Xocova (ensitrelvir) is an antiviral used to lower your risk of getting sick after being exposed to someone with COVID-19.
Like all medicines, Xocova can cause side effects and may interact with other medicines, supplements, or alcohol.
Keep reading to learn about possible Xocova side effects, how to manage them, and which medicines may interact with Xocova.
This article does not include all possible side effects or interactions. Tell your health care provider about any symptoms that concern you or do not improve.
Xocova Side Effects
Common side effects
The most common side effects reported with Xocova include:
- Headache
- Diarrhea
- Cough
Serious side effects
While less common, Xocova may cause an allergic reaction, which can be serious. If you have symptoms that feel serious or life-threatening, seek medical care right away.
How to Manage Xocova Side Effects
Some Xocova side effects (including headache, diarrhea, and cough) can also be symptoms of COVID. If these symptoms do not go away, get worse, or if you have other possible symptoms of COVID, consider taking a COVID test. If you test positive, ask your health care provider about the latest recommendations for isolation or quarantine and/or treatment for COVID.
While not a complete guide, the following tips can help you prevent or manage common side effects of Xocova.
1. Headache
Headache is a commonly reported side effect of Xocova.
Symptoms may include mild-to-moderate head pain or pressure.
To help manage headaches:
- Rest in a quiet, dark room if needed.
- Try relaxation techniques, such as deep breathing.
- Maintain a regular sleep schedule.
- Minimize stress.
- Drink enough fluids and eat regular meals or snacks.
An over-the-counter (OTC) pain reliever may help ease headache pain, but check with your health care provider or pharmacist first to make sure it is safe for you.
2. Diarrhea
Diarrhea is a common side effect of Xocova. Possible symptoms include loose or watery stools, stomach cramps, and an urgent need to use the bathroom.
Mild diarrhea often improves on its own within a short time. To help manage diarrhea at home:
- Eat bland foods, such as rice, bananas, or toast.
- Avoid greasy, spicy, or high-fiber foods that may worsen symptoms. Avoid caffeine and alcohol.
- Avoid fried foods, and limit dairy products such as butter and cream.
- Drink fluids often to prevent dehydration. Opt for water, broth, or electrolyte drinks such as Gatorade or Pedialyte.
- Ask your health care provider if an OTC antidiarrheal medicine may help.
3. Cough
Cough is a common side effect of Xocova.
There are things you can try at home to help your cough:
- Drink warm fluids to soothe your throat.
- Stay hydrated.
- Sleep with your head and chest elevated.
- Try cough drops if your throat is irritated.
- Moisturize the air you breathe, either with a vaporizer or humidifier. You could also run a hot shower in a closed bathroom and breathe in the air.
- Some people find honey soothing for a cough.
An OTC cough medicine may help ease your cough, but check with your health care provider or pharmacist first to make sure it is safe for you.
Xocova Interactions
Xocova can interact with other medicines and supplements.
An interaction happens when a substance changes how a medicine works or affects the body. Some interactions may increase the risk of side effects of the other medicine, while others may make Xocova less effective.
Some interactions can happen because Xocova is broken down in the body by an enzyme called CYP3A4. Some medicines and supplements can increase the activity of this enzyme, causing the body to break down Xocova faster than normal. This may lower Xocova levels in the body, making it less effective at preventing a COVID infection.
Xocova also affects CYP3A4 and other medicine transport systems that help your body break down or get rid of certain medicines. This may raise the levels of certain medicines in your body, increasing your risk of side effects.
This is not a full list of interactions, but the following are important to know about while taking Xocova.
1. Medicines that make Xocova less effective
Some medicines can speed up the breakdown of Xocova in your body, lowering its levels in your bloodstream. This reduces its ability to prevent a COVID infection.
Examples include:
- Some seizure medicines, such as carbamazepine and phenytoin
- Some cancer medicines, such as apalutamide and enzalutamide
- Rifampin, an antibiotic
- Lumacaftor/ivacaftor, a medicine for cystic fibrosis
Xocova should not be taken while you are using these medicines. Before taking Xocova, tell your health care provider about all of the medicines you are taking. This will help your health care provider know if Xocova is the right medicine for you.
2. Quinidine
Quinidine is used for certain heart rhythm problems. Taking Xocova with quinidine may increase the side effects of quinidine.
Xocova slows down how the body breaks down quinidine. This may increase the amount of medicine in the body and raise the risk of heart rhythm problems, which can be serious.
These medicines should not be taken together. Your health care provider can suggest a different option instead.
3. Colchicine
Colchicine is used for gout. Taking Xocova with colchicine may increase the side effects of colchicine.
Xocova slows down the breakdown of colchicine. This may increase the amount of medicine in the body and raise the risk of side effects.
These medicines should not be taken together, especially if your kidneys or liver are not working as well as they should be. Tell your health care provider if you have kidney or liver problems. Your health care provider can order lab tests to see how well they are working to better understand your risk.
4. Certain mental health medicines
Antipsychotics are used for certain mental health conditions. Taking Xocova with some antipsychotics may increase their side effects.
Examples of antipsychotic medicines that interact with Xocova include lurasidone and pimozide.
Xocova slows down how the body breaks down lurasidone and pimozide. This may increase the amount of medicine in the body and raise the risk of side effects that may be serious or life-threatening.
These medicines should not be taken together. Your health care provider can suggest a different option.
5. Certain migraine medicines
Ergot alkaloids are used to treat migraine headaches. When taken with Xocova, ergot alkaloids may be more likely to cause side effects.
Examples of ergot alkaloid medicines that interact with Xocova include dihydroergotamine and ergotamine.
Xocova slows down how the body breaks down dihydroergotamine and ergotamine. This may increase the amount of medicine in the body and raise the risk of side effects.
Do not take these medicines together. Your health care provider may recommend other options.
6. Simvastatin
Simvastatin is used to lower cholesterol levels. Simvastatin may be more likely to cause side effects if taken with Xocova.
Xocova slows down the breakdown of simvastatin in the body. This may increase the amount of medicine in the body and raise the risk of side effects.
You should not take these medications together. If you take simvastatin and you and your health care provider decide that Xocova is right for you, talk to your health care provider about when to stop simvastatin and for how long before starting Xocova.
FAQs: Xocova Interactions
Does Xocova interact with alcohol?
It is unknown if drinking alcohol will affect Xocova. However, drinking large amounts of alcohol, even once in a while, reduces your body’s ability to fight off infections, including COVID. It is best to limit the amount of alcohol you drink.
Does Xocova interact with any supplements?
Yes. One example is St. John’s wort, an herbal supplement sometimes used for depression. It can make your body break down Xocova faster than normal. This may lower the amount of Xocova in your bloodstream and keep it from working as well as it should.
Other supplement interactions are also possible. Make sure to let your health care provider know if you are using any supplements before taking Xocova.
Reducing Your Risk of Side Effects and Interactions
You can help reduce your risk of side effects and interactions by taking Xocova exactly as prescribed and following all instructions from your health care provider.
Helpful tips include:
- Always tell your health care provider and pharmacist about all prescription drugs, OTC medicines, and any vitamins, herbs, or other supplements you use.
- Ask your health care provider before you start or stop any medicine, vitamin, or supplement.
- Keep all recommended lab test appointments before you start taking Xocova.
- Follow any directions from your health care provider about temporarily stopping any medicine.
- Report any new or worsening symptoms to your health care provider.
Your health care provider can review your treatment plan and make adjustments if needed to help ensure that this medicine is safe for you.
