Maharashtra government on late Monday issued new guidelines on the use of table Molnupiravir in the treatment of SARS-CoV-2 infections stating that until further advised it should be used with abundant caution and in certain conditions & that also on full advised dose. Moreover, it should be given to those who have mild symptoms and should be administered within five days of the illness.
This is about the use of Tablet Molnupiravir in the treatment of SARS-CoV-2 infection. This drug has received Emergency Use Authorization & based on the opinion of some experts has also been included in treatment protocol circulated on 6th January 2022 in our State subject to certain conditions.
“Subsequently certain State Governments like Odisha have withdrawn this drug from the market. ICMR has also not recommended its use in the treatment of SARS-CoV-2 infection. Molnupiravir has not been included in the Standard Treatment Protocol released by the Government of India on 17th January 2022. Molnupiravir has been shown to reduce hospitalization in a clinical trial and thus has received Emergency Use Authorization, not an FDA approval,” read a letter issued by Dr Pradeep Vyas, Chief Additional Secretary.
Molnupiravir is an antiviral drug that may be prescribed for the treatment of COVID in patients who have mild illness not requiring oxygen, one or more risk factors that will cause hospitalization & impending severe disease, in whom there are no other options available and where there are no contraindications to the use of Molnupiravir'
“Patients qualifying in the above criteria should have a definite positive SARS-CoV-2 test report. It is important to remember the contraindications. Patients under the age of 18 and also pregnant ladies should not be given Molnupiravir. lt also should be avoided in females of the reproductive age group. if it is decided to be given in this age group then, females of childbearing potential are advised to use a reliable method of birth control correctly and consistently during treatment with Molnupiravir and for three months after the final dose. Males with reproductive potential who are sexually active with females of childbearing potential are advised to use a reliable method of birth control correctly and consistently during treatment with Molnupiravir and for at least three months after the final dose as Molnupiravir will affect sperm cells,” read the letter.
The biggest concern with Molnupiravir is its potential for adverse effects such as induced mutations on the reproductive cells, such as males and female gametes. Secondly, fast dividing cells may accumulate mutations in bone & cartilages. Most importantly Molnupiravir, when taken in suboptimal doses, is likely to cause sublethal mutations and perpetuate further variants. Hence it is very very important to take a full course, once the medicine is started.