Happened again
SILVER ELITE
It's tricky to prescribe. I suspect many prescribers are cheating a bit, upping dosage ( don't ask, don't tell). We will see if it ever emerges from EUA status - the interaction with so many common drugs is sketchy. The culprit is ritonavir - anytime you you mess with liver enzymes, you mess with a boatload of commonly taken drugs ranging from hormone contraceptives to serious stuff like cholesterol meds, antiarrhythmic medications, etc. Stuff that a guy like Biden may be taking (wink wink). You could weakly argue that vitamins and other supplements mess with liver enzymes as well.Anecdotally including Biden I’m aware of no less than 10 bounce back cases on paxlovid. It seems to be quite common. Except for high risk cases (like Biden) they really need to pause it until they can do proper studies on either extending or upping the dose. If you are young and healthy there is zero reason to be on paxlovid and it’s possible we are just encouraging resistance. But they won’t do it because of $$$.
No way anyone does additional studies to determine whether upping the dosage gets rid of the rebound. I love how every headline about biden's rebound makes it seem rebouding is soooo uncommon. It's not, plenty of rebouding going around. Most people just stick out the rebound, wait another 5 days or so, test again then move on with life.
By prescribing paxlovid, it shows how worried they were. It likley did it's job of reducing replication. They could have gone with Merck’s oral antiviral molnupiravir, no known other med interaction but likely decided the effectiveness of Pax (88%) was better than the merck product (30%). Go care team!!