What it is—and how to treat it

Some people have reported an off taste after ingestion, which has been described as “sun-dried garbage bag liquid, a gulp of dirty pennies, and rotten soy milk.” Pfizer‘s antiviral Covid-19 drug Paxlovid. writing for them Wall Street JournalAlex Janin explains why “Paxlovid mouth” occurs and suggests ways to address the unpleasant side effect.

What is “Paxlovid Mouth”?

According to a Pfizer spokesman, the side effect is called dysgeusia. A Pfizer-funded study found that 5.6% of patients taking Paxlovid suffered from taste disorders – and most of their symptoms were mild.

“Paxlovid mouth” is most likely caused by ritonavir, which is designed to increase the concentration of antiviral drugs. In other cases it has been linked to dysgeusia.

Patients who have experienced the side effect “have tried to eliminate the taste with ointments ranging from cinnamon to milk to pineapple. They also trade strategies online,” writes Janin.

For example, Lisa Crawford said she searched the internet for possible solutions when she started suffering from taste disorders. “It was like the smell that hot trash has, but in your mouth,” Crawford said.

Finally, Crawford found a post Reddit who recommended eating pineapple to relieve her symptoms. She found some relief eating pineapple every 10 to 15 minutes.

“I probably don’t have enamel anymore,” she said, “but it was the only thing that saved my sanity.”

But doctors – and many patients who have taken Paxlovid – have said it’s a small price to pay for the roughly 90% reduction in hospitalizations and deaths in patients at risk of serious illness from Covid-19.

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While the drug can trigger the nasty side effect, doctors warn patients should take the entire course to prevent a rebound case.

“If you don’t complete the entire course, you’re adding to the virus the ability to hang around with less drug presence to block replication,” he said Yale School of Medicine Infectious Disease Specialist Scott Roberts.

“If a patient vomits or experiences an allergic reaction, they should discontinue the course and talk to their doctor about other antivirals,” writes Janin. “In some cases, doctors may prescribe medications to treat other possible side effects of Paxlovid, such as nausea.”

How Can Patients Relieve “Paxlovid Mouth”?

If a patient has taste disorders, Roberts suggests sucking on things that bind to the mouth’s taste receptors, including lozenges and breath mints.

According to Shivanjali Shankaran, a doctor and infectious disease specialist Rush University Medical CenterCoating the mouth with chocolate milk or a spoonful of peanut butter before each dose can help mitigate the side effect.

“Cinnamon gum is also effective for two reasons: the flavor is overwhelming and almost numbing, and the gum helps improve salivation, which can prevent dryness, which can make the taste worse,” adds Janin.

When Jacklyn Grace Lacey tweeted about taking Paxlovid in May, she received a direct message from a former student who recommended using mouthwash and other mint-flavored items to combat bad taste. According to Lacey, she “ordered pretty much every mint item they had” on a grocery delivery app.

But unfortunately, some say the taste prevented them from completing the treatment. “I actually strained my neck because the gagging reaction was so strong,” recalled Chantal McLaughlin.

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While the drug’s instructions specifically state that the pills should be taken whole, McLaughlin chopped up the starting dose and stirred it in lemon water.

“The moment I took a sip, my taste buds just rejected it,” she recalled. When McLaughlin, who has trouble swallowing large pills, tried again with a thick peanut butter and banana smoothie, she was still only able to swallow a few.

Andrea Freire said she drank four bottles of strawberry-flavored Pedialyte every day for three to four days to try to mask the taste of the drug.

Still, Freire, who has a heart defect, said she didn’t hesitate to take the drug again when she was reinfected. “I would take it 100 times over,” she said. (Janin, Wall Street Journal8/16)

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