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Frank Son, PharmD

What is Paxlovid and is it Vegan-Friendly?

Updated: Apr 9, 2022

Paxlovid is a new oral medication that has been authorized for emergency use by the FDA in mild to moderate coronavirus disease 2019 (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Paxlovid is the brand name for a combination of two separate active medications called Nirmatrelvir and Ritonavir.


President Biden’s Test-to-Treat Initiative

Through this newly launched initiative, patients who test positive for COVID-19 will be able to have quick access to potentially life-saving, Paxlovid. Patients will be able to go through local pharmacy-based clinics, federally qualified community health centers, and residents of long-term care facilities will be assessed by a health care provider (HCP) who has the authority to prescribe the medication.


Who will need to take this medication? Who is high-risk for severe COVID-19 Infection?

The CDC has a resource that details conditions that may put patients at high-risk for developing severe COVID-19. These include the following:

Conditions with Evidence of Higher Risk for Severe COVID-19 Outcomes

What is in Paxlovid?

Paxlovid (Nirmatrelvir + Ritonavir) 150 mg + 100 mg

Paxlovid is an antiviral medication that helps fight the COVID-19 virus. It is an inhibitor of the enzyme responsible for viral replication of SARS-CoV-2. It is comprised of two 150 mg tablets of Nirmatrelvir with one 100 mg tablet of Ritonavir, with all three tablets taken together twice daily for 5 days. The medication is recommended to be administered as soon as COVID-19 symptoms begin or within 5 days of symptom onset.

Nirmatrelvir and Ritonavir's Active Ingredients, Inactive Ingredients, and Film Coating

Is Paxlovid Vegan?

Not Animal-Free

The short answer is no. Technically, medications are not considered vegan because they often require animal testing during the drug development process. The accurate question is, “Is Paxlovid animal-free?”. Paxlovid is not animal-free due to lactose monohydrate, an inactive ingredient within the Nirmatrelvir tablets, which is commonly associated with dairy products.


What does the data show?

  • Efficacy: A landmark randomized-control trial published in the New England Journal of Medicine (NEJM) with 2,246 patients found that treatment of symptomatic Covid-19 with Nirmatrelvir plus Ritonavir resulted in an 89% lower risk of progression to severe Covid-19 when compared to placebo. This study was sponsored by the manufacturer, Pfizer.

  • Safety: Looking at the overall data, Paxlovid does not appear to have any significant safety concerns. Here is a table published in the NEJM summarizing its adverse effects.

NEJM Summary of Adverse Events, Serious Adverse Events, and Adverse Events Leading to Discontinuation through Day 34 (Safety Analysis Population)

Reference: Jennifer Hammond, Heidi Leister-Tebbe and Annie Gardner et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. The New England Journal of Medicine. DOI: 10.1056/NEJMoa2118542


Want more resources?

Visit COVID.gov for more information on COVID-19 testing, vaccines, treatments, protection, and travel.


Co-authored by: Angela Wolfe


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Disclaimer: The product and/or medical information provided on VeganMed is of a general nature and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or product.

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