Outpatient COVID-19 Treatments: Information for Healthcare Providers

Updated September 7, 2022

The U.S. Food and Drug Administration (FDA) has authorized several widely-available therapeutics to treat mild-to-moderate COVID-19 in people who are at high-risk for progressing to severe COVID-19. Treatment must start within days after symptom onset to be effective. This webpage will help assist you in understanding which treatments might be beneficial for your patients.

On this page:

Who’s eligible?

Outpatients should be prioritized for early treatment of COVID-19 if they meet one or more of the following criteria:

  • Age 50 or older
  • Not up to date on COVID-19 vaccinations
  • One or more underlying medical conditions, including chronic lung disease, heart disease, or a weakened immune system. See the CDC list of underlying medical conditions.

Therapeutics overview

Oral antivirals Paxlovid and Lagevrio (molnupiravir) are widely available. Intravenous antiviral Veklury (remdesivir) can be used in some outpatient situations. Monoclonal antibody therapy bebtelovimab is only available commercially.

Find the latest important updates on COVID-19 therapeutics from ASPR, including shelf life extensions.

Paxlovid (nirmatrelvir and ritonavir)

  • FDA EUA Fact Sheet
  • Eligibility: At least 12 years old, weighing at least 88 pounds. Must start within 5 days of symptom onset.
  • Administration: Oral. Patient takes 2 tablets of nirmatrelvir and 1 tablet of ritonavir twice daily for 5 days.
  • How it works: Nirmatrelvir stops the virus from replicating. Ritonavir helps nirmatrelvir stay in the body longer and at higher concentrations.
  • Special considerations: Renal-adjusted dosage available. Review drug-drug interactions before prescribing: online checker and printable checklist (PDF).

Lagevrio (molnupiravir)

  • FDA EUA Fact Sheet
  • Eligibility: At least 18 years old, weighing at least 88 pounds. Must start within 5 days of symptom onset.
  • Administration: Oral. Patient takes 4 capsules every 12 hours for 5 days.
  • How it works: Molnupiravir introduces mistakes into the virus's genetic code, preventing the virus from replicating properly.
  • Special considerations: Not recommended for pregnant or breastfeeding patients.

Veklury (remdesivir) Gilead

  • Fact Sheet (PDF)
  • Eligibility: At least 28 days old, weighing at least 7.7 pounds. Must start within 7 days of symptom onset.
  • Administration: Intravenous infusion. One dose given per day for 3 days. Observe patient for at least 1 hour after injection.
  • How it works: Remdesivir interferes with one of the key enzymes the virus needs to replicate.
  • Special considerations: FDA-approved for treating hospitalized patients.

Bebtelovimab

FDA EUA Fact Sheet Eligibility: At least 12 years old, weighing at least 88 pounds. Must start within 7 days of symptom onset. Administration: Intravenous injection. Patient receives a single dose over at least 30 seconds. Observe patient for at least 1 hour after injection. How it works: Like other monoclonal antibodies, bebtelovimab works by binding to the spike protein of the virus, blocking the virus from attaching to the body's cells. Special considerations: Supply is only available through the commercial market.

Resources for health professionals

Order form 

Decision aids 

Locator tools 

Treatment guidelines 

Webinars 

Flyer 

Pre-exposure protection: Evusheld

Evusheld (tixagevimab/cilgavimab) is a long-acting monoclonal antibody therapy that has been authorized by the FDA under EUA for pre-exposure prophylaxis for COVID-19. In Alaska, Evusheld is available through nearly all infusions centers and clinics that care for the eligible patient populations.

  • Eligibility: At least 12 years old, weighing at least 88 pounds; and are moderately to severely immunocompromised, or cannot be fully vaccinated with any available COVID-19 vaccines.
  • Administration: Intramuscular injection. Administered once every 6 months. Patient is given 2 injections during the same session (one 300 mg injection of tixagevimab and one 300 mg injection of cilgavimab). Observe patient for at least 1 hour after injection.
  • How it works: Tixagevimab and cilgavimab are two types of monoclonal antibodies that are designed to stay in the body for long periods of time. They can prevent an infection by blocking the virus from attaching to the body's cells.
  • Special considerations: Cannot be used to treat an active COVID-19 infection. Cannot be given after a known COVID-19 exposure. Not a substitute for vaccination in individuals for whom COVID-19 vaccination is recommended. Patient should wait at least 2 weeks after COVID-19 vaccination to receive Evusheld.

More information