pharmd.html). Last updated on Oct 24, 2024.\n\n**Official Answer** by Drugs.com\n\nNo, a second round of Paxlovid treatment is not needed after the initial 5-day treatment if COVID rebound occurs. Case reports suggest that most people who develop COVID rebound after completing 5 days of treatment have either no symptoms or mild illness. To date, there is no association between Paxlovid treatment and COVID rebound.\n\nAn FDA analysis has stated that COVID rebound associated with symptoms and \/ or a positive viral test may occur as part of the natural course of the disease, whether or not you take Paxlovid.\n\nCOVID rebound has also been reported to occur with Lagevrio (molnupiravir), another COVID antiviral medicine, in people who have not taken any treatment, and those who are vaccinated or not vaccinated.\n\nAt this time, the original 5-day treatment period for Paxlovid is recommended in the product labeling and by the Centers for Disease Control and Prevention (CDC). In studies, Paxlovid has been shown to reduced hospitalizations and deaths due to COVID-19 by about 89%.\n\nMost clinicians agree that the use of Paxlovid in patients at high risk for severe disease far outweighs the potential risk of minor rebound symptoms. Severe complications due to rebound have been rarely reported.\n\nData from studies (EPIC-HR, EPIC-SR; both randomized placebo-controlled trials) showed that rebound in SARS-CoV-2 (RNA or virus) shedding or self-reported COVID-19 symptoms occurred in a subset of patients but happened at similar rates in patients receiving either Paxlovid or placebo. According to the FDA, no association between Paxlovid treatment and COVID-19 rebound has been proven.\n\n## What symptoms occur with COVID rebound?\nCase reports suggest that people who develop COVID rebound after completing 5 days of treatment show either no symptoms or mild illness. Symptoms can vary but the most commonly include cough (44%), fatigue or tiredness (35%) and headache (35%).\n\nSymptoms typically return 2 to 8 days after finishing treatment but are transient and usually clear up in 1 to 3 days. There have been no reports of deaths related to COVID rebound.\n\n## What does Paxlovid treat?\n- [Paxlovid](https:\/\/www.drugs.com\/paxlovid.html) (nirmatrelvir and ritonavir) is an oral antiviral treatment and is approved by the FDA to be used for early-stage treatment (within 5 days of symptoms onset) of mild to moderate COVID-19 in adults at high risk for progression to severe disease, hospitalization or death.\n- Paxlovid treatment should begin\n  as soon as possible\n  and within 5 days of COVID symptom onset among persons eligible to receive the treatment.\n\nPaxlovid is also available under an Emergency Use Authorization (EUA) to treat patients 12 to 18 years old (weighing at least 40 kg) for mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death.\n\nSome medicines may interact with Paxlovid and can cause serious side effects. There are certain medicines you cannot take with this medicine.\n\n- Tell your healthcare provider about all the medicines you take, including over-the-counter medicines, vitamins and herbal products.\n- Have your healthcare provider complete a [drug interaction review](https:\/\/www.drugs.com\/drug_interactions.html) prior to starting treatment with Paxlovid.\n## Related questions\n- [Paxlovid side effects: 8 key things to know](https:\/\/www.drugs.com\/medical-answers\/paxlovid-side-effects-8-key-things-3573430\/)\n- [How fast does Paxlovid work?](https:\/\/www.drugs.com\/medical-answers\/fast-paxlovid-work-3570271\/)\n- [Does Paxlovid make you less contagious?](https:\/\/www.drugs.com\/medical-answers\/paxlovid-make-you-contagious-3578401\/)\n## Do I have to isolate if I have Paxlovid rebound?\n- If you test positive again after finishing Paxlovid you should restart isolation for at least 5 full days and contact your healthcare provider for further instructions. You may still be shedding virus and be contagious.\n- You can end your rebound isolation period after 5 days if your fever is gone for 24 hours (without the use of fever-reducing medication) and your symptoms (such as cough, body aches, shortness of breath) are improving.\n- Wear a mask for 10 days after your rebound symptoms start, even if you've ended the 5 day isolation period.\n- Some people continue to test positive 10 days after COVID-19 rebound begins, but are much less likely to be contagious by this time.\n## How quickly does Paxlovid (COVID-19) rebound start?\nCOVID-19 rebound has been reported to begin between 2 and 8 days after initial recovery. You may develop a recurrence of COVID-19 symptoms and \/ or a new positive viral test 2 to 8 days after having tested negative.\n\nCase reports suggest that symptoms and positive test results improve or resolve most commonly within a 3 day period, but can be shorter or longer.\n\nThis rebound effect is not a new COVID infection or due to Paxlovid resistance. The CDC reported no other respiratory pathogens were identified among known cases.\n\n## How often does rebound occur with Paxlovid?\nThe exact incidence is not known. Rebound has been reported to occur in about 8% of people, but numbers could be greater because some people may never retest if they remain asymptomatic (without symptoms). In the EPIC-HR study, rebound was observed in 8.3% of people who took Paxlovid compared to 5.7% of people who took a placebo (inactive) treatment (p=0.04%)\n\nCOVID rebound was also reported in a retrospective study that looked back at the history of patients who took no COVID treatment.\n\n- Rebound associated with symptoms was reported in 26% of people in this study, most commonly 11 days after initial symptom onset.\n- However, both symptoms rebound and high-level viral testing rebound was observed in only 3% of participants.\n\nThis is not all the information you need to know about [Paxlovid](https:\/\/www.drugs.com\/paxlovid.html) (nirmatrelvir and ritonavir) for safe and effective use and does not take the place of your doctor’s directions. Review the full Paxlovid product information and discuss this information and any questions you have with your doctor or other health care provider.\n\nReferences\n\n- Frequently Asked Questions on the Emergency Use Authorization for Paxlovid for Treatment of COVID-19. Revised: 11\/1\/2023. US Food and Drug Administration (FDA). Accessed Nov. 6, 2023 at https:\/\/www.fda.gov\/media\/155052\/download\n- FDA Briefing Document. NDA\\# 217188. Drug name: nirmatrelvir tablets and ritonavir tablets copackaged for oral use. Applicant: Pfizer Inc. Antimicrobial Drugs Advisory Committee Meeting March 16, 2023. Accessed Aug 24, 2023 at <https:\/\/www.fda.gov\/media\/166197\/download>\n- Deo R, Choudhary MC, Moser C, et al; ACTIV-2\/A5401 Study Team. Symptom and Viral Rebound in Untreated SARS-CoV-2 Infection. Ann Intern Med. 2023 Mar;176(3):348-354. doi: 10.7326\/M22-2381.\n- FDA Approves Paxlovid (nirmatrelvir tablets and ritonavir tablets) for Adult Patients at High Risk of Progression to Severe COVID-19 Drugs.com May 25, 2023 at <https:\/\/www.drugs.com\/newdrugs\/fda-approves-paxlovid-nirmatrelvir-ritonavir-adult-patients-risk-progression-severe-covid-19-6028.html>\n- COVID-19 Rebound After Paxlovid Treatment. CDC Health Advisory. May 24, 2022. Accessed Aug 24, 2023 at <https:\/\/emergency.cdc.gov\/han\/2022\/pdf\/CDC_HAN_467.pdf>\n- People with Certain Medical Conditions and COVID-19 risk factors. US Centers for Disease Control and Information (CDC). Updated June 24, 2024. Accessed Oct 24, 2024 at <https:\/\/www.cdc.gov\/covid\/risk-factors\/>\n- Cohen P (author). COVID-19: Management of adults with acute illness in the outpatient setting. Up to Date. Accessed Aug 24, 2023 at <https:\/\/www.uptodate.com\/contents\/covid-19-management-of-adults-with-acute-illness-in-the-outpatient-setting#H777607805>\n- Fact Sheet. EUA for Paxlovid for COVID-19. Pfizer. Updated 5\/2023. Accessed Aug 24, 2023 at <https:\/\/www.fda.gov\/media\/155051\/download>\n- A Study to Learn About a Repeat 5-Day Treatment With the Study Medicines (Called Nirmatrelvir\/Ritonavir) in People 12 Years Old or Older With Return of COVID-19 Symptoms and SARS-CoV-2 Positivity After Finishing Treatment With Nirmatrelvir\/Ritonavir. ID\\# NCT05567952. Clinical Trials.gov. <https:\/\/www.clinicaltrials.gov\/study\/NCT05567952>\n- Ebell MH. Rebound Symptoms Common With COVID-19 Even After Placebo Treatment. Am Fam Physician. 2023 Apr;107(4):432-433. PMID: 37054427.\n- Paxlovidinformation.com. Pfizer Inc. <https:\/\/www.paxlovidinformation.com\/>\n## Read next\n## How effective is Paxlovid for COVID-19?\nPaxlovid is effective at lowering the risk of hospitalization or death by 86% for adult patients who are at high risk of COVID-19 progressing to severe illness when Paxlovid is started within the first 3 days of COVID-19 symptoms. [Continue reading](https:\/\/www.drugs.com\/medical-answers\/effective-paxlovid-covid-19-3564414\/)\n\n## When should you take Paxlovid?\nIf you have been prescribed Paxlovid (nirmatrelvir and ritonavir), you should take it as soon as possible. Paxlovid works best if it is taken within 5 days of the start of COVID-19 symptoms.\n\n[Continue reading](https:\/\/www.drugs.com\/medical-answers\/when-you-take-paxlovid-3577824\/)\n\n## How do Paxlovid and molnupiravir compare for COVID-19?\nPaxlovid (nirmatrelvir and ritonavir) and Lagevrio (molnupiravir) are two oral treatment options for mild-to-moderate coronavirus disease 2019 (COVID-19) in people who are at high risk for severe COVID-19 disease. However, they have some key differences.\n\n[Continue reading](https:\/\/www.drugs.com\/medical-answers\/how-paxlovid-molnupiravir-compare-covid-19-3577831\/)\n## See also:\n### [Vyndaqel](https:\/\/www.drugs.com\/vyndaqel.html)\nVyndaqel (tafamidis meglumine) is a transthyretin stabilizer that may be given to reduce death or ...\n\n**Reviews & ratings**\n\n[4 Reviews](https:\/\/www.drugs.com\/comments\/tafamidis\/vyndaqel.html)\n\n[View more](https:\/\/www.drugs.com\/vyndaqel.html)\n\n### [Attruby](https:\/\/www.drugs.com\/attruby.html)\nAttruby (acoramidis) tablets are used to treat cardiomyopathy of wild-type or hereditary ...\n\n**Reviews & ratings**\n\n[Add a review](https:\/\/www.drugs.com\/members_comments_add\/?ddc_id=4656&brand_name_id=20932&condition_id=0)\n\n[View more](https:\/\/www.drugs.com\/attruby.html)\n\n### [Amvuttra](https:\/\/www.drugs.com\/amvuttra.html)\nAmvuttra is used to treat polyneuropathy associated with hereditary transthyretin-mediated ...\n\n**Reviews & ratings**\n\n[1 Review](https:\/\/www.drugs.com\/comments\/vutrisiran\/amvuttra.html)\n\n[View more](https:\/\/www.drugs.com\/amvuttra.html)\n\n### [Wainua](https:\/\/www.drugs.com\/wainua.html)\nWainua (eplontersen) is used to treat polyneuropathy of hereditary transthyretin-mediated ...\n\n**Reviews & ratings**\n\n[1 Review](https:\/\/www.drugs.com\/comments\/eplontersen\/wainua.html)\n\n[View more](https:\/\/www.drugs.com\/wainua.html)\n\n### [Onpattro](https:\/\/www.drugs.com\/onpattro.html)\nOnpattro is used to treat polyneuropathy in adults with hereditary transthyretin-mediated ...\n\n**Reviews & ratings**\n\n[Add a review](https:\/\/www.drugs.com\/members_comments_add\/?ddc_id=3948&brand_name_id=18924&condition_id=0)\n\n[View more](https:\/\/www.drugs.com\/onpattro.html)\n\n### [Inotersen](https:\/\/www.drugs.com\/inotersen.html)\nInotersen (brand name Tegsedi) is a self-administered, once-weekly injection that may be used to ...\n\n**Reviews & ratings**\n\n[Add a review](https:\/\/www.drugs.com\/members_comments_add\/?ddc_id=3969&brand_name_id=0&condition_id=0)\n\n[View more](https:\/\/www.drugs.com\/inotersen.html)\n\n### [Patisiran](https:\/\/www.drugs.com\/patisiran.html)\nPatisiran (brand name Onpattro) is an injectable treatment for polyneuropathy caused by hereditary ...\n\n**Reviews & ratings**\n\n[Add a review](https:\/\/www.drugs.com\/members_comments_add\/?ddc_id=3948&brand_name_id=0&condition_id=0)\n\n[View more](https:\/\/www.drugs.com\/patisiran.html)\n\n### [Eplontersen](https:\/\/www.drugs.com\/eplontersen.html)\nEplontersen (Wainua) is used to treat polyneuropathy of hereditary transthyretin-mediated ...\n\n**Reviews & ratings**\n\n[1 Review](https:\/\/www.drugs.com\/comments\/eplontersen\/)\n\n[View more](https:\/\/www.drugs.com\/eplontersen.html)\n\n### [Vutrisiran](https:\/\/www.drugs.com\/vutrisiran.html)\nVutrisiran (brand name Amvuttra) is used to treat nerve damage associated with hereditary ...\n\n**Reviews & ratings**\n\n[1 Review](https:\/\/www.drugs.com\/comments\/vutrisiran\/)\n\n[View more](https:\/\/www.drugs.com\/vutrisiran.html)\n\n### [Xenazine](https:\/\/www.drugs.com\/xenazine.html)\nXenazine (tetrabenazine) is used to treat Huntington's chorea (uncontrolled muscle ...\n\n**Reviews & ratings**\n\n[2 Reviews](https:\/\/www.drugs.com\/comments\/tetrabenazine\/xenazine.html)\n\n[View more](https:\/\/www.drugs.com\/xenazine.html)\n\n### [Ingrezza](https:\/\/www.drugs.com\/ingrezza.html)\nIngrezza (valbenazine) is used to treat tardive dyskinesia (TD) and chorea associated with ...\n\n**Reviews & ratings**\n\n6\\.2 \/ 10\n\n[24 Reviews](https:\/\/www.drugs.com\/comments\/valbenazine\/ingrezza.html)\n\n[View more](https:\/\/www.drugs.com\/ingrezza.html)\n\n### [Vitamin B6](https:\/\/www.drugs.com\/mtm\/vitamin-b6.html)\nVitamin B6 is used for anemia, dietary supplementation, drug induced vitamin\/mineral deficiency ...\n\n**Reviews & ratings**\n\n[3 Reviews](https:\/\/www.drugs.com\/comments\/pyridoxine\/vitamin-b6.html)\n\n[View more](https:\/\/www.drugs.com\/mtm\/vitamin-b6.html)\n\n### [Gocovri](https:\/\/www.drugs.com\/gocovri.html)\nGocovri (amantadine) is used in the treatment of Parkinson's disease. Includes Gocovri side ...\n\n**Reviews & ratings**\n\n[6 Reviews](https:\/\/www.drugs.com\/comments\/amantadine\/gocovri.html)\n\n[View more](https:\/\/www.drugs.com\/gocovri.html)\n\n### [Symmetrel](https:\/\/www.drugs.com\/cons\/symmetrel.html)\nSymmetrel is used for extrapyramidal reaction, parkinson's disease\n\n**Reviews & ratings**\n\n[3 Reviews](https:\/\/www.drugs.com\/comments\/amantadine\/symmetrel.html)\n\n[View more](https:\/\/www.drugs.com\/cons\/symmetrel.html)\n\n### [Osmolex ER](https:\/\/www.drugs.com\/mtm\/osmolex-er.html)\nOsmolex ER is used for extrapyramidal reaction, parkinson's disease\n\n**Reviews & ratings**\n\n[Add a review](https:\/\/www.drugs.com\/members_comments_add\/?ddc_id=148&brand_name_id=18795&condition_id=0)\n\n[View more](https:\/\/www.drugs.com\/mtm\/osmolex-er.html)\n\n### [Valbenazine](https:\/\/www.drugs.com\/valbenazine.html)\nValbenazine (Ingrezza) is used to treat tardive dyskinesia (TD) and chorea associated with ...\n\n**Reviews & ratings**\n\n6\\.3 \/ 10\n\n[25 Reviews](https:\/\/www.drugs.com\/comments\/valbenazine\/)\n\n[View more](https:\/\/www.drugs.com\/valbenazine.html)\n\n### [Vitamin e](https:\/\/www.drugs.com\/vitamin_e.html)\nVitamin E is an antioxidant that occurs naturally in some foods and is used to treat or prevent ...\n\n**Reviews & ratings**\n\n[7 Reviews](https:\/\/www.drugs.com\/comments\/vitamin-e\/)\n\n[View more](https:\/\/www.drugs.com\/vitamin_e.html)\n\n### [Pyridoxine](https:\/\/www.drugs.com\/mtm\/pyridoxine.html)\nPyridoxine is used for anemia, dietary supplementation, drug induced vitamin\/mineral deficiency ...\n\n**Reviews & ratings**\n\n[4 Reviews](https:\/\/www.drugs.com\/comments\/pyridoxine\/)\n\n[View more](https:\/\/www.drugs.com\/mtm\/pyridoxine.html)\n\n### [Amantadine](https:\/\/www.drugs.com\/amantadine.html)\nEasy-to-read patient leaflet for amantadine. Includes indications, proper use, special ...\n\n**Reviews & ratings**\n\n6\\.8 \/ 10\n\n[64 Reviews](https:\/\/www.drugs.com\/comments\/amantadine\/)\n\n[View more](https:\/\/www.drugs.com\/amantadine.html)\n### Related medical questions\n- [Does Paxlovid prevent Long COVID?](https:\/\/www.drugs.com\/medical-answers\/paxlovid-prevent-long-covid-3575586\/)\n- [Can pharmacists prescribe Paxlovid?](https:\/\/www.drugs.com\/medical-answers\/pharmacists-prescribe-paxlovid-3577842\/)\n- [Should I take Paxlovid after a Positive COVID-19 Test?](https:\/\/www.drugs.com\/insights\/paxlovid-after-positive-covid-19-test-3571219\/)\n- [What Drugs Prevent or Treat Serious COVID-19 Cases](https:\/\/www.drugs.com\/insights\/medications-prevent-treat-serious-covid-19-cases-3571309\/)\n- [Can you have Covid without a fever?](https:\/\/www.drugs.com\/medical-answers\/you-covid-fever-3565057\/)\n- [Which breathing techniques help with 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system?](https:\/\/www.drugs.com\/medical-answers\/zinc-protect-you-covid-19-boost-immune-system-3535446\/)\n- [What is the difference between Spikevax and mNEXSPIKE?](https:\/\/www.drugs.com\/medical-answers\/what-difference-between-spikevax-mnexspike-3580787\/)\n- [How do I Treat Nasal Congestion with COVID-19?](https:\/\/www.drugs.com\/insights\/treat-nasal-congestion-covid-19-3571216\/)\n- [Does Losartan block COVID-19 Coronavirus Receptors?](https:\/\/www.drugs.com\/medical-answers\/losartan-shown-receptor-block-coronavirus-3534166\/)\n- [An Update: Is hydroxychloroquine effective for COVID-19?](https:\/\/www.drugs.com\/medical-answers\/hydroxychloroquine-effective-covid-19-3536024\/)\n- [Does Tamiflu (oseltamivir) work on COVID-19?](https:\/\/www.drugs.com\/medical-answers\/tamiflu-work-covid-19-3537049\/)\n- [Where can I buy an at-home test kit for COVID-19?](https:\/\/www.drugs.com\/medical-answers\/buy-home-test-kit-covid-19-coronavirus-3534945\/)\n- [Can vitamin C prevent or treat COVID-19 (coronavirus)?](https:\/\/www.drugs.com\/medical-answers\/vitamin-protect-you-covid-19-coronavirus-disease-3534829\/)\n- [Does Mucinex help with Covid?](https:\/\/www.drugs.com\/medical-answers\/mucinex-help-covid-3574704\/)\n- [What are JAK inhibitors and how do they work?](https:\/\/www.drugs.com\/medical-answers\/what-jak-inhibitors-how-work-3575417\/)\n- [Can I take NyQuil with COVID or after the COVID vaccine?](https:\/\/www.drugs.com\/medical-answers\/nyquil-covid-after-covid-vaccine-3566108\/)\n### Drug information\n- [Paxlovid Information for Consumers](https:\/\/www.drugs.com\/paxlovid.html)\n- [Paxlovid prescribing info & package insert](https:\/\/www.drugs.com\/pro\/paxlovid.html) (for Health Professionals)\n- [Side Effects of Paxlovid](https:\/\/www.drugs.com\/sfx\/paxlovid-side-effects.html) (detailed)\n- [Paxlovid user reviews](https:\/\/www.drugs.com\/comments\/nirmatrelvir-ritonavir\/paxlovid.html) (541)\n### Related support groups\n- [Paxlovid](https:\/\/www.drugs.com\/answers\/support-group\/paxlovid\/) (19 questions, 22 members)\n- [COVID-19](https:\/\/www.drugs.com\/answers\/support-group\/covid-19\/) (103 questions, 92 members)\n\n[Medical Disclaimer](https:\/\/www.drugs.com\/support\/disclaimer.html)\n\n**Drugs.com Mobile App**\n\nAccess drug & treatment information, identify pills, check interactions and set up personal medication records.\n\n[Download the Medication Guide app on iTunes ![](https:\/\/www.drugs.com\/img\/v-20250930\/apps\/apple-store.png)](https:\/\/apps.apple.com\/us\/app\/drugs-com-medication-guide\/id599471042?platform=iphone)   [Download the Medication Guide app on the Google Play store ![](https:\/\/www.drugs.com\/img\/v-20250930\/apps\/google-play.png)](https:\/\/play.google.com\/store\/apps\/details?id=com.drugscom.app)\n\n![Drugs.com mobile app](https:\/\/www.drugs.com\/img\/v-20250709\/apps\/promo-uberapp.png)\n\n[Drugs.com 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This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex (updated Mar 31, 2026), Cerner Multum™ (updated Apr 12, 2026), ASHP (updated Mar 10, 2026) and others.\n\n[![Certified by TRUSTe](https:\/\/privacy-policy.truste.com\/privacy-seal\/seal?rid=d18cba4a-afc4-4863-af81-8262bb120271)](https:\/\/privacy.truste.com\/privacy-seal\/validation?rid=d18cba4a-afc4-4863-af81-8262bb120271)  ![Verified by TAG](https:\/\/www.drugs.com\/img\/v-20240725\/logo\/vendor\/tag-verified.png)  [![This website is certified by AACI. Click to verify.](https:\/\/www.drugs.com\/img\/v-20251028\/logo\/vendor\/trust-mark-logo.png)](https:\/\/aacihealthcare.com\/certificates\/c173-2022-trust-us\/)   [![AdChoices - Ad privacy information](https:\/\/www.drugs.com\/img\/v-20240725\/logo\/vendor\/adchoices-logomark.png)](https:\/\/www.drugs.com\/support\/privacy\/advertising.html)\n\nCopyright © 2000-2026 Drugs.com. All rights reserved.","attrs_readable_markdown":"**Official Answer** by Drugs.com\n\nNo, a second round of Paxlovid treatment is not needed after the initial 5-day treatment if COVID rebound occurs. Case reports suggest that most people who develop COVID rebound after completing 5 days of treatment have either no symptoms or mild illness. To date, there is no association between Paxlovid treatment and COVID rebound.\n\nAn FDA analysis has stated that COVID rebound associated with symptoms and \/ or a positive viral test may occur as part of the natural course of the disease, whether or not you take Paxlovid.\n\nCOVID rebound has also been reported to occur with Lagevrio (molnupiravir), another COVID antiviral medicine, in people who have not taken any treatment, and those who are vaccinated or not vaccinated.\n\nAt this time, the original 5-day treatment period for Paxlovid is recommended in the product labeling and by the Centers for Disease Control and Prevention (CDC). In studies, Paxlovid has been shown to reduced hospitalizations and deaths due to COVID-19 by about 89%.\n\nMost clinicians agree that the use of Paxlovid in patients at high risk for severe disease far outweighs the potential risk of minor rebound symptoms. Severe complications due to rebound have been rarely reported.\n\nData from studies (EPIC-HR, EPIC-SR; both randomized placebo-controlled trials) showed that rebound in SARS-CoV-2 (RNA or virus) shedding or self-reported COVID-19 symptoms occurred in a subset of patients but happened at similar rates in patients receiving either Paxlovid or placebo. According to the FDA, no association between Paxlovid treatment and COVID-19 rebound has been proven.\n\n## What symptoms occur with COVID rebound?\nCase reports suggest that people who develop COVID rebound after completing 5 days of treatment show either no symptoms or mild illness. Symptoms can vary but the most commonly include cough (44%), fatigue or tiredness (35%) and headache (35%).\n\nSymptoms typically return 2 to 8 days after finishing treatment but are transient and usually clear up in 1 to 3 days. There have been no reports of deaths related to COVID rebound.\n\n## What does Paxlovid treat?\n- [Paxlovid](https:\/\/www.drugs.com\/paxlovid.html) (nirmatrelvir and ritonavir) is an oral antiviral treatment and is approved by the FDA to be used for early-stage treatment (within 5 days of symptoms onset) of mild to moderate COVID-19 in adults at high risk for progression to severe disease, hospitalization or death.\n- Paxlovid treatment should begin\n  as soon as possible\n  and within 5 days of COVID symptom onset among persons eligible to receive the treatment.\n\nPaxlovid is also available under an Emergency Use Authorization (EUA) to treat patients 12 to 18 years old (weighing at least 40 kg) for mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death.\n\nSome medicines may interact with Paxlovid and can cause serious side effects. There are certain medicines you cannot take with this medicine.\n\n- Tell your healthcare provider about all the medicines you take, including over-the-counter medicines, vitamins and herbal products.\n- Have your healthcare provider complete a [drug interaction review](https:\/\/www.drugs.com\/drug_interactions.html) prior to starting treatment with Paxlovid.\n## Related questions\n- [Paxlovid side effects: 8 key things to know](https:\/\/www.drugs.com\/medical-answers\/paxlovid-side-effects-8-key-things-3573430\/)\n- [How fast does Paxlovid work?](https:\/\/www.drugs.com\/medical-answers\/fast-paxlovid-work-3570271\/)\n- [Does Paxlovid make you less contagious?](https:\/\/www.drugs.com\/medical-answers\/paxlovid-make-you-contagious-3578401\/)\n## Do I have to isolate if I have Paxlovid rebound?\n- If you test positive again after finishing Paxlovid you should restart isolation for at least 5 full days and contact your healthcare provider for further instructions. You may still be shedding virus and be contagious.\n- You can end your rebound isolation period after 5 days if your fever is gone for 24 hours (without the use of fever-reducing medication) and your symptoms (such as cough, body aches, shortness of breath) are improving.\n- Wear a mask for 10 days after your rebound symptoms start, even if you've ended the 5 day isolation period.\n- Some people continue to test positive 10 days after COVID-19 rebound begins, but are much less likely to be contagious by this time.\n## How quickly does Paxlovid (COVID-19) rebound start?\nCOVID-19 rebound has been reported to begin between 2 and 8 days after initial recovery. You may develop a recurrence of COVID-19 symptoms and \/ or a new positive viral test 2 to 8 days after having tested negative.\n\nCase reports suggest that symptoms and positive test results improve or resolve most commonly within a 3 day period, but can be shorter or longer.\n\nThis rebound effect is not a new COVID infection or due to Paxlovid resistance. The CDC reported no other respiratory pathogens were identified among known cases.\n\n## How often does rebound occur with Paxlovid?\nThe exact incidence is not known. Rebound has been reported to occur in about 8% of people, but numbers could be greater because some people may never retest if they remain asymptomatic (without symptoms). In the EPIC-HR study, rebound was observed in 8.3% of people who took Paxlovid compared to 5.7% of people who took a placebo (inactive) treatment (p=0.04%)\n\nCOVID rebound was also reported in a retrospective study that looked back at the history of patients who took no COVID treatment.\n\n- Rebound associated with symptoms was reported in 26% of people in this study, most commonly 11 days after initial symptom onset.\n- However, both symptoms rebound and high-level viral testing rebound was observed in only 3% of participants.\n\nThis is not all the information you need to know about [Paxlovid](https:\/\/www.drugs.com\/paxlovid.html) (nirmatrelvir and ritonavir) for safe and effective use and does not take the place of your doctor’s directions. Review the full Paxlovid product information and discuss this information and any questions you have with your doctor or other health care provider.\n\nReferences\n\n- Frequently Asked Questions on the Emergency Use Authorization for Paxlovid for Treatment of COVID-19. Revised: 11\/1\/2023. US Food and Drug Administration (FDA). Accessed Nov. 6, 2023 at https:\/\/www.fda.gov\/media\/155052\/download\n- FDA Briefing Document. NDA\\# 217188. Drug name: nirmatrelvir tablets and ritonavir tablets copackaged for oral use. Applicant: Pfizer Inc. Antimicrobial Drugs Advisory Committee Meeting March 16, 2023. Accessed Aug 24, 2023 at <https:\/\/www.fda.gov\/media\/166197\/download>\n- Deo R, Choudhary MC, Moser C, et al; ACTIV-2\/A5401 Study Team. Symptom and Viral Rebound in Untreated SARS-CoV-2 Infection. Ann Intern Med. 2023 Mar;176(3):348-354. doi: 10.7326\/M22-2381.\n- FDA Approves Paxlovid (nirmatrelvir tablets and ritonavir tablets) for Adult Patients at High Risk of Progression to Severe COVID-19 Drugs.com May 25, 2023 at <https:\/\/www.drugs.com\/newdrugs\/fda-approves-paxlovid-nirmatrelvir-ritonavir-adult-patients-risk-progression-severe-covid-19-6028.html>\n- COVID-19 Rebound After Paxlovid Treatment. CDC Health Advisory. May 24, 2022. Accessed Aug 24, 2023 at <https:\/\/emergency.cdc.gov\/han\/2022\/pdf\/CDC_HAN_467.pdf>\n- People with Certain Medical Conditions and COVID-19 risk factors. US Centers for Disease Control and Information (CDC). Updated June 24, 2024. Accessed Oct 24, 2024 at <https:\/\/www.cdc.gov\/covid\/risk-factors\/>\n- Cohen P (author). COVID-19: Management of adults with acute illness in the outpatient setting. Up to Date. Accessed Aug 24, 2023 at <https:\/\/www.uptodate.com\/contents\/covid-19-management-of-adults-with-acute-illness-in-the-outpatient-setting#H777607805>\n- Fact Sheet. EUA for Paxlovid for COVID-19. Pfizer. Updated 5\/2023. Accessed Aug 24, 2023 at <https:\/\/www.fda.gov\/media\/155051\/download>\n- A Study to Learn About a Repeat 5-Day Treatment With the Study Medicines (Called Nirmatrelvir\/Ritonavir) in People 12 Years Old or Older With Return of COVID-19 Symptoms and SARS-CoV-2 Positivity After Finishing Treatment With Nirmatrelvir\/Ritonavir. ID\\# NCT05567952. Clinical Trials.gov. <https:\/\/www.clinicaltrials.gov\/study\/NCT05567952>\n- Ebell MH. Rebound Symptoms Common With COVID-19 Even After Placebo Treatment. Am Fam Physician. 2023 Apr;107(4):432-433. PMID: 37054427.\n- Paxlovidinformation.com. Pfizer Inc. <https:\/\/www.paxlovidinformation.com\/>\n## Read next\n## How effective is Paxlovid for COVID-19?\nPaxlovid is effective at lowering the risk of hospitalization or death by 86% for adult patients who are at high risk of COVID-19 progressing to severe illness when Paxlovid is started within the first 3 days of COVID-19 symptoms. [Continue reading](https:\/\/www.drugs.com\/medical-answers\/effective-paxlovid-covid-19-3564414\/)\n\n## When should you take Paxlovid?\nIf you have been prescribed Paxlovid (nirmatrelvir and ritonavir), you should take it as soon as possible. Paxlovid works best if it is taken within 5 days of the start of COVID-19 symptoms.\n\n[Continue reading](https:\/\/www.drugs.com\/medical-answers\/when-you-take-paxlovid-3577824\/)\n\n## How do Paxlovid and molnupiravir compare for COVID-19?\nPaxlovid (nirmatrelvir and ritonavir) and Lagevrio (molnupiravir) are two oral treatment options for mild-to-moderate coronavirus disease 2019 (COVID-19) in people who are at high risk for severe COVID-19 disease. However, they have some key differences.\n\n[Continue reading](https:\/\/www.drugs.com\/medical-answers\/how-paxlovid-molnupiravir-compare-covid-19-3577831\/)\n## See also:\n### Related medical questions\n- [Does Paxlovid prevent Long COVID?](https:\/\/www.drugs.com\/medical-answers\/paxlovid-prevent-long-covid-3575586\/)\n- [Can pharmacists prescribe Paxlovid?](https:\/\/www.drugs.com\/medical-answers\/pharmacists-prescribe-paxlovid-3577842\/)\n- [Should I take Paxlovid after a Positive COVID-19 Test?](https:\/\/www.drugs.com\/insights\/paxlovid-after-positive-covid-19-test-3571219\/)\n- [What Drugs Prevent or Treat Serious COVID-19 Cases](https:\/\/www.drugs.com\/insights\/medications-prevent-treat-serious-covid-19-cases-3571309\/)\n- [Can you have Covid without a fever?](https:\/\/www.drugs.com\/medical-answers\/you-covid-fever-3565057\/)\n- [Which breathing techniques help with COVID-19?](https:\/\/www.drugs.com\/medical-answers\/breathing-techniques-covid-19-3536315\/)\n- [How effective is Lagevrio (molnupiravir) for COVID-19?](https:\/\/www.drugs.com\/medical-answers\/effective-lagevrio-molnupiravir-covid-19-3564557\/)\n- [Is Omicron worse than Delta?](https:\/\/www.drugs.com\/medical-answers\/omicron-worse-delta-3564030\/)\n- [Can you become immune to COVID-19?](https:\/\/www.drugs.com\/medical-answers\/you-immune-covid-19-3537185\/)\n- [Is obesity a major risk factor for Covid-19?](https:\/\/www.drugs.com\/medical-answers\/obesity-major-risk-factor-covid-19-3562620\/)\n- [COVID-19 vaccines and variants: What you should know](https:\/\/www.drugs.com\/medical-answers\/coronavirus-mutate-3535321\/)\n- [Should I wear a face mask to protect myself from COVID-19?](https:\/\/www.drugs.com\/medical-answers\/wear-facemask-stop-spread-covid-19-3535713\/)\n- [COVID-19: Why is social distancing so important?](https:\/\/www.drugs.com\/medical-answers\/covid-19-social-distancing-important-3536545\/)\n- [Why do more men die from coronavirus?](https:\/\/www.drugs.com\/medical-answers\/men-die-coronavirus-3536448\/)\n- [Can ivermectin be used to treat COVID-19?](https:\/\/www.drugs.com\/medical-answers\/ivermectin-treat-covid-19-coronavirus-3535912\/)\n- [Can you take Ibuprofen if you have COVID-19 (coronavirus)?](https:\/\/www.drugs.com\/medical-answers\/you-ibuprofen-you-covid-19-coronavirus-disease-3534620\/)\n- [What antibiotics kill Covid-19 (coronavirus)?](https:\/\/www.drugs.com\/medical-answers\/antibiotics-kill-coronavirus-3534867\/)\n- [COVID-19: What are the Stages and Causes of Death?](https:\/\/www.drugs.com\/medical-answers\/covid-19-symptoms-progress-death-3536264\/)\n- [What's the difference between Bacteria and Viruses?](https:\/\/www.drugs.com\/medical-answers\/difference-between-bacteria-virus-3503840\/)\n- [Does Zinc protect you from Covid-19 or boost your immune system?](https:\/\/www.drugs.com\/medical-answers\/zinc-protect-you-covid-19-boost-immune-system-3535446\/)\n- [What is the difference between Spikevax and mNEXSPIKE?](https:\/\/www.drugs.com\/medical-answers\/what-difference-between-spikevax-mnexspike-3580787\/)\n- [How do I Treat Nasal Congestion with COVID-19?](https:\/\/www.drugs.com\/insights\/treat-nasal-congestion-covid-19-3571216\/)\n- [Does Losartan block COVID-19 Coronavirus Receptors?](https:\/\/www.drugs.com\/medical-answers\/losartan-shown-receptor-block-coronavirus-3534166\/)\n- [An Update: Is hydroxychloroquine effective for COVID-19?](https:\/\/www.drugs.com\/medical-answers\/hydroxychloroquine-effective-covid-19-3536024\/)\n- [Does Tamiflu (oseltamivir) work on COVID-19?](https:\/\/www.drugs.com\/medical-answers\/tamiflu-work-covid-19-3537049\/)\n- [Where can I buy an at-home test kit for COVID-19?](https:\/\/www.drugs.com\/medical-answers\/buy-home-test-kit-covid-19-coronavirus-3534945\/)\n- [Can vitamin C prevent or treat COVID-19 (coronavirus)?](https:\/\/www.drugs.com\/medical-answers\/vitamin-protect-you-covid-19-coronavirus-disease-3534829\/)\n- [Does Mucinex help with Covid?](https:\/\/www.drugs.com\/medical-answers\/mucinex-help-covid-3574704\/)\n- [What are JAK inhibitors and how do they work?](https:\/\/www.drugs.com\/medical-answers\/what-jak-inhibitors-how-work-3575417\/)\n- [Can I take NyQuil with COVID or after the COVID vaccine?](https:\/\/www.drugs.com\/medical-answers\/nyquil-covid-after-covid-vaccine-3566108\/)\n### Drug information\n- [Paxlovid Information for Consumers](https:\/\/www.drugs.com\/paxlovid.html)\n- [Paxlovid prescribing info & package insert](https:\/\/www.drugs.com\/pro\/paxlovid.html) (for Health Professionals)\n- [Side Effects of Paxlovid](https:\/\/www.drugs.com\/sfx\/paxlovid-side-effects.html) (detailed)\n- [Paxlovid user reviews](https:\/\/www.drugs.com\/comments\/nirmatrelvir-ritonavir\/paxlovid.html) (541)\n### Related support groups\n- [Paxlovid](https:\/\/www.drugs.com\/answers\/support-group\/paxlovid\/) (19 questions, 22 members)\n- [COVID-19](https:\/\/www.drugs.com\/answers\/support-group\/covid-19\/) (103 questions, 92 members)\n\n[Medical Disclaimer](https:\/\/www.drugs.com\/support\/disclaimer.html)","meta_canonical":null}

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Meta Title	Can you take Paxlovid twice if COVID rebounds?
Meta Description	Official answer: No, a second round of Paxlovid treatment is not needed after the initial 5-day treatment if COVID rebound occurs. Case...
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Boilerpipe Text	Official Answer by Drugs.com No, a second round of Paxlovid treatment is not needed after the initial 5-day treatment if COVID rebound occurs. Case reports suggest that most people who develop COVID rebound after completing 5 days of treatment have either no symptoms or mild illness. To date, there is no association between Paxlovid treatment and COVID rebound. An FDA analysis has stated that COVID rebound associated with symptoms and / or a positive viral test may occur as part of the natural course of the disease, whether or not you take Paxlovid. COVID rebound has also been reported to occur with Lagevrio (molnupiravir), another COVID antiviral medicine, in people who have not taken any treatment, and those who are vaccinated or not vaccinated. At this time, the original 5-day treatment period for Paxlovid is recommended in the product labeling and by the Centers for Disease Control and Prevention (CDC). In studies, Paxlovid has been shown to reduced hospitalizations and deaths due to COVID-19 by about 89%. Most clinicians agree that the use of Paxlovid in patients at high risk for severe disease far outweighs the potential risk of minor rebound symptoms. Severe complications due to rebound have been rarely reported. Data from studies (EPIC-HR, EPIC-SR; both randomized placebo-controlled trials) showed that rebound in SARS-CoV-2 (RNA or virus) shedding or self-reported COVID-19 symptoms occurred in a subset of patients but happened at similar rates in patients receiving either Paxlovid or placebo. According to the FDA, no association between Paxlovid treatment and COVID-19 rebound has been proven. What symptoms occur with COVID rebound? Case reports suggest that people who develop COVID rebound after completing 5 days of treatment show either no symptoms or mild illness. Symptoms can vary but the most commonly include cough (44%), fatigue or tiredness (35%) and headache (35%). Symptoms typically return 2 to 8 days after finishing treatment but are transient and usually clear up in 1 to 3 days. There have been no reports of deaths related to COVID rebound. What does Paxlovid treat? Paxlovid (nirmatrelvir and ritonavir) is an oral antiviral treatment and is approved by the FDA to be used for early-stage treatment (within 5 days of symptoms onset) of mild to moderate COVID-19 in adults at high risk for progression to severe disease, hospitalization or death. Paxlovid treatment should begin as soon as possible and within 5 days of COVID symptom onset among persons eligible to receive the treatment. Paxlovid is also available under an Emergency Use Authorization (EUA) to treat patients 12 to 18 years old (weighing at least 40 kg) for mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death. Some medicines may interact with Paxlovid and can cause serious side effects. There are certain medicines you cannot take with this medicine. Tell your healthcare provider about all the medicines you take, including over-the-counter medicines, vitamins and herbal products. Have your healthcare provider complete a drug interaction review prior to starting treatment with Paxlovid. Related questions Paxlovid side effects: 8 key things to know How fast does Paxlovid work? Does Paxlovid make you less contagious? Do I have to isolate if I have Paxlovid rebound? If you test positive again after finishing Paxlovid you should restart isolation for at least 5 full days and contact your healthcare provider for further instructions. You may still be shedding virus and be contagious. You can end your rebound isolation period after 5 days if your fever is gone for 24 hours (without the use of fever-reducing medication) and your symptoms (such as cough, body aches, shortness of breath) are improving. Wear a mask for 10 days after your rebound symptoms start, even if you've ended the 5 day isolation period. Some people continue to test positive 10 days after COVID-19 rebound begins, but are much less likely to be contagious by this time. How quickly does Paxlovid (COVID-19) rebound start? COVID-19 rebound has been reported to begin between 2 and 8 days after initial recovery. You may develop a recurrence of COVID-19 symptoms and / or a new positive viral test 2 to 8 days after having tested negative. Case reports suggest that symptoms and positive test results improve or resolve most commonly within a 3 day period, but can be shorter or longer. This rebound effect is not a new COVID infection or due to Paxlovid resistance. The CDC reported no other respiratory pathogens were identified among known cases. How often does rebound occur with Paxlovid? The exact incidence is not known. Rebound has been reported to occur in about 8% of people, but numbers could be greater because some people may never retest if they remain asymptomatic (without symptoms). In the EPIC-HR study, rebound was observed in 8.3% of people who took Paxlovid compared to 5.7% of people who took a placebo (inactive) treatment (p=0.04%) COVID rebound was also reported in a retrospective study that looked back at the history of patients who took no COVID treatment. Rebound associated with symptoms was reported in 26% of people in this study, most commonly 11 days after initial symptom onset. However, both symptoms rebound and high-level viral testing rebound was observed in only 3% of participants. This is not all the information you need to know about Paxlovid (nirmatrelvir and ritonavir) for safe and effective use and does not take the place of your doctor’s directions. Review the full Paxlovid product information and discuss this information and any questions you have with your doctor or other health care provider. References Frequently Asked Questions on the Emergency Use Authorization for Paxlovid for Treatment of COVID-19. Revised: 11/1/2023. US Food and Drug Administration (FDA). Accessed Nov. 6, 2023 at https://www.fda.gov/media/155052/download FDA Briefing Document. NDA# 217188. Drug name: nirmatrelvir tablets and ritonavir tablets copackaged for oral use. Applicant: Pfizer Inc. Antimicrobial Drugs Advisory Committee Meeting March 16, 2023. Accessed Aug 24, 2023 at https://www.fda.gov/media/166197/download Deo R, Choudhary MC, Moser C, et al; ACTIV-2/A5401 Study Team. Symptom and Viral Rebound in Untreated SARS-CoV-2 Infection. Ann Intern Med. 2023 Mar;176(3):348-354. doi: 10.7326/M22-2381. FDA Approves Paxlovid (nirmatrelvir tablets and ritonavir tablets) for Adult Patients at High Risk of Progression to Severe COVID-19 Drugs.com May 25, 2023 at https://www.drugs.com/newdrugs/fda-approves-paxlovid-nirmatrelvir-ritonavir-adult-patients-risk-progression-severe-covid-19-6028.html COVID-19 Rebound After Paxlovid Treatment. CDC Health Advisory. May 24, 2022. Accessed Aug 24, 2023 at https://emergency.cdc.gov/han/2022/pdf/CDC_HAN_467.pdf People with Certain Medical Conditions and COVID-19 risk factors. US Centers for Disease Control and Information (CDC). Updated June 24, 2024. Accessed Oct 24, 2024 at https://www.cdc.gov/covid/risk-factors/ Cohen P (author). COVID-19: Management of adults with acute illness in the outpatient setting. Up to Date. Accessed Aug 24, 2023 at https://www.uptodate.com/contents/covid-19-management-of-adults-with-acute-illness-in-the-outpatient-setting#H777607805 Fact Sheet. EUA for Paxlovid for COVID-19. Pfizer. Updated 5/2023. Accessed Aug 24, 2023 at https://www.fda.gov/media/155051/download A Study to Learn About a Repeat 5-Day Treatment With the Study Medicines (Called Nirmatrelvir/Ritonavir) in People 12 Years Old or Older With Return of COVID-19 Symptoms and SARS-CoV-2 Positivity After Finishing Treatment With Nirmatrelvir/Ritonavir. ID# NCT05567952. Clinical Trials.gov. https://www.clinicaltrials.gov/study/NCT05567952 Ebell MH. Rebound Symptoms Common With COVID-19 Even After Placebo Treatment. Am Fam Physician. 2023 Apr;107(4):432-433. PMID: 37054427. Paxlovidinformation.com. Pfizer Inc. https://www.paxlovidinformation.com/ Read next How effective is Paxlovid for COVID-19? Paxlovid is effective at lowering the risk of hospitalization or death by 86% for adult patients who are at high risk of COVID-19 progressing to severe illness when Paxlovid is started within the first 3 days of COVID-19 symptoms. Continue reading When should you take Paxlovid? If you have been prescribed Paxlovid (nirmatrelvir and ritonavir), you should take it as soon as possible. Paxlovid works best if it is taken within 5 days of the start of COVID-19 symptoms. Continue reading How do Paxlovid and molnupiravir compare for COVID-19? Paxlovid (nirmatrelvir and ritonavir) and Lagevrio (molnupiravir) are two oral treatment options for mild-to-moderate coronavirus disease 2019 (COVID-19) in people who are at high risk for severe COVID-19 disease. However, they have some key differences. Continue reading See also: Related medical questions Does Paxlovid prevent Long COVID? Can pharmacists prescribe Paxlovid? Should I take Paxlovid after a Positive COVID-19 Test? What Drugs Prevent or Treat Serious COVID-19 Cases Can you have Covid without a fever? Which breathing techniques help with COVID-19? How effective is Lagevrio (molnupiravir) for COVID-19? Is Omicron worse than Delta? Can you become immune to COVID-19? Is obesity a major risk factor for Covid-19? COVID-19 vaccines and variants: What you should know Should I wear a face mask to protect myself from COVID-19? COVID-19: Why is social distancing so important? Why do more men die from coronavirus? Can ivermectin be used to treat COVID-19? Can you take Ibuprofen if you have COVID-19 (coronavirus)? What antibiotics kill Covid-19 (coronavirus)? COVID-19: What are the Stages and Causes of Death? What's the difference between Bacteria and Viruses? Does Zinc protect you from Covid-19 or boost your immune system? What is the difference between Spikevax and mNEXSPIKE? How do I Treat Nasal Congestion with COVID-19? Does Losartan block COVID-19 Coronavirus Receptors? An Update: Is hydroxychloroquine effective for COVID-19? Does Tamiflu (oseltamivir) work on COVID-19? Where can I buy an at-home test kit for COVID-19? Can vitamin C prevent or treat COVID-19 (coronavirus)? Does Mucinex help with Covid? What are JAK inhibitors and how do they work? Can I take NyQuil with COVID or after the COVID vaccine? Drug information Paxlovid Information for Consumers Paxlovid prescribing info & package insert (for Health Professionals) Side Effects of Paxlovid (detailed) Paxlovid user reviews (541) Related support groups Paxlovid (19 questions, 22 members) COVID-19 (103 questions, 92 members) Medical Disclaimer
Markdown	[Skip to main content](https://www.drugs.com/medical-answers/you-paxlovid-covid-rebounds-3569972/#content) [![Drugs.com - Go to homepage](https://www.drugs.com/img/logo/drugscom-logo.svg)](https://www.drugs.com/) [Register](https://www.drugs.com/account/register/) [Sign in](https://www.drugs.com/account/login/) Site navigation - [Upgrade to a Plus Plan Remove ads and unlock more features.](https://www.drugs.com/account/plan/?launch=ddc-tier-1) - [Register](https://www.drugs.com/account/register/) [Sign in](https://www.drugs.com/account/login/) - [Drugs A-Z](https://www.drugs.com/drug_information.html) - [Pill Identifier](https://www.drugs.com/pill_identification.html) - [Drug Interaction Checker](https://www.drugs.com/drug_interactions.html) - [Compare Drugs](https://www.drugs.com/compare/) - [News](https://www.drugs.com/news.html) - [Pro Edition](https://www.drugs.com/professionals.html) - [More Resources](https://www.drugs.com/sitemap.html) - [Help & Support](https://www.drugs.com/support/) Close 1. [Home](https://www.drugs.com/) 2. [Paxlovid](https://www.drugs.com/paxlovid.html) 3. FAQ # Can you take Paxlovid twice if COVID rebounds? Medically reviewed by [Leigh Ann Anderson, PharmD](https://www.drugs.com/support/editor/14/leigh-ann-anderson-pharmd.html). Last updated on Oct 24, 2024. Official Answer by Drugs.com No, a second round of Paxlovid treatment is not needed after the initial 5-day treatment if COVID rebound occurs. Case reports suggest that most people who develop COVID rebound after completing 5 days of treatment have either no symptoms or mild illness. To date, there is no association between Paxlovid treatment and COVID rebound. An FDA analysis has stated that COVID rebound associated with symptoms and / or a positive viral test may occur as part of the natural course of the disease, whether or not you take Paxlovid. COVID rebound has also been reported to occur with Lagevrio (molnupiravir), another COVID antiviral medicine, in people who have not taken any treatment, and those who are vaccinated or not vaccinated. At this time, the original 5-day treatment period for Paxlovid is recommended in the product labeling and by the Centers for Disease Control and Prevention (CDC). In studies, Paxlovid has been shown to reduced hospitalizations and deaths due to COVID-19 by about 89%. Most clinicians agree that the use of Paxlovid in patients at high risk for severe disease far outweighs the potential risk of minor rebound symptoms. Severe complications due to rebound have been rarely reported. Data from studies (EPIC-HR, EPIC-SR; both randomized placebo-controlled trials) showed that rebound in SARS-CoV-2 (RNA or virus) shedding or self-reported COVID-19 symptoms occurred in a subset of patients but happened at similar rates in patients receiving either Paxlovid or placebo. According to the FDA, no association between Paxlovid treatment and COVID-19 rebound has been proven. ## What symptoms occur with COVID rebound? Case reports suggest that people who develop COVID rebound after completing 5 days of treatment show either no symptoms or mild illness. Symptoms can vary but the most commonly include cough (44%), fatigue or tiredness (35%) and headache (35%). Symptoms typically return 2 to 8 days after finishing treatment but are transient and usually clear up in 1 to 3 days. There have been no reports of deaths related to COVID rebound. ## What does Paxlovid treat? - [Paxlovid](https://www.drugs.com/paxlovid.html) (nirmatrelvir and ritonavir) is an oral antiviral treatment and is approved by the FDA to be used for early-stage treatment (within 5 days of symptoms onset) of mild to moderate COVID-19 in adults at high risk for progression to severe disease, hospitalization or death. - Paxlovid treatment should begin as soon as possible and within 5 days of COVID symptom onset among persons eligible to receive the treatment. Paxlovid is also available under an Emergency Use Authorization (EUA) to treat patients 12 to 18 years old (weighing at least 40 kg) for mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death. Some medicines may interact with Paxlovid and can cause serious side effects. There are certain medicines you cannot take with this medicine. - Tell your healthcare provider about all the medicines you take, including over-the-counter medicines, vitamins and herbal products. - Have your healthcare provider complete a [drug interaction review](https://www.drugs.com/drug_interactions.html) prior to starting treatment with Paxlovid. ## Related questions - [Paxlovid side effects: 8 key things to know](https://www.drugs.com/medical-answers/paxlovid-side-effects-8-key-things-3573430/) - [How fast does Paxlovid work?](https://www.drugs.com/medical-answers/fast-paxlovid-work-3570271/) - [Does Paxlovid make you less contagious?](https://www.drugs.com/medical-answers/paxlovid-make-you-contagious-3578401/) ## Do I have to isolate if I have Paxlovid rebound? - If you test positive again after finishing Paxlovid you should restart isolation for at least 5 full days and contact your healthcare provider for further instructions. You may still be shedding virus and be contagious. - You can end your rebound isolation period after 5 days if your fever is gone for 24 hours (without the use of fever-reducing medication) and your symptoms (such as cough, body aches, shortness of breath) are improving. - Wear a mask for 10 days after your rebound symptoms start, even if you've ended the 5 day isolation period. - Some people continue to test positive 10 days after COVID-19 rebound begins, but are much less likely to be contagious by this time. ## How quickly does Paxlovid (COVID-19) rebound start? COVID-19 rebound has been reported to begin between 2 and 8 days after initial recovery. You may develop a recurrence of COVID-19 symptoms and / or a new positive viral test 2 to 8 days after having tested negative. Case reports suggest that symptoms and positive test results improve or resolve most commonly within a 3 day period, but can be shorter or longer. This rebound effect is not a new COVID infection or due to Paxlovid resistance. The CDC reported no other respiratory pathogens were identified among known cases. ## How often does rebound occur with Paxlovid? The exact incidence is not known. Rebound has been reported to occur in about 8% of people, but numbers could be greater because some people may never retest if they remain asymptomatic (without symptoms). In the EPIC-HR study, rebound was observed in 8.3% of people who took Paxlovid compared to 5.7% of people who took a placebo (inactive) treatment (p=0.04%) COVID rebound was also reported in a retrospective study that looked back at the history of patients who took no COVID treatment. - Rebound associated with symptoms was reported in 26% of people in this study, most commonly 11 days after initial symptom onset. - However, both symptoms rebound and high-level viral testing rebound was observed in only 3% of participants. This is not all the information you need to know about [Paxlovid](https://www.drugs.com/paxlovid.html) (nirmatrelvir and ritonavir) for safe and effective use and does not take the place of your doctor’s directions. Review the full Paxlovid product information and discuss this information and any questions you have with your doctor or other health care provider. References - Frequently Asked Questions on the Emergency Use Authorization for Paxlovid for Treatment of COVID-19. Revised: 11/1/2023. US Food and Drug Administration (FDA). Accessed Nov. 6, 2023 at https://www.fda.gov/media/155052/download - FDA Briefing Document. NDA\# 217188. Drug name: nirmatrelvir tablets and ritonavir tablets copackaged for oral use. Applicant: Pfizer Inc. Antimicrobial Drugs Advisory Committee Meeting March 16, 2023. Accessed Aug 24, 2023 at <https://www.fda.gov/media/166197/download> - Deo R, Choudhary MC, Moser C, et al; ACTIV-2/A5401 Study Team. Symptom and Viral Rebound in Untreated SARS-CoV-2 Infection. Ann Intern Med. 2023 Mar;176(3):348-354. doi: 10.7326/M22-2381. - FDA Approves Paxlovid (nirmatrelvir tablets and ritonavir tablets) for Adult Patients at High Risk of Progression to Severe COVID-19 Drugs.com May 25, 2023 at <https://www.drugs.com/newdrugs/fda-approves-paxlovid-nirmatrelvir-ritonavir-adult-patients-risk-progression-severe-covid-19-6028.html> - COVID-19 Rebound After Paxlovid Treatment. CDC Health Advisory. May 24, 2022. Accessed Aug 24, 2023 at <https://emergency.cdc.gov/han/2022/pdf/CDC_HAN_467.pdf> - People with Certain Medical Conditions and COVID-19 risk factors. US Centers for Disease Control and Information (CDC). Updated June 24, 2024. Accessed Oct 24, 2024 at <https://www.cdc.gov/covid/risk-factors/> - Cohen P (author). COVID-19: Management of adults with acute illness in the outpatient setting. Up to Date. Accessed Aug 24, 2023 at <https://www.uptodate.com/contents/covid-19-management-of-adults-with-acute-illness-in-the-outpatient-setting#H777607805> - Fact Sheet. EUA for Paxlovid for COVID-19. Pfizer. Updated 5/2023. Accessed Aug 24, 2023 at <https://www.fda.gov/media/155051/download> - A Study to Learn About a Repeat 5-Day Treatment With the Study Medicines (Called Nirmatrelvir/Ritonavir) in People 12 Years Old or Older With Return of COVID-19 Symptoms and SARS-CoV-2 Positivity After Finishing Treatment With Nirmatrelvir/Ritonavir. ID\# NCT05567952. Clinical Trials.gov. <https://www.clinicaltrials.gov/study/NCT05567952> - Ebell MH. Rebound Symptoms Common With COVID-19 Even After Placebo Treatment. Am Fam Physician. 2023 Apr;107(4):432-433. PMID: 37054427. - Paxlovidinformation.com. Pfizer Inc. <https://www.paxlovidinformation.com/> ## Read next ## How effective is Paxlovid for COVID-19? Paxlovid is effective at lowering the risk of hospitalization or death by 86% for adult patients who are at high risk of COVID-19 progressing to severe illness when Paxlovid is started within the first 3 days of COVID-19 symptoms. [Continue reading](https://www.drugs.com/medical-answers/effective-paxlovid-covid-19-3564414/) ## When should you take Paxlovid? If you have been prescribed Paxlovid (nirmatrelvir and ritonavir), you should take it as soon as possible. Paxlovid works best if it is taken within 5 days of the start of COVID-19 symptoms. [Continue reading](https://www.drugs.com/medical-answers/when-you-take-paxlovid-3577824/) ## How do Paxlovid and molnupiravir compare for COVID-19? Paxlovid (nirmatrelvir and ritonavir) and Lagevrio (molnupiravir) are two oral treatment options for mild-to-moderate coronavirus disease 2019 (COVID-19) in people who are at high risk for severe COVID-19 disease. However, they have some key differences. 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Readable Markdown	Official Answer by Drugs.com No, a second round of Paxlovid treatment is not needed after the initial 5-day treatment if COVID rebound occurs. Case reports suggest that most people who develop COVID rebound after completing 5 days of treatment have either no symptoms or mild illness. To date, there is no association between Paxlovid treatment and COVID rebound. An FDA analysis has stated that COVID rebound associated with symptoms and / or a positive viral test may occur as part of the natural course of the disease, whether or not you take Paxlovid. COVID rebound has also been reported to occur with Lagevrio (molnupiravir), another COVID antiviral medicine, in people who have not taken any treatment, and those who are vaccinated or not vaccinated. At this time, the original 5-day treatment period for Paxlovid is recommended in the product labeling and by the Centers for Disease Control and Prevention (CDC). In studies, Paxlovid has been shown to reduced hospitalizations and deaths due to COVID-19 by about 89%. Most clinicians agree that the use of Paxlovid in patients at high risk for severe disease far outweighs the potential risk of minor rebound symptoms. Severe complications due to rebound have been rarely reported. Data from studies (EPIC-HR, EPIC-SR; both randomized placebo-controlled trials) showed that rebound in SARS-CoV-2 (RNA or virus) shedding or self-reported COVID-19 symptoms occurred in a subset of patients but happened at similar rates in patients receiving either Paxlovid or placebo. According to the FDA, no association between Paxlovid treatment and COVID-19 rebound has been proven. ## What symptoms occur with COVID rebound? Case reports suggest that people who develop COVID rebound after completing 5 days of treatment show either no symptoms or mild illness. Symptoms can vary but the most commonly include cough (44%), fatigue or tiredness (35%) and headache (35%). Symptoms typically return 2 to 8 days after finishing treatment but are transient and usually clear up in 1 to 3 days. There have been no reports of deaths related to COVID rebound. ## What does Paxlovid treat? - [Paxlovid](https://www.drugs.com/paxlovid.html) (nirmatrelvir and ritonavir) is an oral antiviral treatment and is approved by the FDA to be used for early-stage treatment (within 5 days of symptoms onset) of mild to moderate COVID-19 in adults at high risk for progression to severe disease, hospitalization or death. - Paxlovid treatment should begin as soon as possible and within 5 days of COVID symptom onset among persons eligible to receive the treatment. Paxlovid is also available under an Emergency Use Authorization (EUA) to treat patients 12 to 18 years old (weighing at least 40 kg) for mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death. Some medicines may interact with Paxlovid and can cause serious side effects. There are certain medicines you cannot take with this medicine. - Tell your healthcare provider about all the medicines you take, including over-the-counter medicines, vitamins and herbal products. - Have your healthcare provider complete a [drug interaction review](https://www.drugs.com/drug_interactions.html) prior to starting treatment with Paxlovid. ## Related questions - [Paxlovid side effects: 8 key things to know](https://www.drugs.com/medical-answers/paxlovid-side-effects-8-key-things-3573430/) - [How fast does Paxlovid work?](https://www.drugs.com/medical-answers/fast-paxlovid-work-3570271/) - [Does Paxlovid make you less contagious?](https://www.drugs.com/medical-answers/paxlovid-make-you-contagious-3578401/) ## Do I have to isolate if I have Paxlovid rebound? - If you test positive again after finishing Paxlovid you should restart isolation for at least 5 full days and contact your healthcare provider for further instructions. You may still be shedding virus and be contagious. - You can end your rebound isolation period after 5 days if your fever is gone for 24 hours (without the use of fever-reducing medication) and your symptoms (such as cough, body aches, shortness of breath) are improving. - Wear a mask for 10 days after your rebound symptoms start, even if you've ended the 5 day isolation period. - Some people continue to test positive 10 days after COVID-19 rebound begins, but are much less likely to be contagious by this time. ## How quickly does Paxlovid (COVID-19) rebound start? COVID-19 rebound has been reported to begin between 2 and 8 days after initial recovery. You may develop a recurrence of COVID-19 symptoms and / or a new positive viral test 2 to 8 days after having tested negative. Case reports suggest that symptoms and positive test results improve or resolve most commonly within a 3 day period, but can be shorter or longer. This rebound effect is not a new COVID infection or due to Paxlovid resistance. The CDC reported no other respiratory pathogens were identified among known cases. ## How often does rebound occur with Paxlovid? The exact incidence is not known. Rebound has been reported to occur in about 8% of people, but numbers could be greater because some people may never retest if they remain asymptomatic (without symptoms). In the EPIC-HR study, rebound was observed in 8.3% of people who took Paxlovid compared to 5.7% of people who took a placebo (inactive) treatment (p=0.04%) COVID rebound was also reported in a retrospective study that looked back at the history of patients who took no COVID treatment. - Rebound associated with symptoms was reported in 26% of people in this study, most commonly 11 days after initial symptom onset. - However, both symptoms rebound and high-level viral testing rebound was observed in only 3% of participants. This is not all the information you need to know about [Paxlovid](https://www.drugs.com/paxlovid.html) (nirmatrelvir and ritonavir) for safe and effective use and does not take the place of your doctor’s directions. Review the full Paxlovid product information and discuss this information and any questions you have with your doctor or other health care provider. References - Frequently Asked Questions on the Emergency Use Authorization for Paxlovid for Treatment of COVID-19. Revised: 11/1/2023. US Food and Drug Administration (FDA). Accessed Nov. 6, 2023 at https://www.fda.gov/media/155052/download - FDA Briefing Document. NDA\# 217188. Drug name: nirmatrelvir tablets and ritonavir tablets copackaged for oral use. Applicant: Pfizer Inc. Antimicrobial Drugs Advisory Committee Meeting March 16, 2023. Accessed Aug 24, 2023 at <https://www.fda.gov/media/166197/download> - Deo R, Choudhary MC, Moser C, et al; ACTIV-2/A5401 Study Team. Symptom and Viral Rebound in Untreated SARS-CoV-2 Infection. Ann Intern Med. 2023 Mar;176(3):348-354. doi: 10.7326/M22-2381. - FDA Approves Paxlovid (nirmatrelvir tablets and ritonavir tablets) for Adult Patients at High Risk of Progression to Severe COVID-19 Drugs.com May 25, 2023 at <https://www.drugs.com/newdrugs/fda-approves-paxlovid-nirmatrelvir-ritonavir-adult-patients-risk-progression-severe-covid-19-6028.html> - COVID-19 Rebound After Paxlovid Treatment. CDC Health Advisory. May 24, 2022. Accessed Aug 24, 2023 at <https://emergency.cdc.gov/han/2022/pdf/CDC_HAN_467.pdf> - People with Certain Medical Conditions and COVID-19 risk factors. US Centers for Disease Control and Information (CDC). Updated June 24, 2024. Accessed Oct 24, 2024 at <https://www.cdc.gov/covid/risk-factors/> - Cohen P (author). COVID-19: Management of adults with acute illness in the outpatient setting. Up to Date. Accessed Aug 24, 2023 at <https://www.uptodate.com/contents/covid-19-management-of-adults-with-acute-illness-in-the-outpatient-setting#H777607805> - Fact Sheet. EUA for Paxlovid for COVID-19. Pfizer. Updated 5/2023. Accessed Aug 24, 2023 at <https://www.fda.gov/media/155051/download> - A Study to Learn About a Repeat 5-Day Treatment With the Study Medicines (Called Nirmatrelvir/Ritonavir) in People 12 Years Old or Older With Return of COVID-19 Symptoms and SARS-CoV-2 Positivity After Finishing Treatment With Nirmatrelvir/Ritonavir. ID\# NCT05567952. Clinical Trials.gov. <https://www.clinicaltrials.gov/study/NCT05567952> - Ebell MH. Rebound Symptoms Common With COVID-19 Even After Placebo Treatment. Am Fam Physician. 2023 Apr;107(4):432-433. PMID: 37054427. - Paxlovidinformation.com. Pfizer Inc. <https://www.paxlovidinformation.com/> ## Read next ## How effective is Paxlovid for COVID-19? Paxlovid is effective at lowering the risk of hospitalization or death by 86% for adult patients who are at high risk of COVID-19 progressing to severe illness when Paxlovid is started within the first 3 days of COVID-19 symptoms. [Continue reading](https://www.drugs.com/medical-answers/effective-paxlovid-covid-19-3564414/) ## When should you take Paxlovid? If you have been prescribed Paxlovid (nirmatrelvir and ritonavir), you should take it as soon as possible. Paxlovid works best if it is taken within 5 days of the start of COVID-19 symptoms. [Continue reading](https://www.drugs.com/medical-answers/when-you-take-paxlovid-3577824/) ## How do Paxlovid and molnupiravir compare for COVID-19? Paxlovid (nirmatrelvir and ritonavir) and Lagevrio (molnupiravir) are two oral treatment options for mild-to-moderate coronavirus disease 2019 (COVID-19) in people who are at high risk for severe COVID-19 disease. However, they have some key differences. 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