Rapid Rx Quiz: COVID Treatments

Mary L. Windle, PharmD


March 01, 2022

EUA for molnupiravir was granted on December 23, 2021, for treatment of mild to moderate COVID-19 in adults aged 18 years or older who test positive for SARS-CoV-2 virus and are at high risk for progression to severe COVID-19, including hospitalization or death. Given its lower efficacy compared with nirmatrelvir-ritonavir (Paxlovid), molnupiravir is considered a second or third choice (behind nirmatrelvir-ritonavir or remdesivir).

Molnupiravir (Lagevrio) is an oral antiviral agent that is a prodrug of the nucleoside derivative N4-hydroxycytidine. It elicits antiviral effects by introducing copying errors during viral RNA replication of the SARS-CoV-2 virus.

The phase 3 MOVe-OUT study (n = 1433) found that molnupiravir reduced risk for hospitalization or death from 9.7% (68 of 699 persons) in the placebo group to 6.8% (48 of 709 persons) in the molnupiravir group, for an absolute risk reduction of 3% (P =.02) and a relative risk reduction of 30%. Nine deaths were reported in the placebo group and one in the molnupiravir group. These data are consistent with the interim analysis.

On the basis of animal reproduction studies, molnupiravir may cause fetal harm when administered to pregnant females.

Learn more about molnupiravir.


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