COVID-19 Treatments in Canada
Did you know that there are several treatments for COVID-19?
There are now treatments for COVID-19 that can help prevent hospitalizations and death, especially in those who are at greater risk for severe complications. They are most beneficial taken within 5 to 7 days of the onset of mild or moderate symptoms. Eligibility to receive treatment depends on your risk factors, chronic conditions, age, whether you are vaccinated, and where you reside in Canada.
Since the identification of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its subsequent variants, researchers have been developing vaccines to prevent infection and one prevention medication. Click here for information about vaccines and medication to prevent COVID-19 infection.
Those who have been fully vaccinated against the virus (2 doses) and had booster shots, as appropriate, generally have self-limiting symptoms and recover naturally.
Who is at Risk of Severe COVID-19?
Not everyone needs or is eligible for COVID-19 treatment. All the approved treatments so far have only been studied in, and approved for, people who are at high risk of severe infection, hospitalization, and/or death. There was variability in how the different treatment studies classified high risk individuals and healthcare professionals and health authorities across Canada are still debating the criteria for who should be considered in this group. For example, some studies classified all adults over 50 years of age to be at high risk, while other studies only classified these adults as high risk if they also had a significant chronic health condition.
COVID-19 Treatments
Currently, Health Canada has approved a few treatments for COVID-19. Medication availability and access varies by province and territory, and we have all the available links listed below. For more immediate information about your specific situation, ask your local pharmacist, doctor, or public health authority to learn more about which treatments are available in your region and how to access them.
Many of these treatments must begin within 5 to 7 days of symptom onset to work as expected. You must act quickly if you test positive for COVID-19 and have symptoms. Individual access to these medications is conditional, factoring in your risk for severe infection and hospitalization, your age, and whether you have any chronic condition(s), as explained above. You vaccination status is also a factor.
The medications listed below do not stop you from contracting COVID-19. They can only prevent severe symptoms and/or hospitalization in those who are high risk.
Nirmatrelvir and Ritonavir (Paxlovid™)3
Paxlovid™ is the only oral medication available in Canada for the treatment of adults (18 years of age and older) who are at high risk of hospitalization or death due to COVID-19. A treatment course is 5 days. Nirmatrelvir, an antiviral agent, works to stop the virus from replicating in your body. It is combined with ritonavir, which boosts the levels of nirmatrelvir in the body. This can help you overcome the infection and reduce risk of hospitalization and death. You can take Paxlovid™ in any healthcare setting or at home. In some cases, e.g., in BC, a healthcare professional might follow up with you about your treatment.
Remdesivir (Veklury®)5
Veklury® is administered by intravenous (IV) infusion in a healthcare setting, once daily for 3 days. It is used for in-hospital patients as well as those who are at high risk of hospitalization or death due to COVID-19. Remdesivir is an antiviral drug that works by stopping the virus from replicating in your body and is currently one of the main IV medications recommended by the various Canadian health authorities.
Other Treatments
The following treatments have also been approved by Health Canada, but the use and availability of these medications varies by province or territory and, if recommended, the healthcare professionals assessing you for COVID-19 treatment will provide you with information on how to access them.
It’s a Balance
Some medications, such as Paxlovid™, have drug-to-drug interactions, and you might need to stop or reduce the dose of your usual medications during treatment. If your existing medications cannot be adjusted and there is a significant drug interaction, you shouldn’t use Paxlovid™. It’s also important to consider the potential side effects of these treatments. Medications requiring an infusion may sometimes cause reactions, including itchiness, rash, flushing, shortness of breath, nausea, or vomiting. Before starting any type of COVID-19 treatment, you should immediately discuss the benefits and risks with your doctor or pharmacist to ensure that the therapy is safe and effective.
Selecting a COVID-19 Treatment
Selection of a COVID-19 treatment depends on which options are available, the feasibility of administering an injection or intravenous infusion, the potential for drug-to-drug interactions, and the virus variant or sub-variant suspected. For example, studies14 show that Paxlovid™ is effective against the BA.2 sub-variant of the Omicron variant and is the first line treatment in most regions in Canada. Veklury® has demonstrated some success against Alpha, Beta, Gamma, Epsilon, Kappa, Lambda, Iota, and Zeta variants but less activity against Delta and Omicron variants.2 Xevudy® was shown to be effective against earlier variants of COVID-19 but is less effective against the newer Omicron subvariants such as BA.2 and others which are becoming the variants of concern. The treatment selected will continue to change as we identify more variants and subvariants of concern in the population over time.
CAUTION: Unproven Treatments and Poisonings
While the internet can be a wealth of information and education, it also contains a lot of misinformation. Two unproven treatments that became prominent early in the COVID-19 pandemic include ivermectin (Stromectol®), an antiparasitic drug, and hydroxychloroquine sulfate (Plaquenil®), a drug used to prevent and treat malaria in areas where malaria remains sensitive to chloroquine or to treat some autoimmune conditions. Neither one of these treatments has been shown to have any positive impact in the treatment of COVID-19 and they can cause severe side effects when used inappropriately. There have been poisonings related to the misuse of veterinary-grade ivermectin in Canada, causing hospitalizations. Protect yourself from misinformation by discussing treatment options with your healthcare provider and ensure that you are getting your information from reputable and trustworthy sources.
