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COVID-19 Treatments

Effective August 30, 2022, the eligibility criteria for Paxlovid and remdesivir has been expanded to include an additional course of therapy for new and distinct COVID-19 infections in eligible patients.

Antiviral medications may be used in early treatment of mild to moderate COVID-19 illness in unvaccinated and certain vaccinated patients who are at high risk for progression to severe illness that may require hospitalization.

Antiviral treatments Paxlovid™ and remdesivir help reduce the viral load of COVID-19 virus in the body. They are not used to prevent COVID-19 infection before you test positive. Treatments are only effective when initiated in the very early phase of infection.

While most vaccinated people have enough immunity to fight COVID-19 infection, those that are unvaccinated, have a weaker immune system or are 70 years and older and at high risk of severe outcomes may benefit from antiviral therapy reducing the viral load that the immune system has to overcome.

Treatment for COVID-19 is Not a Substitute for Vaccination.

Treatment for COVID-19 does not offer equal protection to vaccination. Getting your first, second and all recommended booster doses remains the most important intervention to reduce risk of hospitalization and other severe outcomes from COVID-19. Find a vaccination clinic near you.

There is no cost for COVID-19 treatments in Saskatchewan.

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1. Antiviral medications: Paxlovid™

Treatment with Paxlovid must start within five days of symptom onset. The medication consists of three tablets taken every 12 hours for five days.

The decision to prescribe an antiviral medication will be made by a pharmacists or HealthLine 811 taking into consideration patient risks, current medications, and underlying conditions.

Paxlovid Eligibility

Eligibility criteria is fairly strict and residents will be screened by their participating pharmacist, physician, nurse practitioner or through HealthLine 811 to ensure they meet the criteria.

Paxlovid is only recommended for adults over 18 who:

  • test positive (PCR or rapid test) with mild or moderate COVID-19 symptoms;
  • are within five days of developing symptoms;
  • do not have any medical conditions that would make treatment inappropriate;
  • are not taking any medications that may cause potential drug interactions; and
  • if you are immunocompromised, regardless of vaccination status;
  • 70 years and older with designated risk factors, regardless of vaccination status or
  • meet one of the following criteria:
    • have a medical condition that puts you at high risk and are not fully vaccinated; or
    • are 55 to 69 years old and not fully vaccinated.

If you test positive for COVID-19 on a rapid antigen test or a PCR test and believe you may meet all the criteria for Paxlovid treatment, call a participating pharmacist, HealthLine 811 or a nurse practitioner. Stay home if you are ill and arrange for curbside pickup of medication if possible.

You cannot go directly to a health care provider to receive antiviral medication. You will be provided a prescription based on the eligibility criteria.

Effective August 30, 2022, the eligibility criteria for Paxlovid™ has been expanded to include an additional course of therapy for new and distinct COVID-19 infections in eligible patients.

Pharmacies with Paxlovid

View map of pharmacies prescribing and dispensing

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2. Antiviral medication: Remdesivir

Treatment with remdesivir must start within seven days of symptom onset. This is an intravenous treatment of at least 60 minutes for three, consecutive days.

The decision to prescribe remdesivir will be made by the treating clinician, taking into consideration patient risks, current medications, and underlying conditions.

Remdesivir Eligibility

A health care provider will review your symptoms, eligibility, and other factors to determine whether this treatment is appropriate.

Remdesivir is only recommended for adults over 18 who:

  • test positive (PCR or rapid test) with mild or moderate COVID-19 symptoms;
  • are within seven days of developing symptoms;
  • do not have any medical conditions that would make treatment inappropriate;
  • are not taking any medications that may cause potential drug interactions;
  • if you are immunocompromised, regardless of vaccination status;
  • 70 years and older with designated risk factors, regardless of vaccination status or
  • meet one of the following criteria:
    • have a medical condition that puts you at high risk and are not fully vaccinated; or
    • are 55 to 69 years old and not fully vaccinated.

If you test positive for COVID-19 on a rapid antigen test or a PCR test and believe you may meet all the criteria for COVID-19 treatment, call HealthLine 811. You will receive additional screening and be referred appropriately.

You cannot receive remdesivir directly from your primary health care provider or through pharmacists. You must be referred based on the eligibility criteria.

Effective August 30, 2022, the eligibility criteria for remdesivir has been expanded to include an additional course of therapy for new and distinct COVID-19 infections in eligible patients.

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3. Risk Factors that may affect your eligibility for Remdesivir and Paxlovid™

Additional risk factors for those who are not fully vaccinated may include:

  • Diabetes
  • Body mass index greater than 30 kg/m2
  • Chronic kidney disease with eGFR greater than 30 mL/min/1.73m2
  • Cardiovascular or cerebrovascular disease (eg. Coronary artery disease, high blood pressure, congestive heart failure, atrial fibrillation, high cholesterol, past stroke)Chronic lung disease (e.g. COPD, moderate to severe asthma, cystic fibrosis, pulmonary fibrosis, pulmonary hypertension) Neurodevelopmental disorders (e.g. cerebral palsy, Downs syndrome)
  • Sickle cell disease

People who are fully vaccinated but otherwise immunocompromised could also be eligible for COVID-19 treatment. Immunocompromised conditions include, but are not limited to:

  • People in active treatment for cancer
  • Solid-organ transplant or hematopoietic stem cell transplant recipients
  • People with a moderate or severe primary immunodeficiency
  • People taking immunosuppressive medication such as high-dose corticosteroids, biologic agents, alkylating agents and anti-metabolites

If you think you are eligible for Remdesivir or Paxlovid™ or if you have further questions, please call Healthline 811 to speak with a nurse.

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4. Monoclonal antibody: Evusheld™

Evusheld™ is a one-time treatment, which is administered by a qualified health care provider as two ventrogluteal intramuscular (IM) injections.

Evusheld™ is available in Saskatchewan for pre-exposure prophylaxis of COVID-19 in adults and adolescents (12 years of age or older), weighing at least 40 kg, who have NOT had a known recent exposure to an individual affected with COVID-19 and:

  • Who are immunocompromised and are unlikely to mount an adequate immune response to vaccination; OR
  • For whom COVID-19 vaccination is not recommended.

If Evusheld™ is being considered for use, it should be on a case-by-case basis where the potential benefit is expected to outweigh any potential risk. Consult your prescriber (physician or nurse practitioner) to discuss whether this is an option for you. Evusheld™ is only available if a prescription is issued by your prescriber.

Evusheld™ Eligibility

In Saskatchewan, the case-by-case use of Evusheld™ should be limited to patients who:

  • Are severely immunocompromised. This includes:
    • Solid organ transplant recipients;
    • Individuals with malignant hematologic conditions (e.g.; leukemia, lymphoma or myeloma), who have received active treatment within the last year with chemotherapy, targeted therapies including CAR—T, and immunotherapy).
    • Individuals who have received a bone marrow or stem cell transplant within the last 2 years.
    • Individuals who are taking immunosuppressant medications for graft vs. host disease (GVHD),
    • Patients who have taken anti-CD20 agents or B-cell depleting agents (e.g., rituximab, ocrelizumab, ofatumumab, obinotuzimab, blinatumomab, inotuzumab, ibrutinib, etc.) within the last 6 months.
    • Individual with significant primary immunodeficiency affecting T-cells, immune dysregulation or type 1 interferon defects;

      and

  • Have additional risk factors or exceptional circumstances that correlate with an extremely high risk of poor outcomes from COVID-19 (i.e: unable to receive COVID-19 vaccination, unable to complete COVID-19 vaccination course, treatment of COVID-19 is contraindicated, or severe GVHD). Other risk factors may exist and should be considered on a case-by-case basis as per the prescribing clinician’s discretion.

    In addition,

  • The patient must not have known cardiovascular disease (e.g. coronary artery disease, history of myocardial infarction or stroke, unstable angina, heart failure, congenital heart disease, or arrhythmias). Other risk factors for cardiovascular disease should also be considered (e.g. hyperlipidemia, hypertension).

    Note: It is not recommended that Evusheld™ be administered to patients who are severely compromised without additional risk factors for hospitalization from COVID-19.

At time of administration, confirm individual:

  • is COVID-19 negative.
  • has had no known exposure to an individual infected with COVID-19 in last 8 days.
  • has not been infected with COVID-19 within past 14 days and has recovered from infection if previously infected.
  • has not received COVID-19 vaccine within past 14 days.

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