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Molnupiravir
Molnupiravir
Brand
name:Lagevrio
use
Molnupiravir is a product that the FDA is allowing to be given for emergency use to treat COVID-19.
It is used by adults 18 years of age and older who have recently tested positive for coronavirus, have
had mild to moderate symptoms for no more than 5 days and are not hospitalized.
To receive this product you must also be at high risk for COVID-19 complications due to older age,
obesity, or ongoing medical conditions (such as lung or heart disease or diabetes, among others.
Mechanism of Action
Metabolized to cytidine nucleoside analogue, NHC, which distributes into cells where NHC is
phosphorylated to form the pharmacologically active ribonucleoside triphosphate (NHC-TP)
NHC-TP incorporation into SARS-CoV-2 RNA by the viral RNA polymerase results in an accumulation
of errors in the viral genome, leading to inhibition of replication
capsule
• 200mg
Completing the full 5-day treatment course and continuing to isolate in accordance with public health
recommendations are important to maximize viral clearance and minimize viral transmission
If patient is hospitalized due to severe or critical COVID-19 after starting treatment with molnupiravir,
completion of the full 5-day treatment is at the healthcare provider's discretion
Missed dose
• <10 hours: Take missed dose as soon as possible, and resume normal dosing schedule
• >10 hours: Skip dose, and take the next dose at the regularly scheduled time
• Do not double dose to make up for missed dose
Dosage Modifications
Renal impairment
• Mild or moderate (eGFR >30 mL/min): No dosage adjustment necessary
• Severe (eGFR <30 mL/min), end-stage renal disease, or patients on dialysis: Pharmacokinetics not
evaluated; not expected to have a significant effect on NHC (N4-hydroxycytidine) exposure
Hepatic impairment
Adverse Effects
1-10%
Diarrhea (2%)
Nausea (1%)
Dizziness (1%)
<2 %
• Selected Grade 3 and 4 laboratory abnormalities in chemistry (ALT, AST, creatinine, and lipase)
and hematology (hemoglobin, platelets, and leukocytes)
Limitations of use
Use in pregnancy is not recommended.-14 There are no human data on use during pregnancy to
assess the risk of adverse maternal or fetal outcomes.*4 Based on animal data, the drug may
cause fetal harm.
"Molnupiravir" is the first oral coronavirus treatment for adults at high risk, the
authority explained, cutting the threat of hospitalization and death by half for mild to
moderate cases.