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Covid-19 pill Merck's Molnupiravir: 14 Things you need to know.

Covid-19 pill Merck's Molnupiravir: 14 Things you need to know.

April 8, 2022. | 4 Minutes read.

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On December 23, 2021, the FDA authorized Merck’s molnupiravir (US brand Name Lagevrio) pill as an additional oral treatment for Sars-coV-2 infections. Only doctors, advanced practice registered nurses, and physician assistants who are licensed or permitted to prescribe Lagevrio for an individual patient may do so.

1. What is Molnupiravir?

 Merck’s Molnupiravir is an oral Covid-19 treatment, an anti-viral pill, Which the FDA authorized for use in mild to moderate covid-19 infections for the high-risk people group aged 18 years and above. Molnupiravir pill is only available with a Doctor’s prescription.

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2. What are the Ingredients of Molnupiravir (Lageviro)?

Molnupiravir, the 5′-isobutyrate ester of the ribonucleoside analog N4-hydroxycytidine, is found in Lageviro capsules. And suppresses SARS-CoV-2 replication by viral mutagenesis (NHC).

Each oral LageviroO pill includes 200 mg of molnupiravir as well as the inert substances croscarmellose sodium, hydroxypropyl cellulose, magnesium stearate, and microcrystalline cellulose, and purified water. Hypromellose, red iron oxide, and titanium dioxide make up the capsule shell.

3. How does Covid-19 pill Molnupiravir work?

Once Molnupiravir medication enters your body, it stops the virus from replicating. Molnupiravir molecules are absorbed by virus-infected cells and converted into a faulty version of the RNA building blocks. As an outcome, when the virus attempts to replicate, the resulting virus particles have faulty genetic material and are unable to replicate. As a result, the viral load should stay low, lowering the risk of severe disease.

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4. What is Molnupiravir's Efficacy against Covid-19 infection?

An early report indicated that the Merck drug reduced the risk of hospitalization and death in patients with the mild-to-moderate disease by 50%, but a final analysis of the trial reported in November, before FDA approval, reduced that benefit to 30%.

According to Merck’s press release, dated April 1, 2022, “Merck and Ridgeback to Present Data Demonstrating That Treatment With LAGEVRIO™ (molnupiravir) Was Associated With More Rapid Elimination of Infectious SARS-CoV-2 Than Placebo, 

“Molnupiravir was also associated with greater mean reductions from baseline in SARS-CoV-2 RNA than placebo from Days 3 through 10, though molnupiravir and placebo were associated with comparable rates of viral RNA clearance through Day 29.”

5. Is Molnupiravir Effective against Omicron Variants?

In Phase 3 MOVe-OUT study, researchers looked at how effective molnupiravir was against covid variants (Delta, Gamma, and Mu). They found that molnupiravir was effective against these variants. The findings were published in the New England Journal of Medicine.

According to Merck’s media release dated January 28, 2022, data from six “preclinical” studies demonstrated that molnupiravir was active against the SARS-CoV-2 variant Omicron (B1.1.529) in vitro studies. Clinical studies are yet to conduct to know Molnupiravir’s efficacy against omicron variants.

6. What did WHO say about Molnupiravir?

WHO released a statement to the media on March 3, 2022, that recommended Molnupiravir for the “People who have not received a COVID-19 vaccination, older people, people with immunodeficiencies, and people living with chronic diseases.

Children and pregnant and breastfeeding women should not be given the drug. People who take molnupiravir should have a contraceptive plan, and health systems should ensure access to pregnancy testing and contraceptives at the point of care.”

7. Who can use Molnupiravir?

Patients should speak with their healthcare practitioner to see if they are suitable for Lagevrio depending on personal conditions and whether alternative COVID-19 treatment alternatives recognized or authorized by the FDA are available or clinically appropriate.

The Covid-19 Treatment Guidelines Panel advises administering molnupiravir (800 mg in total per day) orally twice daily for 5 days only in nonhospitalized patients aged 18 years and above who have mild to moderate Covid-19 and are at high risk of disease progression.

Molnupiravir should be prescribed where ritonavir-boosted nirmatrelvir (Paxlovid), or other therapies cannot be used in certain circumstances for the patient.

8. Who should not take Molnupiravir?


Molnupiravir is not approved for usage in patients under the age of 18 years, because it can interfere with bone and cartilage development. It is not approved for Covid-19 pre-exposure or post-exposure prophylaxis, or for the starting of therapy for patients hospitalized due to Covid-19, because no effect has been found in those who received treatment after being hospitalized due to Covid-19.

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9. Can pregnant women use Molnupiravir?

Molnupiravir is not suggested for use in pregnant women, according to the FDA, because fetal toxic effects have been noted in Molnupiravir animal studies.

When other treatments are not accessible, pregnant people with Covid-19 who are at high risk of improving to severe disease may choose molnupiravir therapy after being made aware of the risks, especially if they are past the time of embryogenesis.

For lactating mothers, during therapy and for 4 days following the final dosage of Molnupiravir, breastfeeding is not suggested.

The prescribing physician should document that a risk-benefit discussion took place and that the patient chose this therapy. The patient should also be made aware of the pregnancy surveillance program and given the option to participate.

10. When should I start taking Molnupiravir?

For people who tested positive for the Sars-CoV-2 virus directly, Molnupiravir therapy should begin as soon as possible and should be taken twice a day, (Morning 2 tablets of 200Mg and Evening 2 tablets of 200Mg), within 5 days of the onset of symptoms.

11. Can I take Molnupiravir with other medications?

Yes!. Molnupiravir has no known drug-drug interactions, according to the FDA’s Emergency use authorization. However, you should inform the physician about the medications you are taking for your health conditions.

12. What are the side effects of Molnupiravir?

According to Merck’s clinical trial, the Molnupiravir has seemed to have a smooth safety profile, which means that no severe side effects were observed in trial participants.

Based on the vitro studies, Molnupiravir’s most common side effects are diarrhea, nausea, and dizziness.

13.Covid-19 Antiviral pill Molnupiravir available, May I skip vaccines?

According to FDA, Molnupiravir is not a replacement for Vaccines, People should get vaccinated and eligible individuals should get their booster doses.

If the new Covid-19 medications work in real-world situations, vaccine will remain key to preventing SARS-CoV-2 infection and reducing its spread.

All the clinical trials proved that vaccines are good at protecting people from hospitalization and death.

14. What is the best way to store Molnupiravir?

Molnupiravir capsules should be stored between 20° to 25°C (68° to 77°F), with variations allowed between 15° and 30°C (59° to 86°F).

Early treatment will stop the infection from getting worse, Take a Covid-19 Test for early detection.

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