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Medications for patients with COVID-19

Advice for healthcare workers on medications for patients with COVID-19.

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Early therapies

There are a range of medications provisionally approved by the Therapeutic Goods Administration (TGA) and available in Victoria through the National Medical Stockpile (NMS). These medications are for the treatment of patients in the early phase of infection with COVID-19 who are at risk of progression to severe disease.

The medications currently available for mild disease are:

  • nirmatrelvir and ritonavir (Paxlovid™)
  • remdesivir (Veklury™)
  • molnupiravir (Lagevrio™)
  • inhaled corticosteroids: budesonide (Pulmicort™) or ciclesonide (Alvesco™)
  • sotrovimab (Xevudy™)
  • casirivimab plus imdevimab (Ronapreve™)
  • tixagevimab and cilgavimab (Evusheld™) in exceptional circumstances.

Resources to support prescribing include:

COVID-19 medications for at risk people who do not require oxygen

Paxlovid™ prescribing guideExternal Link

Algorithm for the Management of Children with Symptomatic COVID-19External Link

PBS eligibility criteria – Paxlovid™External Link

PBS eligibility criteria – Lagevrio™External Link

Victorian COVID-19 therapies PBS prescriber helpline

Note: This service will cease from 14 April 2023.

For current information for prescribers and pharmacists on PBS access to COVID19 medications, visit the PBS websiteExternal Link .

Locating a community pharmacy stocking antivirals

Pharmacies holding oral antiviral stock across the state can be found using these resources:

Clinicians regularly prescribing PBS oral antivirals are encouraged to have discussions with their local pharmacies to let them know they will be prescribing to facilitate stock being available same day. All pharmacies can order stock as required with a next business day turnaround on average.

Develop a COVID-19 treatment plan for your patients

Actively engaging with at-risk patients to develop a COVID-19 treatment plan enables them to quickly access the best available treatment should they become infected.

Clinicians should consider contacting at-risk patients that may be eligible for early therapies for a proactive consultation to develop a COVID treatment plan, or do this during an elective/non-urgent consultation.

Examples of COVID treatment plan templates are available to download:

Pre-exposure prophylaxis (Evusheld™)

Tixagevimab and cilgavimab (EvusheldTM) continues to be available in Victoria for use in high-risk people for pre-exposure prophylaxis (PrEP) of COVID-19, with all stock from the National Medical Stockpile (NMS) expiring on 31 December 2022. It is highly unlikely that further stock will be available from the NMS in 2023. Therefore, from January 2023 access will be up to individual hospitals to consider making available with a projected cost per dose of >$2500.

The Therapeutic Goods Association (TGA) announced revised dosing recommendations for the use of EvusheldTM, increasing the standard dose from 300mg to 600mg. Top-up doses for already treated patients is at clinician discretion. Sites can administer double dose for PrEP, however there is no guarantee that NMS stock used will be replaced as there is limited NMS stock available in Victoria.

The TGA has also provided provisional approval for EvusheldTM for treatment of COVID-19 indication.

Recent pre-print laboratory studies have found EvusheldTM may have reduced effectiveness in protecting against some, but not all, circulating Omicron subvariants (BA.2.75.2, BQ.1, BQ.1.1, XBB, BF.7 and BA.4.6 and possibly XBF). The proportion of COVID-19 infections caused by these subvariants is estimated to be >60% (and increasing) in Victoria based on recent genomic sequencing data.

In the absence of an alternative option for pre-exposure prophylaxis and mix of circulating variants, EvusheldTM continues to be available for use. Clinicians should consider this information in making individual patient management decisions. Patients should also be reminded of additional protective behaviours to prevent infection as well as the importance of early testing and their eligibility for antivirals.

Resources to support clinical decision making for tixagevimab and cilgavimab (Evusheld™) pre-exposure prophylaxis include:

Request to access forms

View request to access forms for the following medications:

  • Medication for mild COVID-19
  • Medication for moderate to severe COVID-19
  • tixagevimab and cilgavimab (Evusheld™) for pre-exposure prophylaxis

Product information

Consumer medicine information

Further information

National COVID-19 Clinical Evidence TaskforceExternal Link
Australian guidelines for the clinical care of people with COVID-19External Link

What are the recommendations for influenza vaccination?

With COVID-19 spreading across Australia, this year it is more important than ever to ensure that patients receive the seasonal influenza vaccination. Influenza vaccination should be given as soon as possible. The regular influenza season may coincide with the peak of the current COVID-19 pandemic, potentially placing additional burden on the Australian health system.

Influenza vaccine distribution to immunisation providers has commenced. Adjuvanted influenza vaccines are available for people aged 65 years and over.

Claims that influenza vaccination may increase the risk of COVID-19 infection have been circulating on social media. There is no evidence to support these claims.

Can Tamiflu still be given to patients with mild flu-like symptoms?

The antiviral medication Tamiflu (oseltamivir) is not effective against COVID-19. Tamiflu is used to treat influenza. In otherwise healthy adults who have a low risk of complications, treatment with a neuraminidase inhibitor (such as Tamiflu) reduces duration of influenza symptoms by less than one day on average, when treatment is started within 48 hours of symptom onset. Such benefit must be balanced against the potential adverse effects of antiviral treatment, including nausea, vomiting, headaches and neuropsychiatric events.

It is recommended that Tamiflu be reserved for use in patients:

  • who need to be admitted to hospital for management of influenza
  • with moderate-severity or high-severity community-acquired pneumonia, during the influenza season
  • who are at higher risk of poor outcomes from influenza (for example, pregnant women).

Information about COVID-19 vaccines

Information about COVID-19 vaccines can be found at Information for COVID-19 vaccine providersExternal Link , including:

  • information about the COVID-19 vaccines available in Australia
  • training for COVID-19 vaccine providers
  • site readiness for COVID-19 vaccination clinics
  • administering the vaccines and managing side effects
  • supporting COVID-19 vaccine recipients
  • an information hub.

Reviewed 15 May 2023

COVID-19

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