The Therapeutic Goods Administration has approved the oral anti-viral treatments Paxlovid® (nirmatrelvir and ritonavir) and Lagevrio® (molnupiravir) for use in Australia for people with COVID-19. Both are available via the Pharmaceutical Benefits Scheme. These anti-viral medicines can be prescribed by a General Practitioner or Nurse Practitioner to people in the community who may be at risk of developing more COVID-19 severe symptoms.
Evusheld ( tixagevimab and cilgavimab ) may be considered in exceptional circumstances for individuals who are severely immunocompromised to be prescribed for use as a prophylaxis for COVID-19
Prescribing COVID anti-viral medications
Information accurate at 6 February 2023, Paxlovid and Lagevrio can be prescribed to people who are:
- 70 years and older.
- Moderately to severely immunocompromised people irrespective of vaccination status over 18 years.
- 50 years of age or older with two additional risk factors for developing severe disease or have had a past COVID-19 infection resulting in hospitalisation.
- Aboriginal and Torres Strait Islander people aged 30 years or older with one additional high-risk factor for developing severe disease.
- People over the age of 18 years who have been previously hospitalised with COVID-19.
- Patients with any significantly immunocompromising condition where in the last 12 months the patient has received anti-CD20 monoclonal antibody treatment.
When determining whether to prescribe a COVID anti-viral, the following criteria must be considered:
- Patients can only be commenced on these medications in the first five days of symptoms
- A longer appointment will be necessary to prescribe these medications as a comprehensive history is required
- The pharmacist will have to be able to contact the patient who is being prescribed the medication to complete an assessment
- Ensure the use of contraception is discussed for both males and females of childbearing age
See our Western Victoria pharmacies dispensing COVID medications page for details on where to access Paxlovid and Lagevrio in western Victoria.
Prescribing Evusheld
Evusheld (Tixagevimab plus cilgavimab) was available in 2022 from the National Medical Stockpile (NMS), with access facilitated via health services and select pharmacies via a community-based special access scheme. In 2023, access to and use of Evusheld is very significantly reduced.
Evudheld is no longer available via the NMS and is not PBS listed. There is potential decreased effectiveness against some circulating COVID-19 variants and suggestion of increased rates of cardiac events in some treatment trials.
Evusheld is not routinely recommended for pre-exposure prophylaxis. It may be considered in exceptional circumstances, in individuals who are severely immunocompromised.
More details- Evusheld™ prescribing resources for GPs and specialists | health.vic.gov.au and Medications for patients with COVID-19 | health.vic.gov.au
Prescribing resources and support
Other resources
- Oral treatments for COVID-19 | Australian Government Department of Health and Aged Care
- Paxlovid® (nirmatrelvir and ritonavir) PBS listing
- Lagevrio® (molnupiravir) PBS listing
- Medications for patients with COVID-19 | Victorian State Government Department of Health