The U.S. Food and Drug Administration has issued emergency use authorization (EUA) for the following outpatient medications, listed below in order of treatment preference as recommended by the NIH.

Preferred therapies
Listed in order of preference:

• Paxlovid (nirmatrelvir tablets and ritonavir tablets) is authorized for the treatment of mild-to-moderate COVID-19 in adults and certain pediatric patients with COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death.
• Veklury (remdesivir) is an approved antiviral drug for adults and certain pediatric patients with COVID-19. Not recommended in severe renal (eGFR <30) or liver failure.

Alternative therapies
For use only when neither of the preferred therapies are available, feasible to use or clinically appropriate. Listed in alphabetical order:

• Lagevrio (molnupiravir) is authorized for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options authorized by the FDA are not accessible or clinically appropriate.

Note: These treatments are only viable options if given within a certain number of days from symptom onset. Paxlovid and molnupiravir within five (5) days; remdesivir within seven (7) days. All COVID-19 treatments will require a physician order.

Learn more about these treatments at fda.gov.

How can I access these outpatient treatments?

MU Health Care has limited quantities of COVID-19 antiviral treatments, and they are available by prescription only. Demand for these treatments is expected to outpace supply, so MU Health Care is following the below outpatient protocol.

If you are a patient with a test-confirmed COVID-19 diagnosis and you are experiencing symptoms, you may be eligible for an outpatient treatment option, based on when your symptoms started. See section above for timeframes. You can contact your primary care physician to get a order. Note: Only contact your doctor if we have medication in stock. Check inventory.

If you are a prescribing provider, please follow these steps:

1. Determine patient’s tier of eligibility based on the NIH table below. Note: MU Health Care will focus on filling prescriptions for tier 1 patients first, and then expand to additional tiers as supply allows.
2. If patient is in an eligible tier, check the inventory table below for inventory status.
3. If the treatment is in stock, submit an order by following the instructions below.

Note: If you are an MU Health Care provider looking for the inpatient treatment protocol, please see the "Physician resources" section of our internal site.

Outpatient Infusion Locations

Our outpatient infusion sites are located at:

Women’s Hospital, 1st floor across from ED
404 N Keene St, Columbia, MO 65201
This location services patients 18+
Hours: Available by appointment only at 8:00 a.m. seven days a week
Phone: 573-771-5867
Fax: 573-882-5369

University Hospital, Children’s Hospital Procedure Suite (Building map)
1 Hospital Dr
Columbia MO (Directions)
This location serves patients <18
Phone: 573-771-3900 Monday-Friday 7-5pm
Fax: 573-219-3919
Phone: 573-882-6985 Saturday and Sunday
Fax: 573-219-4219

COVID-19 outpatient antiviral treatment protocol

This protocol is for providers only. COVID-19 antiviral treatments are available by prescription only.

Step 1: Tiered eligibility determination

MU Health Care is following NIH Treatment Guidelines to determine patient eligibility and prioritize treatment. While supply is limited, only patients in eligible tiers will receive antiviral treatment.

Step 2: Inventory status

Note: Treatment options listed in order of NIH preference.

IMPORTANT: Inventory information is updated as stock status changes. Please DO NOT send prescription orders if drug status is out of stock. Check back and wait for the drug to be in stock to order.

Step 3: Prescribing options

These options are for providers only. COVID-19 antiviral treatments are available by prescription only.

• Paxlovid (nirmatrelvir tablets and ritonavir tablets)
  • Send prescription electronically to Mizzou Pharmacy at South Providence or Keene Street.
    • Outside providers not affiliated with MU Health Care must also complete and submit this form to attest to patient eligibility: COVID-19 Antiviral Eligibility Screening Form
  • Reference the Paxlovid EUA fact sheet for dosing information, contraindications, and drug-drug interactions.
  • Check Paxlovid drug-drug interactions with Paxlovid. This may be done at www.covid19-druginteractions.org/.

• Veklury (remdesivir)
  • MU Health Care providers can place the orders for infusion via the electronic medical record.
    • For patients 18+ fax the completed consent form to 573-882-5369 for scheduling.
    • For patients <18 Monday – Friday, 7-5pm, call 573-771-3900 to schedule and fax the completed consent form to 573-219-3919.
    • For patients <18 Saturday or Sunday, call 573-882-6985 to schedule and fax the completed consent form to 573-219-4219.
  • Outside providers not affiliated with MU Health Care
    • For patients 18+ fax the completed consent form to 573-882-5369 for scheduling.
    • For patients <18 Monday – Friday, 7-5pm, call 573-771-3900 to schedule and fax the completed consent form to 573-219-3919.
    • For patients <18 Saturday or Sunday, call 573-882-6985 to schedule and fax the completed consent form to 573-219-4219.
  • Disqualifiers
    • Patient requiring new oxygen therapy attributable to active Covid-19 diagnosis.
    • Patient requiring increase in baseline oxygen attributable to active Covid-19 diagnosis.
  • Order Form for Outside Providers
  • Patient Consent Form
• Lagevrio (molnupiravir)
  • Send prescription electronically to Mizzou Pharmacy at South Providence or Keene Street.
    • Outside providers not affiliated with MU Health Care must also complete and submit this form to attest to patient eligibility: COVID-19 Antiviral Eligibility Screening Form
  • Reference the Molnupiravir EUA fact sheet for dosing information, contraindications, and drug-drug interactions.

IMPORTANT: Inventory information is updated as stock status changes. Please DO NOT send prescription orders if drug status is out of stock. Check back and wait for the drug to be in stock to order.