The World Health Organisation has updated its living guidelines on COVID-19 therapeutics to include a conditional recommendation on molnupiravir, a new antiviral medicine. This is the first oral antiviral drug to be included in the treatment guidelines for COVID-19. As this is a new medicine, there is little safety data. WHO recommends active monitoring for drug safety, along with other strategies to mitigate potential harms.
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Because of these concerns and data gaps, molnupiravir should be provided only to non-severe COVID-19 patients with the highest risk of hospitalisation. These are typically people who have not received a COVID-19 vaccination, older people, people with immunodeficiencies and people living with chronic diseases.
Children, and pregnant and breastfeeding women should not be given the drug. People who take molnupiravir should have a contraceptive plan, and health systems should ensure access to pregnancy testing and contraceptives at the point of care, an official statement issued by WHO has said.
Under the care of a health care provider, molnupiravir, an oral tablet, is given as four tablets (total 800 mg) twice daily for five days within five days of symptom onset. Used as early as possible after infection, it can help prevent hospitalisation. Thursday’s recommendation is based on new data from six randomised controlled trials involving 4,796 patients. This is the largest dataset on this drug so far.
