Does Paxlovid Cause a Metallic Taste?
Yes, Paxlovid can cause a metallic taste in the mouth, known medically as dysgeusia. This side effect affects about 6% of patients in clinical trials and is one of the most commonly reported issues.[1][2]
How Common Is This Side Effect?
In the EPIC-HR trial, dysgeusia occurred in 5.6% of Paxlovid users versus 0.3% in the placebo group. Real-world data from sources like the FDA's adverse event reporting shows it persisting for days to weeks after treatment ends.[1][3] It's temporary for most but can make food taste off or unpleasant.
Why Does Paxlovid Cause a Metallic Taste?
Paxlovid contains nirmatrelvir and ritonavir. Ritonavir, the booster component, is linked to taste changes due to its impact on taste receptors and possible effects on zinc levels or saliva composition. Similar metallic tastes occur with other ritonavir-based HIV drugs.[2][4]
How Long Does the Metallic Taste Last?
It typically starts within days of beginning the 5-day course and resolves 1-2 weeks after stopping, though some report it lingering up to a month. Staying hydrated, using mints, or eating citrus can help manage it.[3][5]
What Other Taste or Side Effects Come with Paxlovid?
Diarrhea (3%), altered taste beyond metallic (like bitter or sour), nausea, and vomiting are common. Serious effects like liver issues or allergic reactions are rare (under 1%). Taste changes are not dangerous but affect quality of life.[1][2]
Can You Avoid or Reduce the Metallic Taste?
No proven prevention, but tips from users and doctors include:
- Chew gum or suck on hard candy during meals.
- Rinse with salt water.
- Avoid strong flavors initially.
Consult a doctor before using zinc supplements, as they interact with Paxlovid.[3][5] No drug interactions directly worsen it.
Who Experiences It More?
More frequent in adults over 65 or those on multiple meds, but data shows no strong age or sex differences. It's underreported in kids due to limited pediatric use.[1][4]
[1]: FDA Paxlovid Prescribing Information
[2]: NEJM EPIC-HR Trial
[3]: CDC Paxlovid Monitoring
[4]: Drugs.com Paxlovid Side Effects
[5]: Mayo Clinic Paxlovid Overview