There’s even a term for it, “Paxlovid mouth,” with people reporting a terrible bitter, metallic taste after taking the pills. But thankfully, there are things you can do about it. Here’s everything you need to know.
What is ‘Paxlovid mouth’?
People who are prescribed Paxlovid to treat COVID have reported an unusual bitter, metallic, sour taste in their mouth—this side effect is common but harmless. The effect has a medical name: ‘dysgeusia,’ and the same thing can occur with more than 30 other common medications, including certain antibiotics, some blood pressure medicines, antihistamines, diuretics and chemotherapy drugs, Dr. William Li, MD, doctor, researcher, Angiogenesis Foundation President/Founder and author or Eat To Beat Disease.
Why Does Paxlovid Mouth Happen?
Taste disturbances occur for a number of reasons. “One reason is the drug itself can be found in saliva which tastes bitter. Another reason can be the drug causes temporary changes to the taste function on the taste buds on your tongue,” says Dr. Li. “When the drug is gone from your system, the metallic taste normally goes away.” There is no cause for worry unless the taste causes you to become nauseous and vomit—which is unlikely. Mostly, the dysgeusia from Paxlovid is a temporary annoyance that disappears when you have finished your five days of treatment, Dr. Li adds. Paxlovid is a combination of a new medication for COVID called Nirmatrelvir and an older medication called ritonavir that ‘boosts’ the levels of Nirmatrelvir. “Ritonavir is well-known to many healthcare providers because it used to be commonly used in the same way with HIV medications,” says Dr. Jason Gallagher, PharmD, infectious disease expert, a Clinical Professor at Temple University’s School of Pharmacy, and a Clinical Pharmacy Specialist in Infectious Diseases at Temple University Hospital. “The side effect of taste disturbance is a known problem with ritonavir. The tablet itself is bitter, but even if it doesn’t touch the mouth the unpleasant taste can still occur.” While definitely unpleasant, the taste disturbances go away within a day or so after the medication is stopped. It’s also important for people to know that it isn’t related to the loss of taste and smell that can happen from COVID itself, Dr. Gallagher explains.
What to Do About Paxlovid Mouth
Breath mints
Dr. Li recommends using strong breath mints like Altoids, or a ginger chew to mask the metallic taste of Paxlovid. “Like almost every aspect of this pandemic, the taste-altering effect of Paxlovid has triggered outsized reactions and wild hyperbole,” Dr. Li states. “We in the medical community need to emphasize and reassure patients that many other useful drugs do the same thing, and the benefits outweigh the risks of the metallic taste. Paxlovid is a game-changing medicine that lowers the risk of hospitalization and death from COVID by almost 90%.” Dr. Gallagher explains that due to both the effect of the medication itself and the taste of the tablet, treating dysgeusia from Paxlovid isn’t easy. “Certainly swallowing the tablet without letting it linger in the mouth is advisable, but it doesn’t prevent the effects. Try different foods, gums, etc. to see what works. Different people are reporting different success stories, but honestly, they’re all pretty moderate,” he says. The most important thing to remember? Once you stop taking Paxlovid, this taste will go away—so it’s a temporary discomfort that has longterm benefits. Next up: This Easy 15-Minute Practice May Treat Side Effects of Long COVID
Sources
Dr. William Li, internationally renowned medical doctor, researcher, Angiogenesis Foundation President/Founder and author of New York Times bestseller, Eat To Beat DiseaseOral Health and Preventive Dentistry: “Drug-related Dysgeusia: A Systematic Review”Dr. Jason Gallagher, PharmD, infectious disease expert, a Clinical Professor at Temple University’s School of Pharmacy, and a Clinical Pharmacy Specialist in Infectious Diseases at Temple University Hospital
