What to Take for COVID When Symptoms Start

If you begin to feel unwell with symptoms like fever, cough, sore throat or fatigue, starting treatment early can help reduce the risk of severe illness. This guide explains which medications and home remedies are most helpful, based on the latest medical evidence. Always speak to a doctor if you have any serious or life-threatening concerns.

1. Confirm Your Symptoms

Before you begin any treatment, it’s wise to check whether your symptoms fit COVID-19. You can do a free, online symptom check for COVID-19 to see if you should seek testing or medical advice.

Common early symptoms include:

• Fever or chills
• Cough (new or worsening)
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• Sore throat
• New loss of taste or smell
• Congestion or runny nose
• Nausea, vomiting or diarrhea

If you test positive or strongly suspect COVID-19, start treatment as soon as symptoms appear—ideally within five days—to get the most benefit from antiviral medicines.

2. Antiviral Treatments

For people at higher risk of severe COVID-19 (older age, underlying health conditions, weakened immune system), two oral antiviral options have been shown to reduce hospitalization and death when started early.

2.1 Paxlovid (nirmatrelvir + ritonavir)

• What it is: A combination of nirmatrelvir (blocks the virus from replicating) and ritonavir (boosts nirmatrelvir levels).
• When to start: Within 5 days of symptom onset.
• Who should consider it:
  • People aged 65 or older
  • Those with conditions like diabetes, obesity, chronic lung or heart disease
  • Immunocompromised individuals
• Effectiveness: Reduced risk of hospitalization or death by about 88% in high-risk, nonhospitalized adults (Hammond et al., N Engl J Med, 2022).
• How to take it:
  • 300 mg nirmatrelvir (two 150 mg tablets) plus 100 mg ritonavir (one tablet) twice daily for 5 days
• Cautions & Interactions:
  • Many common medications (e.g., certain cholesterol-lowering drugs, antiarrhythmics, sedatives) interact with ritonavir.
  • Kidney or liver impairment may require dose adjustments.
  • Always review your current medicines with a healthcare provider or pharmacist.

2.2 Molnupiravir (Lagevrio)

• What it is: An antiviral that introduces copying errors into the viral genome, preventing replication.
• When to start: Within 5 days of symptom onset.
• Who should consider it:
  • High-risk patients who cannot take Paxlovid (due to drug interactions or contraindications).
• Effectiveness: Reduced risk of hospitalization or death by about 30% (Jayk Bernal et al., N Engl J Med, 2022).
• How to take it:
  • 800 mg (four 200 mg capsules) every 12 hours for 5 days
• Cautions:
  • Not recommended during pregnancy.
  • Potential risk of bone or cartilage effects seen in animal studies; avoid use in children.

3. Over-the-Counter Symptom Relief

Even if you don’t qualify for antivirals, or while you’re waiting for a prescription, you can ease symptoms with common medications and self-care measures.

3.1 Fever, Aches & Pains

• Acetaminophen (Tylenol)
  • Dose: 500–1,000 mg every 6 hours as needed (do not exceed 3,000 mg per 24 hours).
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
  • Ibuprofen (Advil, Motrin) 200–400 mg every 4–6 hours; naproxen (Aleve) 220 mg every 8–12 hours.
  • Take with food to avoid stomach upset.

3.2 Cough & Sore Throat

• Lozenges or throat sprays containing menthol or benzocaine
• Honey (for adults and children over 1 year): 1–2 teaspoons can soothe a cough at bedtime
• Cough syrups with dextromethorphan or guaifenesin for relief of dry or productive cough

3.3 Congestion & Runny Nose

• Saline nasal spray or drops to clear nasal passages
• Decongestants like pseudoephedrine (Sudafed) or phenylephrine for short-term relief
• Steam inhalation or humidifier use to loosen mucus

3.4 Hydration & Rest

• Drink plenty of water, broths, and electrolyte-rich fluids
• Aim for extra rest and sleep to support your immune system

3.5 Supplements (Limited Evidence)

• Vitamin D, C or zinc: Some studies suggest a potential benefit in immune support, but evidence is weak.
• Consult your doctor before starting new supplements, especially if you have underlying health issues.

4. Monitoring and Warning Signs

Most people with mild COVID-19 recover at home, but it’s crucial to watch for signs that you need urgent medical care. Seek help immediately (call 911 or go to the nearest emergency department) if you experience:

• Trouble breathing or shortness of breath at rest
• Chest pain or pressure
• New confusion or inability to stay awake
• Bluish lips or face
• High fever that doesn’t improve with acetaminophen/ibuprofen

For any severe or life-threatening symptoms, do not delay—speak to a doctor or seek emergency care.

5. Talking With Your Doctor

• If you’re at high risk for severe disease, ask about antiviral prescriptions as soon as you test positive.
• Review all your current medications to avoid dangerous interactions, especially before starting Paxlovid.
• Discuss any chronic conditions (like liver or kidney problems) that may affect dosing.

Your doctor can help tailor treatment to your health needs and ensure you get the right care.

6. Prevention & Recovery

• Isolation: Stay home and avoid contact with others until at least 5 days have passed since symptoms began and you’ve been fever-free for 24 hours without fever reducers.
• Masking: Wear a well-fitting mask around others for a total of 10 days from symptom onset.
• Follow-up care: Even after you feel better, keep an eye on your health. Some people experience lingering fatigue or respiratory symptoms for weeks. If new or worsening symptoms appear, contact your doctor.

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Starting treatment early—ideally within five days of symptoms—can make a significant difference, especially if you’re at higher risk of severe COVID-19. Use the antivirals your doctor recommends, manage symptoms with over-the-counter medications, and watch for warning signs that need emergency care. If in doubt about any symptom or treatment, always speak to a doctor.