Listen for Questions About Molnupiravir to Treat COVID-19

You'll hear buzz about molnupiravir, an oral antiviral to treat that it's under Health Canada review.

Think of molnupiravir for COVID-19 as similar to Tamiflu (oseltamivir) to treat influenza.

Both are oral antivirals that patients can take at home to reduce the risk of serious symptoms and hospitalization.

Molnupiravir incorporates into the RNA of the SARS-CoV-2 virus and introduces "errors" in the code...causing the virus to mutate to death.

It's 4 capsules bid for 5 days...and seems well tolerated.

Be aware that molnupiravir seems to reduce hospital injectable COVID-19 monoclonal antibodies, or "MAbs," (sotrovimab, etc) do.

Either may be an option for certain outpatients with mild to moderate COVID-19...who are at high risk of developing severe illness.

But molnupiravir has less evidence. And animal studies suggest it may cause birth defects.

Refer questions about molnupiravir to your pharmacist.

Molnupiravir will likely be authorized for NONpregnant adults with a positive COVID-19 test...who have risk factors for severe COVID-19 illness (diabetes, age 65 or older, etc)...regardless of vaccination status.

Keep in mind, molnupiravir should be started within 5 days of symptoms...versus 10 days with MAbs.

Patients who get molnupiravir still need to self-isolate. There's no evidence it prevents spread of infection.

Encourage COVID-19 vaccination...treatment is not a substitute. Patients on molnupiravir can be vaccinated as soon as they stop isolation.

Stay tuned for the antiviral Paxlovid (nirmatrelvir/ritonavir). It may overshadow molnupiravir...partly because it seems more effective.

Compare meds in our chart, Treatments of Interest for COVID-19.

Key References

  • N Engl J Med. 2021 Dec 16. doi: 10.1056/NEJMoa2116044
  • (1-4-22)
  • (1-4-22)
Pharmacy Technician's Letter Canada. January 2022, No. 380101

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