While effective and generally safe, Paxlovid does have the potential for some side effects. One temporary, but particularly distasteful side effect reported is “Paxlovid mouth.”
Paxlovid (Nirmatrelvir + Ritonavir) has become a household name since its March 2022 Emergency Use Authorization (EUA) approval as an at-home option to treat COVID-19. It consists of a 5 day treatment pack of the two antiviral drugs, Nirmatrelvir and Ritonavir. When taken within the first 5 days of symptoms by adults and children older than 12 with mild-moderate COVID-19 symptoms, it is about 90% effective at reducing progression to severe illness and the need for hospitalization. Since March 2022, the U.S. federal government has distributed 175,000 treatments per week. We are learning more about Paxlovid as access to treatment expands.
Dysgeusia is the medical term given to this quirky symptom – it means a distorted sense of taste that can be described as bitter, metallic or sour. In Pfizer’s clinical trial for Paxlovid, about 5% of people complained of bitter taste and it wasn’t bothersome enough for anyone to stop taking the medication before their course was completed.
It’s not clear why this symptom occurs with taking Paxlovid. Many medications can cause this temporary yucky taste disturbance. Theories include reduced production of saliva or perhaps secretion of the medication itself into our saliva as it’s metabolized.
Good news – although it’s bothersome to some users, Paxlovid Mouth resolves when the 5 day treatment is complete. In the meantime, if you find yourself with a less than delicious taste while taking the medication, a few easy tricks might help relieve the symptoms:
Regular brushing, flossing and rinsing with mouthwash
Stay hydrated with frequent sips of drinks
Treat yourself and increase saliva production with lemon or mint hard candy
Overall, Paxlovid Mouth is a temporary annoyance and seems very unlikely to have any long lasting effects. And since having COVID-19 already can alter our sense of taste and smell anyway, it’s a small inconvenience relative to the benefit Paxlovid can provide for reducing severity of COVID-19 infection.
If you test positive for COVID-19, speak to your health care provider about your treatment options – they can help you decide if you are a candidate for antiviral treatments (like Paxlovid) or monoclonal antibody infusion (like Sotrovimab). If you aren’t sure how to access treatment, don’t forget about the federal Test to Treat program, which directly connects people to sites where they can get tested for COVID, prescribed medication and fill the prescription all in one location. More information about sites can be found here.
Stay safe. Stay well.
Those Nerdy Girls