COVID-19 Medication Options - Minnesota Dept. of Health
As we learn more about COVID-19, recommendations and guidance are updated frequently. Please check back often.

COVID-19 Medication Options

Monoclonal antibodies

Monoclonal antibody treatment can be used in people 12 years of age and older who weigh at least 88 pounds (40 kg) who are at high risk for severe COVID-19, including hospitalization or death for:

  • Prevention of COVID-19 in people who have had close contact or are at high risk of being in close contact with someone with COVID-19, such as people in the same institutional setting (for example, nursing homes or prisons) where COVID-19 is circulating.
    To be eligible, people:
    • Must not be fully vaccinated against COVID-19 or
    • Are not expected to build up enough of an immune response to the complete COVID-19 vaccination (for example, someone with immunocompromising conditions, including someone who is taking immunosuppressive medications).
  • Treatment of mild to moderate symptoms of COVID-19.
    To be eligible, patients must:
    • Test positive for SARS-CoV-2.
    • Be within 10 days of the start of their symptoms.
    • Not be hospitalized.

Below is a compilation list of the high-risk conditions developed by the FDA for monoclonal antibody treatment and the list of high-risk conditions developed by CDC. This list does not include all medical conditions or factors that might result in a person being at high risk:

  • Cancer
  • Chronic kidney disease (for example, being on dialysis, polycystic kidney disease)
  • Chronic lung disease (for example, COPD, asthma, cystic fibrosis)
  • Congenital abnormalities
  • Dementia (for example Alzheimer's disease) or other neurological conditions
  • Diabetes
  • Disability
  • Down syndrome
  • Genetic or metabolic conditions (for example, chromosome abnormalities, mitochondrial diseases)
  • Having a medical-related technological dependence (for example, tracheostomy, gastrostomy, or positive pressure ventilation [not related to COVID-19])
  • Heart conditions (for example coronary artery disease, congestive heart failure, hypertension)
  • Immunocompromised state (for example HIV/AIDS, leukemia, solid organ or blood stem cell transplant, steroid treatment, or other treatments that weaken your immune system)
  • Liver disease (for example, fatty liver disease, cirrhosis)
  • Neurodevelopmental conditions (for example, cerebral palsy)
  • Older age (for example 65 years of age or older)
  • Obesity or being overweight (for example, adults with a BMI of more than 25 kg/m2)
  • Patient identifies as Black/African American; Hispanic/Latino; Asian; Native Hawaiian or Pacific Islander; or American Indian or Alaskan Native
  • Pregnancy
  • Sickle cell disease or thalassemia
  • Smoking, current or former
  • Stroke
  • Substance use disorders

Talk to your doctor or other health care provider about treatments that are right for you, including if you have other medical conditions that are not listed above.

COVID-19 Medication (PDF)
Handout summary of when monoclonal antibodies are used to prevent and treat COVID-19.

Antibodies are proteins that people's bodies make to fight viruses, such as the virus that causes COVID-19. Antibodies made in a laboratory act a lot like natural antibodies to limit the amount of virus in your body. They are called monoclonal antibodies.

Antibodies can be given into a vein by intravenous (IV) infusion or into the skin by subcutaneous (SQ) injection. Antibodies may be administered only in settings where health care providers have immediate access to medications to treat any reactions and where emergency medical systems are available, if needed.

Monoclonal antibody treatment with bamlanivimab and etesevimab, REGEN-COV™ (casirivimab and imdevimab), or sotrovimab are for people who have tested positive for COVID-19 and have mild to moderate symptoms. Additionally, monoclonal antibody treatment with bamlanivimab and etesevimab or REGEN-COV™ (casirivimab and imdevimab) can be given to people who have had close contact or are at high risk of being in close contact with someone with COVID-19. These treatments are allowed by the U.S. Food and Drug Administration (FDA) under an Emergency Use Authorization (EUA) while clinical studies continue to look at their usefulness and safety.

Fact sheets for patients, parents, and caregivers

Bamlanivimab and etesevimab

REGEN-COV™ (casirivimab and imdevimab)

Sotrovimab

Clinical trials for monoclonal antibodies against COVID-19 have shown a decrease in hospitalizations and emergency room visits and a decrease in the amount of virus carried by an infected person. Studies are still ongoing.

Monoclonal antibody treatment may have side effects. The most common reported side effects include:

  • For bamlanivimab/etesevimab: nausea, dizziness, itching, and rash.
  • For casirivimab/imdevimab: nausea, vomiting, hyperglycemia, and pneumonia.
  • For sotrovimab: itching, fever, rash, and diarrhea.

The side effects of getting any medicine by vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the infusion site. Additionally, because bamlanivimab/etesevimab, casirivimab/imdevimab, and sotrovimab are antibody treatments, they could affect your body's own immune response to future infections with SARS-CoV-2, the virus that causes COVID-19, or they could affect your immune response to a vaccine for COVID-19.

Allergic reactions including hypersensitivity reactions (such as itching or flushing) and anaphylaxis have been reported in clinical trials of casirivimab/imdevimab, bamlanivimab/etesevimab, and sotrovimab. These allergic reactions are very rare and in all cases were successfully treated and resolved. Clinical studies are ongoing to evaluate the usefulness and safety of antibody treatment. It is possible that not all risks are known yet.

We do not know yet if it is safe to use the antibody treatment while pregnant. Women who are pregnant or breastfeeding should talk with their doctor or other health care provider. There is no available data on the presence of lab-made antibodies in human or animal milk, the effects on breastfed infants, or the effects on milk production.

CDC: Considerations for Newborns and Breastfeeding

We do not yet know how effective vaccines are in someone who has previously received an antibody treatment for a COVID-19 infection, or whether the antibody treatment could interfere with your body's own immune response to a vaccine. Once you have had COVID-19, you are very unlikely to be reinfected for three months afterward. So, if you receive an antibody treatment, you should delay receiving a vaccine for three months as a precaution.

It is important to know that if you have already received a vaccine for COVID-19, you are still eligible for antibody treatment. You may be treated with monoclonal antibodies whether you have received one or two doses of vaccine. If you have only received one dose of vaccine, you should delay receiving the second dose for three months after treatment, but you do not have to start the vaccine series over again.

See CDC: Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States

The federal government distributed antibody supplies at no cost to patients. However, some hospitals may have billed insurance companies to administer the drug. The state of Minnesota is working to ensure that any location that gives antibody treatments is considered in network and covered by insurance. However, if you are treated at a health care facility outside of your usual network, it is possible that you may have additional out-of-pocket charges (for example, if an E-Health visit is necessary to confirm eligibility). More information on insurance coverage of antibody treatments can be found at CMS: Coverage of Monoclonal Antibody Products to Treat COVID-19 (PDF).

How can I get monoclonal antibody treatment?

The Minnesota Resource Allocation Platform (MNRAP) is an online tool that connects people and health care providers with COVID-19 medications. People, their caregivers, or their health care providers can use MNRAP to find out which medications are available, whether they will help the person, and whether the person is able to get medication.

If someone can get a COVID-19 medication, MNRAP passes along information on their behalf to a health care facility that can give it. A final decision about whether someone can get a medication is up to the health care provider at that facility.

For patients or
caregivers

For health care
providers

Remdesivir and convalescent plasma

These medication options are typically for people with severe COVID-19 who require hospitalization.

For more information, visit combatCOVID: Available COVID-19 Treatment Options.

Updated Wednesday, 13-Oct-2021 10:48:36 CDT