Your Doctor Prescribed Paxlovid — But No Pharmacy Has It

It's a scenario that happens more often than it should. You test positive for COVID-19, your doctor prescribes Paxlovid 5-Day, and then you discover that no pharmacy near you has it in stock. Or maybe the cost without insurance — around $1,400 to $1,600 — makes it impractical.

Either way, you still have COVID-19, and you still need treatment. The good news: Paxlovid isn't your only option. Several alternatives exist, and your doctor can help you find the right one based on your health situation.

Before exploring alternatives, it's worth trying Medfinder to check if any pharmacies near you have Paxlovid in stock — you might be surprised.

What Is Paxlovid 5-Day and How Does It Work?

Paxlovid is the brand name for Nirmatrelvir/Ritonavir, an oral antiviral combination made by Pfizer. It's FDA-approved for treating mild-to-moderate COVID-19 in adults who are at high risk for severe illness.

Here's how it works:

• Nirmatrelvir blocks the SARS-CoV-2 main protease (called 3CL protease or Mpro), an enzyme the virus needs to copy itself. Without this enzyme, the virus can't replicate.
• Ritonavir doesn't fight the virus directly. Instead, it slows down the breakdown of Nirmatrelvir in your body, so it stays at effective levels longer.

The standard treatment is two Nirmatrelvir tablets (300 mg total) plus one Ritonavir tablet (100 mg), taken twice daily for 5 days. It should be started within 5 days of symptom onset.

For a more detailed overview, check out: How Does Paxlovid 5-Day Work? Mechanism of Action Explained.

Alternative #1: Lagevrio (Molnupiravir)

Lagevrio, made by Merck, is another oral antiviral for COVID-19. It's available under FDA Emergency Use Authorization (EUA) for adults with mild-to-moderate COVID-19 who are at high risk for severe illness.

How it works: Molnupiravir works differently from Paxlovid. It introduces errors into the virus's genetic code during replication, eventually making the virus unable to reproduce. Think of it as causing the virus to make so many typos that its copies are no longer functional.

Key differences from Paxlovid:

• Taken as four capsules (800 mg) twice daily for 5 days
• Fewer drug interactions — a major advantage for patients on multiple medications
• Clinical trials showed it was less effective than Paxlovid at reducing hospitalization and death (about 30% reduction vs. Paxlovid's roughly 89% in the original trials)
• Not recommended during pregnancy
• Still under EUA, not fully FDA-approved

Best for: Patients who can't take Paxlovid due to drug interactions (especially those on immunosuppressants, certain heart medications, or blood thinners) or when Paxlovid isn't available.

Alternative #2: Remdesivir (Veklury)

Remdesivir, made by Gilead Sciences, is an FDA-approved antiviral for COVID-19. Unlike Paxlovid and Lagevrio, it's given as an intravenous (IV) infusion — not a pill.

How it works: Remdesivir blocks the RNA polymerase enzyme that the SARS-CoV-2 virus uses to copy its genetic material. It's been used since the early days of the pandemic and has a strong evidence base.

Key details:

• Given as a 3-day IV infusion for outpatients (each session takes about 30-60 minutes)
• Requires visiting an infusion center, hospital outpatient clinic, or similar facility
• FDA-approved for adults and pediatric patients (weighing at least 3 kg)
• Fewer drug interactions than Paxlovid
• Can be used in patients with kidney or liver impairment (with monitoring)

Best for: Patients who can't take oral antivirals, those with significant drug interactions, or when neither Paxlovid nor Lagevrio is available. The downside is the need for three separate infusion visits.

Alternative #3: Monoclonal Antibodies

Monoclonal antibody treatments for COVID-19 have had a complicated history. Many earlier products (like Bebtelovimab, Evusheld, and Bamlanivimab) lost their authorization as the virus mutated and new variants emerged.

Current status: As of early 2026, availability of monoclonal antibodies for COVID-19 treatment depends on which variants are circulating. The FDA periodically reviews and updates authorizations based on whether existing products are effective against current strains.

Key details:

• Administered via IV infusion or injection
• Effectiveness depends on the circulating variant
• Pemgarda has been authorized for pre-exposure prophylaxis in immunocompromised patients
• Your doctor or local health department can advise on current availability

Best for: Immunocompromised patients or those who can't take antiviral medications. Check with your healthcare provider about which products are currently authorized.

Alternative #4: Supportive Care and Symptom Management

If you're unable to access any antiviral treatment, supportive care remains important — especially if you're not in a high-risk category.

• Over-the-counter medications: Acetaminophen (Tylenol) or ibuprofen (Advil) for fever and body aches
• Hydration: Plenty of fluids
• Rest: Allow your body to fight the infection
• Monitor symptoms: Watch for warning signs of severe illness (difficulty breathing, persistent chest pain, confusion, inability to stay awake)

Supportive care isn't a substitute for antiviral treatment in high-risk patients, but it's an important complement to any treatment plan.

How to Decide Which Alternative Is Right for You

This is a decision to make with your doctor, not on your own. Factors they'll consider include:

• Your current medications and potential drug interactions
• Your kidney and liver function
• Whether you can visit an infusion center (for Remdesivir)
• How many days since your symptoms started
• Your specific risk factors for severe COVID-19

If Paxlovid is your doctor's first choice, don't give up on finding it. Use Medfinder to search for pharmacies with stock, and read our guide: How to Find Paxlovid 5-Day in Stock Near You.

Final Thoughts

Not being able to fill your Paxlovid prescription is stressful, but it doesn't mean you're out of options. Lagevrio, Remdesivir, and in some cases monoclonal antibodies can provide effective treatment for COVID-19. The most important thing is to talk to your doctor quickly so they can pivot to an alternative before the treatment window closes.

For the latest on Paxlovid availability and pricing, check out: Paxlovid 5-Day Shortage Update: What Patients Need to Know in 2026.