The U.S. Food and Drug Administration (FDA) has approved or issued emergency use authorizations (EUA) for therapeutics for treatment of early mild-to-moderate COVID-19 in high-risk patients:
- The preferred agent at this time is the oral antiviral nirmatrelvir boosted with ritonavir (PAXLOVID) begun within 5 days of symptom onset.
- Similar effectiveness can be achieved with the intravenous antiviral remdesivir (VEKLURY) which requires infusion on 3 consecutive days and must be started within 7 days of symptom onset.
- If neither of these therapeutics is available or appropriate, the oral medication molnupiravir may be given starting within 5 days of symptom onset.
Five previously authorized monoclonal antibodies are no longer authorized due to the presence of variants that reduce their effectiveness: Casirivimab/imdevimab (REGEN-COV), Bamlanivimab/etesevimab, Sotrovimab, Bebtelovimab, and Evusheld.
Use of antiviral IV therapy or oral antiviral medications is not a substitute for vaccination against COVID-19. Everyone is still encouraged to get vaccinated as soon as they can, whether it is a first, second or booster dose.
FDA shelf-life extension
There have been recent changes in shelf-life extensions for several therapeutics.
Please see the FDA website for a complete list of up-to-date extensions.
- FDA shelf-life extension for Lagevrio (Oct. 21, 2022)
- From 24 to 30 months
Please be sure to always check for the most up to date and product-specific expiration dates.
In most cases, the packaging labels do not represent the most current expiration date for that product.
- DPH Guidance, November 22, 2022: Paxlovid Treatment Guidance PDF | Doc
- DPH Guidance, February 10, 2023: Guidance for the Use of Therapeutics for Treatment of COVID-19
- This guidance replaces guidance issued by the Department on January 30, 2023, December 5, 2022, November 16, 2022, July 19, 2022, April 26, 2022, April 7, 2022, March 25, 2022, March 7, 2022, February 22, 2022, January 28, 2022, January 12, 2022, and December 23, 2021
- DPH Guidance, updated January 28, 2022: Procedures and Requirements for Hospitals/Clinics Dispensing COVID-19 Oral Antivirals
- DPH Guidance, December 16, 2021: COVID-19 Monoclonal Antibody (mAb) Therapy Checklist for Providers
- DPH Guidance, December 16, 2021:Allocation of COVID-19 Monoclonal Antibody Therapeutics to Health Care Providers
- This guidance replaces guidance issued by the Department on October 29 and October 1, 2021
An FDA-approved antiviral IV therapy and oral antivirals are available through state-sponsored sites located across the Commonwealth.
Transportation to a treatment site should NOT be a barrier to care for patients diagnosed with COVID-19. Sites will work with your patient to arrange for transportation to and from the treatment site closest to their home. There is no cost to the patient for this transportation.
|Site||Phone or email||Fax||Website|
|Fairhaven/New Bedford||508-973-2659||508-973-2660||Southcoast Health|
|Baystate Referral Form|
|Hyannis||508-534-7103||508-568-1650||Cape Cod Health|
|Lawrence||978-722-2870||Greater Lawrence Family Health Center|
|Plymouth||508-830-2778||508-830-2789||COVID-19 Resources — Beth Israel Lahey Health (bilh.org)|
|Pittsfield||855-262-5465||Berkshire Health Systems|
|Worcester||800-431-5151||UMass Memorial Health|
|Boston/Roxbury||617-858-2444||Whittier Street Health Center|
- Treatments are available widely via retail pharmacies across the Commonwealth.
- COVID-19 treatments should be considered for all your patients and given to all patients appropriate for treatment. This group includes nearly 40 percent of all MA residents eligible due to heart, lung, liver, or kidney disease, diabetes, pregnancy, dementia, cancer, disability, substance use disorder, mental health disorder, age over 65, overweight/obesity and immunocompromised. View the full CDC list of medical conditions.
- Massachusetts has supply available to meet the needs of all residents who can benefit from these treatments.
- Individuals may qualify for our in-home treatment program. Visit mass.gov/InHomeCovidTreatments to learn more about eligibility.
- Telehealth is available for individuals 18 or older living in Massachusetts who test positive for COVID-19 and are experiencing symptoms. This telehealth service can determine if Paxlovid may be an option. If it is, pickup at a pharmacy or free overnight delivery is available. More at mass.gov/CovidTelehealth.
Additionally, hospitals and other healthcare providers throughout Massachusetts serve as sites for distribution of COVID-19 therapeutics and will administer monoclonal antibodies and remdesivir and dispense oral antiviral therapy. The COVID-19 Therapeutics Locator can be used to locate sites offering monoclonal antibodies and antiviral therapies. For referrals to hospital sites, providers should use the contact number for the site listed on the site in locator map. Patients or their representative should follow the instructions provided by the healthcare provider as to how to receive the dispensed medication at the COVID-19 therapeutics site.