As we get older—and our immune system isn’t as resilient as it used to be—our risk of serious illness from respiratory viruses like COVID is higher.

But the upside is there are medications available, including antiviral COVID treatments, that can lower your odds of getting very sick, needing to be hospitalized, or even dying from COVID. Knowing your options can help you act quickly if you test positive and reduce the chance of a severe infection.

FDA-Approved or FDA-Authorized COVID Treatments

Why is timely COVID treatment important for older adults?

COVID can affect anyone, but age remains the strongest risk factor for severe disease. People age 65 and older are more likely to develop complications like pneumonia, acute respiratory failure, and damage to organs like the heart and liver. The Centers for Disease Control and Prevention (CDC) estimates that adults over 65 account for about 81% of COVID-19 deaths. For people in this age group, the risk of dying is 97 times higher than that of younger adults age 18-29.¹

Other people more likely to get very sick from COVID include:

• Those with chronic health conditions such as lung disease, heart disease, diabetes, obesity, blood disorders, dementia, liver and kidney disease, or a weak immune system
• People who have never received a COVID vaccine or are not up to date on their COVID shots

What are the treatment options for COVID-19?

The U.S. Food and Drug Administration (FDA) has approved several treatments for mild to moderate COVID in people who are more likely to get very sick with the virus. These treatments must be prescribed by a health care provider:

• Antiviral treatments like Paxlovid and Lagevrio target specific parts of the virus to stop it from multiplying in the body, helping to prevent severe sickness and death. These medications work best when started soon after symptoms begin—usually within five days of testing positive. That’s why it’s important to get tested right away if you feel sick.
• Pemivibart (brand name Pemgarda) is the only long-acting monoclonal antibody FDA-authorized for COVID pre-exposure prophylaxis (prevention). This medication is given through an IV before exposure to help prevent severe COVID in people with moderately or severely weakened immune systems.

Some COVID treatments might have side effects or interact with other medications you are taking. Ask your health care provider if medications to treat COVID are right for you. If you don't have a health care provider, contact your local community health center or health department.

If you are hospitalized with COVID, your health care provider might use other types of treatments, depending on how sick you are. These could include medications to treat the virus, reduce an overactive immune response, or address COVID complications.

Are there medications I should take after COVID exposure?

Ensitrelvir (XOCOVA) is an FDA-approved oral antiviral that may help lower your risk of getting very sick with COVID. This medication is for adults and children age 12 and older who have been exposed to someone with COVID but don't have symptoms yet. In the U.S., it's only approved to help prevent COVID after an exposure—not to treat COVID once you're already sick.

In one study, a preventive regimen of ensitrelvir reduced the risk of developing COVID by about two-thirds after a household exposure to the virus.²

To work properly, ensitrelvir must be started as soon as possible, within 72 hours of exposure to someone with an active COVID infection. You take ensitrelvir for five days. This medication must be prescribed by a health care provider.

What is COVID rebound?

Sometimes, COVID symptoms return—or you may test positive again—about three to seven days after you feel better from the first illness or you test negative for the virus.

While the rebound phenomenon has been linked with taking the antiviral Paxlovid, a review by the Centers for Disease Control and Prevention (CDC) debunked that theory. CDC states rebound can happen whether or not you took an antiviral medication. Symptoms are usually mild and go away within a few days.

What’s more, research shows rebound does not increase the risk of severe illness. If you are at higher risk for serious COVID disease, the benefits of taking treatment outweigh the chance of rebound.

If you think you may be experiencing COVID rebound, contact your health care provider.

What medications are not approved for the treatment or prevention of COVID-19?

Some drugs have been talked about in the news or online, but they are not approved or recommended for treating COVID. These include:

• Ivermectin (commonly used to treat parasites in humans and animals)
• Hydroxychloroquine or chloroquine, a prescription drug used for malaria or certain autoimmune diseases
• Antibiotics (such as azithromycin), which fight bacteria—not viruses

Using these medications to treat a COVID infection has not been proven safe or effective. They may cause harmful side effects if taken in the wrong way or without a doctor’s supervision.

Can I still take my blood pressure medication if I have COVID?

If you take medicine for high blood pressure (like ACE inhibitors or ARBs), you may have wondered whether it’s safe to keep using them if you get COVID. Early in the pandemic, there was confusion about whether these drugs made COVID worse. But evidence shows it’s safest to continue their use.

If you get COVID, keep taking your high blood pressure medications as directed. Stay in touch with your health care provider, especially if you notice new or worsening symptoms.

What should I do if I think I have COVID?

If you fall into the high-risk category:

• Get tested quickly if you develop COVID symptoms such as fever, chills, cough, or shortness of breath. See our guide to COVID testing for older adults.
• Call your doctor right away if you test positive, even if your symptoms are mild.
  • Let your doctor know about all the medicines you take in case you need COVID treatment, since some antivirals may interact with certain drugs.
  • Keep taking your regular medications as directed.
  • Use over-the-counter medicines like acetaminophen or ibuprofen to manage your symptoms as necessary.
• Even if you don’t test positive, but you know you were exposed to the virus, ask your health care provider about post-exposure prophylaxis (preventive) medication for COVID.
• Don’t wait to start treatment. If you’re prescribed antiviral medication, don’t put it off. COVID treatments work best when they’re started within days of getting sick.

Why you should stay up to date on your COVID vaccine

If you're age 65 or older or have one or more underlying health conditions, it's important to know your risk for severe COVID-19. Talk with your doctor or pharmacist about whether vaccination is a good choice for you. Since older adults are more likely to get seriously ill, be hospitalized, and develop complications from COVID, staying up to date on your vaccines can help lower your risk by restoring robust protection against the SARS-CoV-2 virus.

“Healthy aging starts with prevention," said Dorothea Vafiadis, NCOA Senior Strategist for Healthy Aging. "For many older adults, that includes staying current on recommended vaccines. Talk with your health care provider about your personal risk and whether the COVID vaccine is right for you. It can help lower your risk of severe illness and support your health and quality of life."

Sources

1. CDC. People with Certain Medical Conditions and COVID-19 Risk Factors. Updated June 11, 2025. Found on the internet at https://www.cdc.gov/covid/risk-factors/index.html

2. CIDRAP. Antiviral ensitrelvir cuts risk of COVID-19 in household contacts by two-thirds, study finds. May 14, 2026. Found on the internet at https://www.cidrap.umn.edu/covid-19/antiviral-ensitrelvir-cuts-risk-covid-19-household-contacts-two-thirds-study-finds