Ever since the emergence of the Coronavirus epidemic, many pharmacological treatments have been studied. Many antiviral therapeutics have recently received approval for emergency use by the FDA, which attack both the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) and the main protease (Mpro). Molnupiravir targets the RNA polymerase of Sars-CoV-2, which serves as the key enzyme in the viral replication cycle. 

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. 

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. 

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.