Molnupiravir (EIDD-2801, MK-4482) is the isopropylester prodrug of [N4-hydroxycytidine].[A193014,A193026] With improved oral bioavailability in non-human primates, it is hydrolyzed _in vivo_, and distributes into tissues where it becomes the active 5’-triphosphate form.[A193026] The active drug incorporates into the genome of RNA viruses, leading to an accumulation of mutations known as viral error catastrophe.[A193029] Recent studies have shown molnupiravir inhibits replication of human and bat coronaviruses, including SARS-CoV-2, in mice and human airway epithelial cells.[A193014] A [remdesivir] resistant mutant mouse hepatitis virus has also been shown to have increased sensitivity to N4-hydroxycytidine.[A193014] Molnupiravir was granted approval by the UK's Medicines and Health products Regulatory Agency (MHRA) on 4 November 2021 to prevent severe outcomes such as hospitalization and death due to COVID-19 in adults.[L39050] Molnupiravir was also granted emergency use authorization by the FDA on December 23, 2021; however, it is not yet fully approved.[L39588]
Synonyms
Molnupiravir
Brand Names
Lagevrio
Indication
[N4-hydroxycytidine] and its prodrug molnupiravir are being studied for its activity against a number of viral infections including influenza, MERS-CoV, and SARS-CoV-2.[A193014, A193029] Molnupiravir is approved in the UK for reducing the risk of hospitalization and death in mild to moderate COVID-19 cases for patients at increased risk of severe disease (eg. with obesity, diabetes mellitus, heart disease, or are over 60 years old).[L39050,L39055] In the US, molnupiravir is authorized for emergency use for the treatment of high-risk adults With mild to moderate COVID-19.[L39588]
Categories
Amines
Anti-Infective Agents
Antiinfectives for Systemic Use
Antiviral Agents
Antivirals for Systemic Use
Cytosine Nucleotides
Direct Acting Antivirals
Esters
Experimental Unapproved Treatments for COVID-19
Nucleic Acids, Nucleotides, and Nucleosides
Nucleosides
Nucleosides and Nucleotides Excl. Reverse Transcriptase Inhibitors
