Formulary
Molnupiravir: Indications, Dosing, Side Effects and Interactions
Molnupiravir (a prodrug) is a ribonucleoside analogue that increases the number of mutations in viral RNA thus preventing multiplication of the virus.
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Molnupiravir: Indications, Dosing, Side Effects and Interactions
Molnupiravir (a prodrug) is a ribonucleoside analogue that increases the number of mutations in viral RNA thus preventing multiplication of the virus.
Drug action
Molnupiravir (a prodrug) is a ribonucleoside analogue that increases the number of mutations in viral RNA thus preventing multiplication of the virus.
Indications and dose
**COVID-19 in patients who do not require oxygen supplementation and are at an increased risk of severe COVID-19 infection**
- **Adult** (By Mouth): 800 mg twice daily for 5 days, treatment to be started as soon as possible after diagnosis and within 5 days of symptom onset.
Side effects
Common or very common Diarrhoea; dizziness; nausea Uncommon Headache; skin reactions; vomiting
Interactions
**Other interactions (3):**
- No clinical interaction studies have been performed with molnupiravir.
- Molnupiravir is hydrolysed to N4-hydroxycytidine (NHC) prior to reaching systemic circulation.
- Based on in vitro studies, neither molnupiravir nor NHC are inhibitors or inducers of major drug metabolising enzymes or inhibitors of major drug transporters.
Pregnancy
Important safety information For molnupiravir MHRA/CHM advice: COVID-19 antivirals: reporting to the UK COVID-19 Antivirals Pregnancy Registry (February 2022) The safety of COVID-19 antiviral treatment, such as molnupiravir, during pregnancy has not been established. The MHRA, in collaboration with the UK Teratology Information Service (UKTIS), is operating the UK COVID-19 Antivirals Pregnancy Registry to collect information about and enable follow-up of reported exposures to COVID-19 antivirals in pregnancy; it is also collecting information on the outcomes of pregnancies, where conception occurred during or shortly after paternal exposure to antiviral treatment. Healthcare professionals in England, Scotland, and Wales (as well as patients and their partners) are advised to report exposure to molnupiravir during pregnancy or around the time of conception, or of partners on molnupiravir around the time of conception. Healthcare professionals in Northern Ireland cannot currently report on behalf of a pregnant female or their partner but should encourage them to self-report. Since exposure can occur in very early pregnancy before pregnancy is recognised, healthcare professionals are advised to report (or to encourage patients to self-report), even if some time has passed since the end of molnupiravir treatment. An exposed pregnancy should be reported by telephone to UKTIS-for more information, see the UKTIS Registry website (available at: ).
Breast feeding
Avoid during treatment and for 4 days after last treatment-no information available. M
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Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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