Since the emergence of the Coronavirus pandemic, numerous pharmacological treatments have been studied including remdesivir. Recently, other antiviral alternatives like molnupiravir are showing effective results in pre-registration studies. molnupiravir targets the RNA polymerase of Sars-CoV-2, which serves as the key enzyme in the viral replication cycle. 

Molnupiravir has shown potent inhibition of SARS-CoV-2 replication, with an EC50 in the submicromolar range in-vitro and animal models. It has also shown good efficacy and safety in phase I/II/III clinical trials. 

Data supports 50% risk reduction for hospitalization or death with the use of molnupiravir in non-hospitalized adults with mild to moderate COVID-19 and those with risk for a serious disease outcome. Further it also rendered similar results in all subgroups, with efficacy unaffected by the timing of symptom onset, underlying risk factors, or type of Sars-CoV-2 variant. 

Furthermore, the available data regarding this drug indicates a generally good safety profile. A clinical study showed a comparable incidence of any adverse event in the molnupiravir and placebo groups (35% and 40%, respectively), and the incidence of drug-related adverse events (12% and 11%, respectively). Further, fewer subjects dropped off molnupiravir therapy because of an adverse event than the placebo group (1.3% vs 3.4%).

But still some data regarding the optimal dose for administration, the timing of administration and any interactions with other drugs used to manage the COVID-19 infection needs to be collected for molnupiravir. Large-scale epidemiological data is warranted to better explain the safety profile of molnupiravir.

SOURCE- Drugs & Therapy Perspectives, 2021; 37:579–580. https://doi.org/10.1007/s40267-021-00879-2