For some of those unlucky enough to have contracted COVID, the medication Paxlovid has been somewhat of a godsend. Made by Pfizer, Paxlovid combines two drugs – nirmatrelvir and ritonavir – and is used as a treatment for COVID.
The drug has for many made COVID bearable, and likely kept a significant number from being admitted to hospital.
But, as with many drugs, there can be side-effects, and for some who have taken the nirmatrelvir/ritonavir combination, the side-effect is a condition colloquially labelled ‘Paxlovid mouth’.
Paxlovid mouth is a taste that can linger for as long as you take the drug, and for most who experience it, the taste is not nice. It has been described as sun-baked trash-bag liquid, a mouthful of dirty pennies, rotten soy milk and, in one particularly graphic example, “like your mouth is just clenched around a grapefruit rind”.
This side-effect, acknowledged by Pfizer, has a name – dysgeusia. The term dysgeusia applies to taste disorders that cause foods to taste sour, sweet, bitter or metallic. As well as medications, vitamin deficiencies and infections can also cause dysgeusia.
According to Pfizer, a study funded by the company and published in the New England Journal of Medicine found that the symptom occurred 5.6 per cent of the time people took the drug, and that the symptoms were usually mild.
What causes dysgeusia and what can be done about it?
Ritonavir, it seems, is the likely villain here, having previously been linked to taste disorders. As for what can be done about it, the answer seems to vary from person to person. Cinnamon, milk and pineapple are among the remedies said to offer relief.
While pineapple worked for 35-year-old Lisa Crawford, it may have come at yet another cost. She said snacking on pineapple four or five times an hour, day after day, worked but “I probably have no tooth enamel left”. Nevertheless, Ms Crawford said it was the only thing that saved her sanity.
The evidence for the effectiveness of pineapple is anecdotal, but in the case of cinnamon there’s at least a bit of science behind the recommendation. Cinnamon gum is effective in a couple of ways. First, its flavour is very strong and almost numbing, and second, chewing the gum helps improve the flow of saliva, in turn preventing a dryness that can worsen the taste.
Milk, on the other hand, can help by coating the mouth before the Paxlovid dose is taken, according to Shivanjali Shankaran, a doctor and infectious disease specialist at Rush University Medical Centre in Chicago.
Lisa Crawford’s experience was an extreme one. But for most the sour taste is a mild annoyance and a small price to pay considering Paxlovid is claimed to achieve
a nearly 90 per cent reduction in hospitalisation and death among those at risk for severe disease from COVID.
In Australia, Paxlovid has been listed on the Pharmaceutical Benefits Scheme (PBS) since May and available to those over 70 and some people over 50. It’s good to know that it’s available if needed, but the best way to avoid its foul taste is to avoid contracting COVID at all.
Have you used Paxlovid to treat COVID? Did you experience problems with taste? Why not share your experience and thoughts in the comments section below?