Molnupiravir is a synthetic nucleoside derivative, N4-hydroxycytidine and is still an experimental antiviral drug that was originally developed for the treatment of influenza and exerts its antiviral action through the introduction of copying errors during the replication of the viral RNA in a process referred to as ‘lethal mutagenesis’. Molnupiravir incorporates into the genome of RNA viruses, leading to an accumulation of inactivating mutations. It is still classified as an investigational drug and has been shown to inhibit the replication of human and bat coronaviruses, including SARS-CoV-2, in mice and humans. It is undergoing phase 2 and 3 clinical trials.
On 1 October 2021, Merck announced that they had stopped a clinical trial early that showed promising results in the treatment of COVID-19. The press release claimed that Molnupiravir reduced the risk of hospitalization or death by 48%. Based on this preliminary data they announced plans to seek an emergency use authorization from the FDA. The USA Department of Health and Human Services committed to buy 1.7 million courses of the drug for US$1.2 billion worth if it was approved.
Data from the initial clinical trial is that it appears that the drug must be taken within three days of first symptoms and confirmation of the COVID-19 infection and that the effectiveness of the drug drops after three days.
The drug does have the potential to interfere with some of the treatments used to treat cancer.
Tradename: Lagevrio
Other names: EIDD-2801, MK-4482
Chemical formula: C13H19N3O7
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