Information for Health Care Providers

COVID-19 Treatment Information

COVID-19 prophylaxis: Evusheld

Evusheld consists of co-packaged monoclonal antibodies (tixagevimab and cilgavimab) authorized for pre-exposure prophylaxis of COVID-19. Administering Evusheld as soon as possible may help protect patients who remain at risk despite the availability of COVID-19 vaccines.

Dosage and administration:

• Evusheld is administered by intramuscular injection and consists of tixagevimab 300 mg and cilgavimab 300 mg

For more information about Evusheld, click here.

Oral antiviral – Paxlovid

Paxlovid is an oral treatment that consists of nirmatrelvir tablets co-packaged and co-administered with ritonavir tablets. Paxlovid treatment must be initiated as soon as possible after COVID-19 diagnosis, within five days of symptom onset.

Recently, the FDA released a Patient Eligibility Screening Checklist as an aid for providers. If a patient is unable to take paxlovid due to medical history, concomitant medications, or other drugs with established or potentially significant interactions, providers should consider bebtelovimab, remdesivir, or molnupiravir.

Nirmatrelvir, the main protease inhibitor in paxlovid, maintained antiviral activity against the Omicron BA.1 variant in vitro.

Dosage and administration:

• Paxlovid is administered orally as 300 mg nirmatrelvir (two 150 mg tablets) with 100 mg ritonavir (one 100 mg tablet), with all three tablets taken together twice daily for five days
• Paxlovid may be administered with or without food

For more information about Paxlovid, click here.

Oral Antiviral – Molnupiravir

Molnupiravir is an oral antiviral treatment that must be initiated as soon as possible after COVID-19 diagnosis, within five days of symptom onset. Due to efficacy concerns, providers should only prescribe Molnupiravir when other treatment options, such as paxlovid, bebtelovimab, or remdesivir, are inappropriate or unavailable.

In vitro studies showed that molnupiravir retains activity against COVID-19 variants of concern, including Omicron. Molnupiravir is expected to work against Omicron and other emerging variants because its mechanism of action is independent of mutations in the spike protein of SARS-CoV-2.

Dosage and administration:

• Molnupiravir is administered orally as 800 mg (four 200 mg capsules) every 12 hours for five days, with or without food

For more information about Molnupiravir, click here.

Monoclonal antibody – Bebtelovimab

On November 30, 2022, the U.S. Food and Drug Administration (FDA) revised the Emergency Use Authorization (EUA) to discontinue the administration of Bebtelovimab. Read the full FDA announcement here: https://www.fda.gov/drugs/drug-safety-and-availability/fda-announces-bebtelovimab-not-currently-authorized-any-us-region.

Intravenous Antiviral – Remdesivir

Remdesivir, under the tradename VEKLURY, is now FDA approved as an out-patient early treatment option for patients diagnosed with mild-to-moderate COVID-19 and are at a high risk of severe disease. Remdesivir should be initiated within 7 days of symptom onset.

A randomized controlled trial, published in January 2022, showed that early treatment with remdesivir “resulted in an 87% lower risk of hospitalization or death” when compared to placebo.

The recommended out-patient treatment consists of a three-day course within seven days of COVID-19 symptom onset.

Dosage and administration:

• Adults and pediatric patients weighing at least 40 kg: a single loading dose of VEKLURY 200 mg on day one followed by once daily maintenance doses of VEKLURY 100 mg from day two via intravenous infusion
• Pediatric patients 28 days of age and older and weighing 3 kg to less than 40 kg: a single loading dose of VEKLURY 5 mg/kg on day one followed by once-daily maintenance doses of VEKLURY 2.5 mg/kg from day two via intravenous infusion

For more information about Remdesivir, click here.

Additional Guidance

Providers are encouraged to frequently monitor Florida Department of Health and CDC websites for updated guidance on COVID-19.

• FloridaHealthCOVID19.gov
• Information for Pediatric Healthcare Providers – CDC Website
• Information for Healthcare Professionals – CDC Website
  • Evaluating and Testing Persons for Coronavirus Disease 2019 (COVID-19)

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Related Outreach Materials

• Screening Facilities