Molnupiravir: A wonder drug or a limited star?

The drug’s efficacy is considerably lower than what was reported in interim analysis in October.

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Last Updated on January 2, 2022 by The Health Master

Molnupiravir: A wonder drug or a limited star?

Some call the oral pill a game-changer, others say more data needed

With the center granting Emergency Use Authorization (EUA) for the antiviral C-19 pill molnupiravir, experts in the city have different views on the efficacy of this drug.

While some state it could be a wonder drug, others say out that more data needs to be out.

Molnupiravir is an oral antiviral that inhibits the replication of multiple RNA viruses, including SARS-CoV-2. It forces SARS-CoV-2 to try to replicate its genetic material.

However, as the process begins, the pill inserts errors into the genetic code of replicating virus, said a set of experts.

Molnupiravir should be administered as soon as possible after a diagnosis of C-19, and within five days of onset of symptoms according to the initial data, the drug is said to prevent the progression of the disease, leading to hospitalisation.

Dr Manohar K N, Consultant, Internal Medicine, Manipal Hospital, Old Airport Road, said: “Adult C-19 patients with comorbidities like diabetes, CKD, COPD, heart disease, COPD, immunocompromised conditions, obesity can be given molnupiravir.”

“Phase-III clinical trial showed that the pill was able to reduce the risk of hospitalisation or death in half. Later, in the final analysis, the company clarified that molnupiravir reduces hospitalization or death by 30 percent.

The drug’s efficacy is considerably lower than what was reported in interim analysis in October.”

In terms of the dosage of the drug, the course has 40 pills — 800mg (four 200 mg capsules) to be taken orally every 12 hours for five days, with or without food.

Completion of the full five-day treatment course is important to maximise viral clearance and minimize transmission of SARS-CoV-2.

Likely to have limited power

Dr Manohar added: “This is not a wonder drug. It is likely to have limited role in high-risk patients if given early in course of disease”.

Dr Anoop Amarnath, member of the state Critical Care Support Team (CCST), said, “We have to see the clinical benefits.

The clearance from the regulatory authority comes with some caveats. Each company has to provide details of the post-marketing surveillance data of 1,000 patients over the next three months.

This data will ascertain safety and efficacy details. Hence it’s too early to consider it as a standard of treatment.”

Based on findings, molnupiravir is not recommended for use in patients who are pregnant or may cause foetal harm.

Experts also pointed out that females of childbearing potential should use a reliable method of contraception correctly, as applicable, for the duration of treatment and for four days after the last dose of molnupiravir and breast-feeding was not recommended during treatment with molnupiravir.

It has even been stated that males of reproductive potential who are sexually active with females of childbearing potential should use a reliable method of contraception correctly and consistently during treatment and for at least three months after the last dose.

Could be a game-changer

Dr Manu Chaudhary, Paediatric Infectious Diseases Specialist, Rainbow Children’s Hospital, Marathahalli stated it could be a game changer.

“The oral anti C-19 medication will be a game-changer as it means fewer hospitalisations for antiviral medication.

The more the options for vaccination, the faster the coverage.

A more vaccinated population means less severe disease and a reduced burden on the healthcare system. They should make the availability and distribution more equitable.”

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