Paxlovid onboard - a factor in cruise choice?

[mjkacmom]

On 5/31/2022 at 7:19 AM, Wendy-Europe said:

Since Paxlovid is treated by some here as if it were an over-the-counter drug, I plead for these users to read again the indication - but also the side effects. And read very carefully what contraindications there are. There are good reasons why paxlovide should only be prescribed after careful review of the medical record. In particular, the partial component ritonavir blocks important degradation processes in the liver. Therefore, experts suspect interactions with numerous drugs during the treatment period. Also, paxlovid should not be taken in cases of severe liver and kidney disorders.

 

Interactions are suspected with certain:

    Prostate medications (eg: alfuzosin).
    heart medications (eg: amiodarone, bepridil, dronedarone, propafenone, etc.)
    cholesterol-lowering drugs (e.g.: lovastatin, simvastatin, lomitapide, etc.)
    antihistamines (e.g., astemizole, terfenadine, etc.)
    gout medications (e.g. colchicine)
    erectile dysfunction medications (sildenafil, avanafil, vardenafil, etc.)
    cancer drugs (e.g.: neratinib, venetoclax, etc.)
    antibiotics (e.g.: fusidic acid, etc.)
    Painkillers, sedatives and migraine medications (eg: pethidine, diazepam, midazolam, dihydroergotamine, etc.)
    Neuroleptics and antipsychotics (e.g.: lurasidone, pimozide, clozapine, etc.) and many more.

 

This list includes only some of the drugs that may interact with each other. The topic of drug interactions is therefore an important part of the medical consultation prior to a possible Paxlovid treatment.

 

A physician in an onboard hospital does not have the information about a patient that one's primary care physician has and cannot assess whether the use is appropriate.

 

 

What? Not everyone has a personal physician. I do, but I’ve received medical care at urgent care centers and ER’s as well. I’ve switched personal physicians without transferring medical records, so I answer all of the health history questions. 

[jsn55]

I think the point of this discussion is that this is a powerful drug that should be carefully analyzed by a doctor very familiar with the patient and their personal medical history.  Nobody knows if it's bad or good, the point is that it needs to be handled cautiously.  Some people have a very good grasp of their own medical history ... others of us only vaguely remember health challenges in the past that could affect the efficacy of a drug like this.

[mjkacmom]

6 minutes ago, jsn55 said:

I think the point of this discussion is that this is a powerful drug that should be carefully analyzed by a doctor very familiar with the patient and their personal medical history.  Nobody knows if it's bad or good, the point is that it needs to be handled cautiously.  Some people have a very good grasp of their own medical history ... others of us only vaguely remember health challenges in the past that could affect the efficacy of a drug like this.

I think it should be left up to the trained physicians to evaluate patients to determine if the illness is severe enough to try medication.

[Tonsoffun44]

HECK NO 

[sanger727]

On 7/4/2022 at 11:51 AM, jsn55 said:

I think the point of this discussion is that this is a powerful drug that should be carefully analyzed by a doctor very familiar with the patient and their personal medical history.  Nobody knows if it's bad or good, the point is that it needs to be handled cautiously.  Some people have a very good grasp of their own medical history ... others of us only vaguely remember health challenges in the past that could affect the efficacy of a drug like this.

 

I am sure that the medical center is full of potentially powerful drugs that they use in the event of an emergency at sea. In a life threatening emergency you don't always have time to go over your full medical history with a doctor and you don't pass up life saving drugs over that. If someone is in a situation where covid may be a life threatening condition for them, then I would fully expect the medical center to utilize any drugs available to them. 

[wcook]

Side note: Good idea to travel with a written list of any drugs you take, allergies, significant Mexican* conditions, etc. Very easy to fill this out in your iPhone in the basic health app (I assume Android has something similar.) 
 

* er, make that significant medical conditions. Though if you have significant Mexican conditions I guess you can list those as well. Loves tacos. Do not serve rice and beans if sharing a room with others, etc. 

[Honolulu Blue]

UPDATE:  I'm adding stories of CC members who recently reported availability onboard their cruise ships - one Princess, one Celebrity, and two Regent Seven Seas.  Further details are in the individual threads and posts: