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Covid-19 treatment for most clinically vulnerable people at highest risk of severe disease

Treatment for COVID-19 is available at Swansea Bay University Health Board for people who are not in hospital but who are considered at highest risk of progression to severe disease, hospital admission or death

The high-risk group includes people who have

What treatments are there for COVID-19?

Sotrovimab (Xevudy®)

Sotrovimab is a biological medicine. It's also known as a neutralising monoclonal antibody (nMAB).

nMABs are synthetic proteins that act like human antibodies in the immune system. They are made by cloning an antibody that can stick to the spike protein of the virus and neutralise it. They stick to the virus and stop it from getting into your lungs and causing an infection.

If you are eligible for COVID-19 treatment you will usually be offered neutralising monoclonal antibodies (nMABs) such as sotrovimab as a first treatment rather than antiviral medicines.

A clinical study showed that sotrovimab decreased the risk of hospitalisation or death by 85% in patients with mild-to moderate disease and at least one risk factor for disease progression.

Who can have sotrovimab?

Sotrovimab can be given to most adults, and children aged 12 years or older who weigh at least 40kg (6 stone 4 lb).

You may be eligible for sotrovimab if ALL of these apply:

  • you're in the high-risk group above
  • you've had a positive PCR test within the last 5 days
  • you’ve had coronavirus (COVID-19) symptoms within the last 5 days

Who may not be able to have sotrovimab?

Sotrovimab is not suitable for some people. To make sure it's safe for you, tell your health care professional if:

  • you have any allergies
  • you are pregnant, trying to get pregnant or breastfeeding

How is sotrovimab given?

Sotrovimab is given to you through a drip in your arm (infusion) over 30 minutes. It will be given in hospital or at a local centre. The dose of sotrovimab is 500mg and you'll only need 1 dose.  You will then need to be monitored for around 30 minutes after the infusion is complete.

Does it have any side effects?

Like all medicines, sotrovimab can cause side effects in some people, but many people have no side effects or only minor ones.

The most common side effects (happen in up to 1 in 10 people) are a mild allergic reaction (hypersensitivity) which can include feeling sick (nausea), feeling dizzy, an itchy rash and redness (this may be less noticeable on black or brown skin) and warmth on your skin.

These symptoms usually happen within the first 24 hours and should go away on their own.

In rare cases, sotrovimab may cause a serious allergic reaction (anaphylaxis).

Other medicines and sotrovimab

There's no evidence to say that sotrovimab will affect any other medicine you are taking.

Sotrovimab may affect how well the COVID-19 vaccine works. If you have been treated with sotrovimab, tell your doctor if you are going to have a COVID-19 vaccine or booster.

There's not enough information to say that herbal remedies or supplements are safe to take with sotrovimab.

Molnupiravir (Lagevrio®)

Molnupiravir is an antiviral medicine that works by stopping the virus that causes coronavirus (COVID-19) from growing and spreading.  It's used to treat early COVID-19 infection and help to prevent more severe symptoms.

Molnupiravir comes as capsules. You'll need to start taking the capsules as soon as possible after you have tested positive for COVID-19 and within 5 days of your symptoms starting.

If you are eligible for COVID-19 treatment you will usually be offered neutralising monoclonal antibodies (nMABs), such as sotrovimab (Xevudy®), before molnupiravir.

Who can have molnupiravir?

You may be eligible for molnupiravir if ALL of these apply:

  • you’re over 18 years old
  • you're in the high-risk group above
  • you've had a positive PCR test within the last 5 days
  • you've had coronavirus (COVID-19) symptoms within the last 5 days

Who may not be able to have molnupiravir?

Molnupiravir is not suitable for some people. Tell your health care professional before starting to take this medicine if you:

  • are pregnant, trying to get pregnant or breastfeeding
  • have ever had an allergic reaction to molnupiravir or any other medicine

How is molnupiravir taken?

Molnupiravir comes as 200mg capsules. The dose is 800mg (four capsules) twice a day (morning and evening) for 5 days.

It's important that you start taking molnupiravir within 5 days of getting coronavirus (COVID-19) symptoms.  Swallow the capsules whole with a glass of water. You can take them with or without food.  Do not open, break or crush the capsules as this will release the medicine into your body too quickly.

Even if you start to feel better it's important you complete the course.

Does it have any side effects?

Like all medicines, molnupiravir can cause side effects in some people, although not everyone gets them.

Common side effects of molnupiravir (affect more than 1 in 100 people) include feeling dizzy and headaches. If you feel dizzy, do not drive, cycle or use tools or machinery.  There are no known serious side effects with molnupiravir.

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to molnupiravir.

Molnupiravir and pregnancy, breast feeding and fertility

Molnupiravir is not recommended in pregnancy. It’s important to use reliable contraception while you’re taking molnupiravir and for 4 days after your last dose so you do not get pregnant.

The manufacturers advise that breastfeeding is not recommended during treatment with molnupiravir and for 4 days after your last dose. It’s not known how much molnupiravir passes into breast milk.

Tell your healthcare professional if you are eligible for molnupiravir and you’re pregnant or breastfeeding. They may be able to offer you other treatments.

It's not known whether taking molnupiravir will affect fertility in either men or women.

How do I get sotrovimab or molnupiravir?

If you are in the high-risk group and would like to receive treatment with sotrovimab or molnupiravir, or wish to discuss which COVID-19 treatment may be best for you use the first link in your text message, or go here to arrange to speak with a member of the NHS Wales COVID-19 Treatment Programme or alternatively, you can contact NHS 111 or your GP.

It's recommended that you have treatment within 5 days of your symptoms starting.

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