XOCOVA (ensitrelvir) is a new oral antiviral approved for post-exposure prophylaxis of COVID-19 in adults and adolescents 12 years and older after being in contact with someone who has COVID-19. In nursing home settings, staff should know when it may be used, how it is dosed, and what safety checks are required before administration.

XOCOVA inhibits the SARS-CoV-2 main enzyme needed for viral replication. Treatment should start as soon as possible and within 72 hours after exposure.  Its important to note, this is different than medications such as paxlovid which is specifically indicated for treatment of active covid-19. The five-day course may support timely prevention efforts during facility exposure events like how Tamiflu is used for flu exposure in nursing home settings.  

Nursing staff help prevent outbreaks by identifying exposed residents, notifying providers, reviewing medication profiles, documenting administration, and monitoring for adverse reactions.

Xocova is relatively safe with common side effects such as headache, diarrhea, and cough.  Health care team should also review patient medications to avoid any interactions, particularly with cyp3A4 metabolized drugs (i.e. phenytoin, carbamazepine, colchicine, simvastatin).  

Xocova Strength and Dosing Chart – Dosing adjustments for renal or hepatic impairment is not needed: