Antiviral medicines for COVID-19 infection

COVID-19 antivirals are medicines used to treat COVID-19 infection. They reduce the amount of virus in your body and may help you become less sick and stay out of hospital.

The preferred COVID-19 antiviral medicine available in Aotearoa New Zealand is Paxlovid (nirmatrelvir with ritonavir). To be effective, Paxlovid must be started within 5 days of your symptoms starting.

Remdesivir injection is also available. It is only useful if started within 7 days of the start of your COVID-19 symptoms. You'll usually get the injection at your local hospital or in a local health centre. Read more about remdesivir.

From March 2023, molnupiravir (Lageviro) capsules are no longer recommended as a treatment for COVID-19 in Aotearoa New Zealand.

Antiviral medicines are best used in the first few days of COVID-19 infection for people at risk of getting very sick with COVID-19.

Most people who have COVID-19 will experience a mild illness and can safely manage their own symptoms and recovery at home. Antivirals are ONLY used to treat people who are at risk of severe illness with COVID-19. 

1. You must have COVID-19 or be a household contact of someone with COVID-19, to get free antiviral medicines. Because there are illnesses with similar symptoms to COVID-19, it is important to have a positive COVID-19 test result. These medicines are only suitable if you have COVID-19. 

2. Your symptoms must be recent (starting in the last 5 days) to qualify for Paxlovid.

3. Eligible people include:

• Māori or Pasifika aged 50 years or older
• everyone aged 65 years and older
• anyone aged 50 years or older who has had fewer than 2 COVID-19 vaccinations.

You are also eligible for these medicines if you have 1 of the following:

• A severely weakened immune system.
• Down syndrome.
• Sickle cell anaemia.
• A previous admission to critical care or high dependency care because of COVID-19 infection and you have tested positive again
• Any combination of 3 or more high risk medical conditions.(external link)

Read more about eligibility for COVID-19 antiviral medicines.(external link)

Please note: Even if you meet the eligibility criteria above, these medicines may not be suitable for you.

There are 2 ways to get antivirals:

• Ask your doctor or nurse practitioner for a prescription.
• Ask your pharmacist. Many pharmacies can give you antiviral medicines without a prescription, after a health check by phone.

You may not need a prescription as some pharmacies can give free COVID-19 antiviral medicines without a prescription to people who are eligible. Check which pharmacies give COVID-19 antiviral medicines on the Healthpoint website(external link), or call your local pharmacy. If your local pharmacy does not provide these medicines, they can tell you the nearest pharmacy that does.

Pharmacy health checks

The pharmacy will do a health check (which can be done over the phone) to see if you are eligible, and to see if the free antiviral is right for you. They need the following information to decide if COVID-19 antiviral medicines are safe for you to take:

• Your current health status.
• Your health history.
• Any other medicines or treatments you are or have been taking, including rongoā rākau (plant remedies) and herbal medicines.
• Whether you might be pregnant.

If you are eligible, the pharmacist will tell you what you need to know about taking antiviral medicines safely.

If you're at risk of serious illness but don't have COVID-19 symptoms, you may be able to get a prescription from your doctor before you get COVID-19. This means the pharmacist will have the prescription ready to use if you become unwell.

Keep rapid antigen test (RAT) kits on hand. If you are at risk of getting very sick with COVID-19, make sure you have RAT kits at home, so you can test yourself as soon as you start to feel sick.

If you test positive, you can then arrange to have the medicine delivered by friends or whānau. Talk to your doctor to see if getting a prescription before you become unwell is right for you. Your pharmacist will still need to check your current health and health history to make sure the medicine is suitable.

Yes, antivirals don't replace the need to be vaccinated against COVID-19. Vaccination is the best way to help prevent you from becoming very unwell from COVID infection and its potentially serious complications. You should still get vaccinated if you have had COVID-19 and taken an antiviral medicine, because you can get infected again. You can talk to your doctor, nurse, pharmacist or some hauora providers about the best timing for your vaccination.

Rongoā whakanoa antiviral medicine(external link) Karawhiua, NZ
COVID-19 Antivirals – Braille(external link), Easy Read(external link), large print and audio(external link), and New Zealand Sign Language(external link) Unite Against COVID-19

COVID-19 and your medicines
COVID-19 | Mate korona – what you need to know
Stopping the spread of COVID-19
COVID-19 vaccines overview

1. About COVID-19 therapeutics(external link) Ministry of Health, NZ
2. New Zealand’s COVID-19 treatments portfolio(external link) Pharmac, NZ
3. COVID-19 antivirals: access criteria(external link) Pharmac, NZ