| COVID-19 Virus Disease

Actemra vs Paxlovid

Side-by-side clinical, coverage, and cost comparison for covid-19 virus disease.

Deep comparison between: Actemra vs Paxlovid with Prescriber.AI

AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.

Safety signalsPaxlovid has a higher rate of injection site reactions vs Actemra based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Paxlovid but not Actemra, including UnitedHealthcare

Category

Actemra

Paxlovid

At A Glance

RouteIV infusion or SC injection

FrequencyEvery 4 weeks (IV) or Every week to Every other week (SC)

ClassIL-6 receptor antagonist

RouteOral

FrequencyTwice daily

ClassSARS-CoV-2 main protease inhibitor

Indications

Rheumatoid Arthritis
Giant Cell Arteritis
Lung disease with systemic sclerosis
Juvenile polyarthritis
Systemic onset juvenile chronic arthritis
Cytokine Release Syndrome
COVID-19 Virus Disease

COVID-19 Virus Disease

Dosing

Rheumatoid Arthritis IV: 4 mg/kg every 4 weeks, increase to 8 mg/kg every 4 weeks based on response; SC: 162 mg every other week (for <100 kg) or every week (for >=100 kg), increase to every week based on response.

Giant Cell Arteritis IV: 6 mg/kg every 4 weeks with tapering glucocorticoids; SC: 162 mg every week with tapering glucocorticoids (may use every other week based on clinical considerations).

Systemic Sclerosis-Associated Interstitial Lung Disease SC: 162 mg every week.

Polyarticular Juvenile Idiopathic Arthritis IV: 10 mg/kg every 4 weeks (<30 kg) or 8 mg/kg every 4 weeks (>=30 kg); SC: 162 mg every 3 weeks (<30 kg) or every 2 weeks (>=30 kg).

Systemic Juvenile Idiopathic Arthritis IV: 12 mg/kg every 2 weeks (<30 kg) or 8 mg/kg every 2 weeks (>=30 kg); SC: 162 mg every 2 weeks (<30 kg) or every week (>=30 kg).

Cytokine Release Syndrome IV: 12 mg/kg (<30 kg) or 8 mg/kg (>=30 kg) as single dose, alone or with corticosteroids; up to 3 additional doses at least 8 hours apart if no improvement.

COVID-19 IV: 12 mg/kg (<30 kg) or 8 mg/kg (>=30 kg) as single 60-minute infusion; one additional dose at least 8 hours later if clinical signs worsen or do not improve.

COVID-19 Virus Disease 300 mg nirmatrelvir (two 150 mg tablets) with 100 mg ritonavir (one 100 mg tablet) taken together orally twice daily for 5 days, initiated within 5 days of symptom onset. For moderate renal impairment (eGFR >=30 to <60): 150 mg nirmatrelvir with 100 mg ritonavir twice daily for 5 days. For severe renal impairment (eGFR <30): 300 mg nirmatrelvir with 100 mg ritonavir once on Day 1, then 150 mg nirmatrelvir with 100 mg ritonavir once daily Days 2-5 (after hemodialysis on dialysis days).

Contraindications

Known hypersensitivity to tocilizumab

Clinically significant hypersensitivity reactions (toxic epidermal necrolysis or Stevens-Johnson syndrome) to nirmatrelvir, ritonavir, or any component
Co-administration with CYP3A substrates with elevated concentrations associated with serious or life-threatening reactions: alfuzosin, ranolazine, amiodarone, dronedarone, flecainide, propafenone, quinidine, colchicine (in renal or hepatic impairment), lurasidone, pimozide, silodosin, eplerenone, ivabradine, dihydroergotamine, ergotamine, methylergonovine, lovastatin, simvastatin, voclosporin, lomitapide, eletriptan, ubrogepant, sildenafil for pulmonary arterial hypertension, triazolam, oral midazolam, flibanserin, tolvaptan, finerenone, naloxegol, suzetrigine
Co-administration with strong CYP3A inducers (potential for loss of virologic response): apalutamide, enzalutamide, carbamazepine, phenobarbital, primidone, phenytoin, rifampin, rifapentine, lumacaftor/ivacaftor, St. John's Wort

Drug Interactions

856View drug interactions

1372View drug interactions

Adverse Reactions

Most common (>=5%) Upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions (SC only).

Serious Serious infections (pneumonia, urinary tract infection, cellulitis, herpes zoster, gastroenteritis, diverticulitis, sepsis, bacterial arthritis), gastrointestinal perforations, hypersensitivity reactions including anaphylaxis.

Postmarketing Fatal anaphylaxis, Stevens-Johnson Syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), pancreatitis, drug-induced liver injury, hepatitis, hepatic failure, jaundice, hypofibrinogenemia.

Most common (>=1%) dysgeusia, diarrhea, vomiting

Postmarketing anaphylaxis, hypersensitivity reactions, toxic epidermal necrolysis, Stevens-Johnson syndrome, headache, hypertension, abdominal pain, nausea, malaise

Pharmacology

Tocilizumab is a humanized IgG1 kappa monoclonal antibody that binds to soluble and membrane-bound IL-6 receptors, inhibiting IL-6-mediated signaling involved in inflammatory and immune processes.

Nirmatrelvir is a peptidomimetic inhibitor of the SARS-CoV-2 main protease (Mpro), preventing viral polyprotein processing and replication. Ritonavir inhibits CYP3A-mediated metabolism of nirmatrelvir, increasing its plasma concentrations.

View Full FDA Information

View full FDA information

Enter your patient's insuranceCheck specific coverage details for your patient.

Most Common Insurance

Anthem BCBS

Actemra