Does Paxlovid make you less contagious?

Taking Paxlovid (nirmatrelvir and ritonavir) to treat COVID-19 within 5 days of symptoms can make you less contagious sooner than if you do not take it, but it is still important to follow public health recommendations if you are sick. This includes staying at home and keeping away from others if you have respiratory symptoms. You can still spread the virus while taking Paxlovid, and how long you are contagious depends on many factors.

In addition to possibly making you less contagious, Paxlovid has been shown to lower the risk of hospitalization from COVID-19 infection by over 50% and the risk of death by 75%. It is FDA approved to treat mild-to-moderate illness due to COVID-19 in adults who are at risk for severe illness. It is authorized under Emergency Use Authorization for children 12 years and older who weigh at least 40 kg (88 lbs) who are at risk for severe COVID-19.

Am I still contagious after starting Paxlovid?

Yes, you can still be contagious after you start taking Paxlovid for COVID-19. One study found that taking Paxlovid three days after symptoms started reduced how contagious people were by 12% in those who did not experience rebound (return of COVID-19 symptoms). Research has also shown that taking Paxlovid after 5 days since your symptoms began reduces its effectiveness in lowering viral shedding.

In a small study of people who took Paxlovid within 5 days of COVID-19 symptoms starting, those who took the medication had a faster drop in viral load (how much virus is in your body) compared to those who did not take it. Having a lower viral load could mean you are less contagious. However, those who took Paxlovid were more likely to experience a rebound in both viral load and symptoms after day 10.

Some people who take Paxlovid experience a return of their symptoms several days after starting the medication. This is known as Paxlovid rebound. There are reports of people spreading the virus to others during the time they had relapse symptoms.

If your symptoms get better and then worse again while you are taking Paxlovid or after your treatment course and you test positive for COVID-19 again, it is recommended to isolate yourself for 5 full days and you have been fever-free for at least 24 hours. It is recommended to wear a mask for 10 days from the time your rebound symptoms began to prevent spreading COVID-19 to others.

How can I prevent the spread of COVID-19?

It’s recommended to stay at home and away from others during the time you have respiratory virus symptoms, such as:

• Fever
• Chills
• Fatigue
• Runny nose
• Cough
• Headache
• Low appetite
• Loss of taste or smell
• Sore throat
• Vomiting

Once your symptoms have been getting better and you have not had a fever (without using a fever-reducer) for at least 24 hours, you can resume normal activities while still taking precautions over the next 5 days. Continue to practice good hygiene, distance yourself from others, wear a mask, and test for COVID-19 during this time. Even if you are feeling better, you may still be contagious and can spread the virus to others.

If at any time you start to feel worse or come down with a fever, stay away from others until you feel better and you have been fever-free for at least 24 hours.

Related questions

• Paxlovid side effects: 8 key things to know
• How fast does Paxlovid work?
• Can you take Paxlovid twice if COVID rebounds?

Am I contagious if I tested positive for COVID-19 with no symptoms?

Yes, you can be contagious if you do not have any symptoms and test positive for COVID-19. After testing positive, take precautions to prevent the spread of the virus to others for the next 5 days. This includes washing your hands often, wearing a mask, and keeping distance from others.

How long will I be contagious if I tested positive for COVID-19?

If you test positive for COVID-19, you are likely to spread the virus to others. How long you will be contagious depends on various factors. This includes how sick you are, your viral load (measured by a PCR test), the strain of virus, how strong your immune system is, how long you have been sick, and whether you have been vaccinated or had a previous COVID-19 infection.

Studies have shown that you are most contagious during the time you have symptoms. In general, you are less likely to be contagious 24 hours after your symptoms have been overall better and you have not had a fever. However, you can still spread the virus during this time and for some days after you tested positive.

Data from the early COVID-19 strains showed that people had infectious virus present on cell culture tests for up to 10 days after their symptoms started. There is not enough information on more recent SARS-CoV-2 variants to inform how long one is typically contagious.

This is not all the information you need to know about Paxlovid (nirmatrelvir and ritonavir) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.