Name of drug (brand name)
PF-07321332 and ritonavir (Paxlovid) Sotrovimab (Xevudy) Remdesivir (Veklury) Molnupiravir (Lagevrio) Casirivimab and imdevimab (REGEN-COV) Bamlanivimab and etesevimab Tixagevimab and cilgavimab (Evusheld)
Manufacturer
Pfizer GlaxoSmithKline Gilead Sciences Merck & Ridgeback Biotherapeutics Regeneron Eli Lilly AstraZeneca
Technology
Antiviral drug Monoclonal antibodies Antiviral drug Antiviral drug Monoclonal antibodies Monoclonal antibodies Monoclonal antibodies
Route of administration
Oral Intravenous infusion Intravenous infusion Oral Intravenous infusion Intravenous infusion 1 dose, consisting of 2 injections into buttocks
Mechanism
Blocks coronavirus protease enzyme, stopping virus from making copies of itself. Antibodies bind to a site on coronavirus spike protein, blocking coronavirus from entering human cells. Halts RNA synthesis by coronavirus, stopping it from making copies of itself. Causes mutations in coronavirus RNA, impairing virus’s ability to make copies of itself. Antibodies bind to 2 sites on coronavirus spike protein, blocking virus from attaching to and entering human cells. Antibodies bind to 2 sites on coronavirus spike protein, blocking virus from attaching to and entering human cells. Blocks viral attachment and entry into cells.
Regulatory status
Emergency Use authorized by FDA for adults and children 12+ years on December 22, 2021. Emergency Use authorized by FDA for adults and children 12+ years weighing at least 88 pounds on May 26, 2021. Approved by FDA for use in adults and children 12+ on October 22, 2020. Emergency Use authorized by FDA in children <12. FDA Advisory Committee recommended authorization by 13-10 vote on November 30. In UK, approved November 4, 2021. Emergency Use authorized by FDA for adults and children 12+ years weighing at least 88 pounds on November 21, 2020. Emergency Use authorized by FDA for adults and children of all ages on December 3, 2021. Approved by FDA for use in adults and children 12+ on December 6, 2021.
Indication
Treatment of non-hospitalized adults and children 12+ years with COVID-19 at high risk of severe illness. For treatment of mild-moderate COVID-19 in non-hospitalized adult and children 12+ years at high risk of severe illness. Not authorized for children <12 years. Treatment of COVID-19 in hospitalized adults and children 12+ years. Company also tested 3-day course in non-hospitalized COVID-19 patients 12+ years at high risk of severe illness. Treatment of non-hospitalized adults with COVID-19 at high risk of severe illness who do not require supplemental oxygen. Treatment of mild-moderate COVID-19 in adults and children 12+ years at high risk of severe illness. For post-exposure prevention of COVID-19 in non-vaccinated at high risk of severe illness. Treatment of mild-to-moderate COVID-19 in adults and children 12+ years at high risk of severe illness. For post-exposure prevention of COVID-19 in nonvaccinated at high risk of severe illness. For prevention of COVID-19 in immuno-compromised or those with history of severe adverse reaction to COVID-19 vaccines and who are not infected with or recently exposed to COVID-19.
Efficacy in non-hospitalized patients
Among those receiving drug within 5 days of onset of symptoms, 0.8% (8/1039) were hospitalized with no deaths compared to 6.3% (66/1046) and 12 deaths in placebo group. Among those receiving drug within 3-5 days of symptom onset, 1.1% (6/528) were hospitalized with no deaths, compared with 5.7% (30/529) and 2 deaths in placebo group. Among those starting 3-day course within 7 days of symptom onset, 0.7% (2/279) were hospitalized with no deaths, compared to 5.3% (15/283) and no deaths in placebo group. Among those receiving drug within 3-5 days of onset of symptoms, 6.8% (48/709) were hospitalized with one death, compared to 9.7% (68/699) and 9 deaths in placebo group. Among those receiving drug within 3 days of testing positive, 1.0% (7/736) were hospitalized, compared with 3.2% (24/748) in placebo group. Among those receiving drug within 3 days of testing positive, 0.8% (4/511) were hospitalized with no deaths, compared with 5.8% (15/258) and 4 deaths in placebo group. Over 6 months, among people receiving drug, 0.2% (8/3,441) tested positive for COVID-19 with symptomatic illness, compared with 1.0% (17/1,731) in placebo group.
Efficacy in hospitalized patients
Not authorized N/A Patients with severe COVID-19 receiving drug: median recovery time of 11 days vs 18 in placebo group. Patients with mild-moderate COVID-19: median recovery time of 5 days in both groups. N/A N/A N/A N/A
Absolute risk reduction (ARR) / Relative risk reduction (RRR)
ARR for hospitalization= 6.2%. RRR for hospitalization = 88%. RRR for death (with high uncertainty) = 100%. ARR for hospitalization= 4.6%. RRR for hospitalization = 79% [95% CI: 50-91%]. RRR for death (with high uncertainty) = 100%. In severe hospitalized patients 7-day (39%) reduction in median recovery time. In non-hospitalized patients, ARR for hospitalization = 4.6% and RRR for hospitalization = 87%. ARR for hospitalization= 2.9%. RRR for hospitalization = 30%. RRR for death (with high uncertainty) = 89%. ARR for hospitalization= 2.2%. RRR for hospitalization = 70%. ARR for hospitalization= 5.0%. RRR for hospitalization = 87%. RRR for death (with high uncertainty) = 100%. ARR = 0.8% RRR = 77%
Number needed to treat (NNT)
18 (to prevent one hospitalization) 22 (to prevent one hospitalization) Not calculable for hospitalized patients. For non-hospitalized patients, 22 (to prevent one hospitalization) 35 (to prevent one hospitalization) 46 (to prevent one hospitalization) 20 (to prevent one hospitalization) 125 (to prevent one COVID-19 illness)
Efficacy vs. variants (none tested against Omicron variant yet)
Expected to be active against omicron variant, according to NIH. Effective against Alpha, Beta, Gamma and Delta variants in in vitro testing, according to company. “Active” in vitro against variants, according to company. "Consistent efficacy" in clinical-study subjects infected with Gamma, Delta, and Mu variants, according to companies. Retained in vitro neutralization activity against major variants. Reduced efficacy in vitro vs. Beta, Gamma, Delta plus, and Mu variants, so not authorized for use in U.S. where frequency of these exceeds 5%. Currently authorized in U.S. Retains neutralizing activity against omicron variant in in vitro testing, according to company.
Contraindications
Potential for significant drug-drug interactions with other medications. Not authorized for use in patients who are hospitalized due to COVID-19 or who require oxygen therapy due to COVID-19. Should be used during pregnancy only if potential benefit justifies potential risk for mother and fetus. Not recommended during pregnancy or breastfeeding and for women who can become pregnant and are not using effective contraception. Not authorized for use in patients hospitalized due to COVID-19 or who require oxygen therapy due to COVID-19. Not authorized for use in patients hospitalized due to COVID-19 or who require oxygen therapy due to COVID-19. Not authorized for treatment of COVID-19 or prevention after exposure to someone infected with COVID-19.
Side effects
Impaired sense of taste, diarrhea, high blood pressure, muscle aches, resistance to HIV drugs, liver damage in those with preexisting liver disease. Most common are infusion reactions, diarrhea, and rash. Rare serious hypersensitivity reactions, including anaphylaxis. Rare infusion and hypersensitivity reactions, including anaphylactic reactions, have been seen. Increases in levels of liver enzymes in blood tests, which may be a sign of liver injury. Most common in clinical trial: mild or moderate diarrhea, nausea, dizziness, headache. Rare allergic reactions may be severe or life-threatening. Worsening symptoms after infusion including fever, difficulty breathing, rapid or slow heart rate, tiredness, weakness, or confusion. Most common are nausea, dizziness, and itchy skin after infusion. Rare serious hypersensitivity reactions, including anaphylaxis and fainting. Allergic reactions. Infrequent serious cardiac events in those with risk factors for cardiac disease or a history of cardiovascular disease.

Our Methods

These drugs were chosen because their use has been authorized, or may soon be authorized, by the U.S. Food and Drug Administration (FDA).

Sources of information about the efficacy and safety of the drugs are FDA documents, European Medicines Agency documents, statements from the companies that developed the drugs, and published clinical trials when available.

This website is updated as new reliable information becomes available.

Pronunciation guide

Drug namepronunciation
bamlanivimabBAM-la-niv-i-mab
casirivimabkas-i-RIV-i-mab
etesevimabe-te-SEV-i-mab
imdevimabim-DEV-i-mab
Lagevriolah-GEV-ree-oh
molnupiravirmall-new-PEER-uh-veer
PaxlovidPACKS-luh-vid
REGEN-COVruh-GEN-coh-vee
remdesivirrem-DES-i-veer
ritonavirri-TOE-na-veer
sotrovimabsoe-TROE-vi-mab
VekluryVEK-lur-ee
Xevudyzeh-VOO-dee