Safety and Effectiveness of Molnupiravir in Covid-19 Treatment: A Rapid Review

Mohammadreza Mobinizadeh; Ali Akbarisari; Alireza Olyaeemanesh; Marita Mohammadshahi; Elham Ahmadnezhad; Parisa Aboee; Zeinab Fakorfard; Raheleh Sadeghi

doi:10.18502/jpc.v10i3.10795

Mohammadreza Mobinizadeh National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran.
Ali Akbarisari Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Alireza Olyaeemanesh National Institute for Health Research and Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran.
Marita Mohammadshahi National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran
Elham Ahmadnezhad National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran.
Parisa Aboee National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran.
Zeinab Fakorfard National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran.
Raheleh Sadeghi National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jpc.v10i3.10795

Keywords: Molnupiravir; Covid-19; Review

Abstract

In the first stage of viral replication, Covid-19 may cause a remarkable inflammatory response in patients. Molnupiravir is an oral antiviral medicine which functions through inhibiting the viral replication of RNA viruses including Corona virus (SARS-CoV-2). The present study intends to help the policymakers decide on using of this medication in Iran.

This study is conducted on Jan. 22, 2022 (from Jan. 2014 -the year of molnupiravir production for treatment of RNA virus diseases), using a rapid review of evidence as well as reviewing reliable databases including the Cochrane library, PubMed and Google scholar. The inclusion criteria were the randomized controlled trials that investigated the safety and efficacy of Molnupiravir at different doses in patients with Covid-19, comparing with placebo or other routine care methods (Population: Covid-19 patients, Intervention: molnupiravir, Control: placebo or other routine care methods, Outcome: Safety, Efficacy and Economic status, Study design: the randomized controlled trials or HTA reports). Prescription for oral administration in 800 mg dose twice daily for 5 days to inpatients and outpatients with mild, moderate or severe symptoms in the early stages of the disease (viral phase) had the most desirable level of efficacy. This medicine has no serious side effects; since the mutations caused by this medication have not been clarified yet, it is not recommended during pregnancy and/or for women planning to become pregnant. According to the manufacturing company, in the United States, each drug package is priced at $712 for a 5-day treatment period. Molnupiravir can be used in outpatients and inpatients (Over 18 years old) with moderate or severe symptoms in the early stages of the disease. But it is not recommended during pregnancy and/or for women planning to become pregnant.