The Food and Drug Administration (FDA) has approved Xocova, a medication designed to help prevent COVID-19 infection in individuals aged 12 and older who have been directly exposed to someone with the virus. The drug is intended for use shortly after exposure to significantly decrease the likelihood of developing the illness.
"It will substantially diminish your risk of getting COVID, particularly if you begin it as quickly as possible after the exposure," said Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center. Studies indicate that taking Xocova within three days of exposure can reduce the chance of infection by two-thirds. Even if an infection occurs, the medication may lead to a milder and shorter illness.
Xocova is a protease inhibitor, a class of medication with which doctors have extensive experience in treating viral infections. Mild side effects, such as gastrointestinal upset, congestion, and muscle aches, have been reported, though trials noted relatively few adverse effects including diarrhea, headache, and cough. These side effects are generally considered preferable to a COVID-19 infection. The medication is taken for five days, and any associated symptoms are typically mild and short-lived.
Despite its availability, the cost of Xocova can be a barrier, potentially reaching up to $1,400 without insurance. However, coverage varies by private insurance plans, and some plans and assistance programs may offer it at a reduced cost or even for free. Efforts are reportedly underway to ensure broader accessibility.
It is crucial to understand that Xocova is not a substitute for COVID-19 vaccination. Vaccination is considered primary prevention, enabling the immune system to fight off infections. Xocova serves as an additional preventive measure rather than a replacement for vaccines. Healthcare providers emphasize that individuals should not forgo vaccination in favor of this medication.
"Definitely don’t skip the vaccine. Don’t wait for this [medication] to be your rescue source. But if you need it, talk to your doctor about it and see if it’s an option based on your exposure situation," advised Dr. Mark Loafman, a family physician in Chicago.
Schaffner also stressed the importance of vaccination, particularly for high-risk groups such as individuals over 65, those with underlying medical conditions, and the immunocompromised. Adherence to general public health precautions, including covering coughs and sneezes, frequent handwashing, and staying home when sick, remains essential. Wearing a high-quality mask can also provide protection against COVID-19 and other respiratory viruses.
This medication is specifically for individuals who have had significant exposure, such as living with or sharing close workspace with an infected person. It is not intended for general use before attending large events or traveling, and there is no evidence to suggest it is effective when taken prophylactically in such scenarios. Doctors are not expected to prescribe it liberally for such purposes. While other pharmaceutical companies are developing additional preventative treatments, including nasal sprays, Xocova is currently the only post-exposure COVID-targeting drug available on the market.