Move on Up: New drug for COVID-19 exposure

By Karen Kier, Pharmacist
On behalf of the ONU HealthWise team

On June 25, 1971, Curtis Mayfield released his debut album with the single “Move on Up.” The original song was 9 minutes in length and did not chart in the United States. A shorter version made it to number 12 in the United Kingdom. Even though this song was never a hit in the United States, you might hear the lyrics today. The song is the post-game anthem for the Arsenal British soccer club and was on the soundtrack of the movie Bend It Like Beckham. The song could be heard at the end of campaign speeches for President Joe Biden. 

Curtis Mayfield was a member of the Impressions before he started his solo career. He was inducted into the Rock and Roll Hall of Fame in 1991 as part of the group and again in 1999 as a solo artist. He continued to sing and write songs after being paralyzed when stage lighting fell on him during a concert. He was part of the movement for progressive soul music. 

COVID-19 is moving on up across the country. With six years of data, scientists with the CDC are able to track better patterns for outbreaks. It appears as if COVID-19 has 2 major seasons with increased cases. We are heading into the late summer season spike and will also see winter increases. As of July 29, 2026, 41 states are reporting a growing number of COVID-19 cases with 7 states not detecting a change in cases. Data were not available for 2 states. 

The CDC has classified Ohio as “likely growing” based on emergency room and wastewater reports. The numbers are low for Ohio, but will increase with this late summer spike. Michigan, Indiana, West Virginia, and Kentucky have all been ranked as “growing” with cases increasing. Pennsylvania is the only state bordering Ohio that has seen no change. The CDC considers this spike in cases due to seasonal variation, traveling and waning immunity from either illness or the COVID-19 vaccine not being administered within the last 3 months. 

On May 29, 2026, the FDA approved a new drug for post-exposure prophylaxis (PEP). The antiviral compound has the generic name of ensitrelvir and a brand name of Xocova®. Ensitrelvir only works on the COVID-19 virus by blocking the SARS-CoV-2 protease enzyme. This inhibition prevents the virus from replicating or reproducing more virus. This reduces the viral load in the blood and allows for a less serious infection. 

Xocova® comes as a 125mg tablet and must be started with 72 hours of exposure to someone with a COVID-19 infection. The drug is administered for 5 days with 3 tablets (375mg) taken the first day and one tablet (125mg) taken on days 2 through 5.  The medication can be taken with or without food and should be taken at the same time each day to provide the best results.

On May 13, 2026, the New England Journal of Medicine published the phase III study demonstrating a 67% decrease in COVID-19 symptoms in patients exposed to the virus who were given ensitrelvir compared to patients exposed to the virus who were given no active drug (placebo). In the study, 2.9% of the ensitrelvir group developed COVID-19 symptoms compared to 9% given placebo.  The adverse reactions between the placebo group and the active drug were similar. The most common side effects were headache, cough, and diarrhea.

Ensitrelvir has numerous drug-drug interactions, which require pharmacists and healthcare professionals to evaluate all medications, including over-the-counter and herbal supplements, prior to dispensing the drug. One of the cautions is for women who take birth control pills. The package labeling indicates to use additional birth control for 10 days after completion of the 5 days. The reason has more to do with the potential for harmful effects with pregnancy while on the medication than a direct interaction with birth control. This drug should be avoided during pregnancy and breastfeeding. Ensitrelvir is approved for individuals 12 years and older. 

This is the first drug FDA-approved for PEP management of COVID-19 exposure, but PEP is not a new concept for viral infections.  During flu season, drugs such as oseltamivir (Tamiflu®) and baloxavir (Xofluza®) can be administered after exposure to influenza to reduce the replication of the virus in the body. In addition, PEP medications are available for managing HIV and sexually transmitted diseases. 

Hopefully, the COVID-19 numbers will remain at a low level and not move on up in Ohio, but we now have another option for exposure. 

 

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