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U.S. Department of Health and Human Services
National Pharmacy & Therapeutics Committee

Paxlovid Call Script

Hello, my name is --- and I am a (physician, nurse practitioner, nurse, etc) calling from Gallup Indian Medical Center to follow up with you after you were tested for COVID-19. Has anyone been able to reach you yet regarding your test result?

If no, please discuss items on bottom of page 2 before proceeding to Paxlovid discussion.

If yes and patient is aware of positive result:

Has anyone talked with you yet about the treatment for COVID-19? It’s a medication called Paxlovid and it works better the sooner we can give it to someone after their symptoms start. Can I verify with you what day you first started having symptoms? Please note that the first day of symptoms is day 0

If patient has already been symptomatic for more than 5 days or has no symptoms they are not eligible for this treatment. If the patient has no symptoms at this time but would otherwise be eligible for treatment please provide them with the number to the COVID Therapeutics cell phone 505-339-8898 where they can call back ASAP if any symptoms do develop. If the patient has been symptomatic for more than 5 days, but less than 7, you can discuss monoclonal antibodies (switch to the monoclonal antibody call script).

If the patient is eligible for treatment: 

Can I give you some information about Paxlovid to see if you might be interested?”

Paxlovid is a combination of two different pills that you take for twice a day for 5 days. Paxlovid works by shutting down the ability of SARS-CoV-2 (the virus that causes COVID) to make more copies of itself. If you take all of the pills for the full 5 day course it reduces the chance of that the virus can get worse to where a person may need to come into the hospital, or even die from COVID-19, by about 89%.

The main side effect of Paxlovid is that some people experience upset stomach (nausea and sometimes vomiting or diarrhea) when they are taking this medication. For that reason we prescribe an anti-nausea medication called ondansetron along with Paxlovid. If you start to feel like the Paxlovid is causing nausea you can start taking the ondansetron to help get rid of this side effect.

The other thing that’s also good to be aware of with this medication is that, just like all of the treatments we have for COVID-19, this medication was developed in the past year and a half. Because of that, it hasn’t been out long enough yet to get full FDA approval. That’s because the complete approval process through the Food and Drug Administration (the FDA) takes several months to years to complete. For that reason this medication is under what’s called “emergency use authorization” by the FDA.

Is this medication something you think you might be interested in?

If yes:

Great. I just need to ask you some questions to confirm that you are a candidate for this medication. This medication has to be given at a lower dose to people who have kidney problems and it is not recommended for people who have very severe kidney or liver problems. Have you ever been told that you have any problems with your kidneys or liver? Make sure to also review the EHR to see if patient has a recent CMP on file or if problem list/last PCP note has any renal or hepatic diagnoses listed.

If no:

This medication can also interact with other medications. Can you tell me all of the medications (including over the counter and herbal medications) that you are currently taking? If the patient is at home you can ask them to gather all of the medication bottles so that they can read you the labels.

You can use the COVID-19 Drug Interaction Checker (available at Liverpool COVID-19 Interactions (covid19-druginteractions.org) to run their home medications against Paxlovid to see if there are drug-drug interactions.

If the patient remains a candidate for Paxlovid:

Ok, it sounds like you are a good candidate for Paxlovid treatment. I am going to prescribe the medication for you to pick up at the main GIMC pharmacy. When you arrive to pick up your medication please make sure to park and stay in your vehicle and call the main pharmacy number at 505-722-1185 so that someone can bring the medication out to you. Please do not enter any of the hospital buildings since you have COVID and can spread the virus to other people. It’s really important to start Paxlovid within 5 days of symptom onset so for that reason the pharmacy will not let you pick it up after that time. The medication also works better the sooner you start it after symptoms begin so I would recommend trying to pick it up today.

If patient is not yet aware of their COVID test result

  1. Make patient aware of test result
  2. Briefly discuss isolation requirements
  3. Briefly discuss testing of close contacts (within 6 feet for >15 minutes with or without a mask during patient’s infectious period which starts 48 hours prior to symptom onset). Contacts should test immediately and again at day 5-7 after exposure (or sooner if any symptoms develop)