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Molnupiravir: Everything to know about UK’s first anti-viral Covid-19 pill treatment

Evening Standard logo Evening Standard 10/11/2021 Ross Lydall
Molnupiravir anti Covid drug 011021 © Merck & Co,Inc./AFP via Getty Im Molnupiravir anti Covid drug 011021

Molnupiravir is the first oral medicine which has had the approval from the NHS for the treatment of Covid-19.

Health Secretary Sajid Javid said the pill would be a “game changer” for older people and those more at risk from Covid.


Here is everything we know about Molnupiravir:

Why has this been hailed as a game-changer?

Molnupiravir is the first anti-viral medication that can be taken at home - meaning that people most at risk from Covid have a good chance of avoiding becoming seriously ill or dying.

The UK is the first country in the world to approve the pill, after it was given the go-ahead by the MHRA, the UK’s medicines regulator.

The aim is to make it available on the NHS “as soon as possible”, probably in a matter of weeks.

A national study is planned by the Department of Health to assess its “real world” effectiveness.

Does it mean vaccines are not required?

Definitely not. Rather, it is “another tool in the toolbox” to tackle covid, and will be used for “mild to moderate” Covid.

Treatments already exist - such as the antiviral remdesivir and generic steroid dexamethasone - but they are for the most seriously ill patients and are given in hospital.

Molnupiravir, which will be branded Lagevrio in the UK, will shortly become generally available for those who develop symptoms at home.

How effective is it?

In clinical trials, it was found to half the risk of serious illness or death in unvaccinated patients most at risk from Covid, from 14.1 per cent to 7.3 per cent.

Dr Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London.

If these outcomes are replicated in the UK population then the number of cases requiring hospital admission could be halved and the number of deaths greatly reduced.

What are antivirals?

Antivirals are treatments used to either treat those who are infected with a virus or protect exposed individuals from becoming infected.

They target the virus at an early stage, preventing progression to more severe, or even critical, symptoms.

Is it available to all people diagnosed with Covid?

No, it will be targeted at the over 60s and people with immunodeficiencies or who have other risk factors that leave them more vulnerable to Covid, such as obesity, diabetes or heart disease.

When does it have to be taken?

The pill is most effective if taken within five days of the onset of Covid symptoms. It is taken twice a day for five days.

It is the first Covid treatment that can be taken orally rather than intravenously.

How much is available?

The UK Government announced last month that it had bought 480,000 courses of the treatment.

The US is expected to approve the pill later this month.

Its manufacturer Merck said it was expecting to produce 10 million courses of the treatment by the end of this year, with at least 20 million set to be manufactured in 2022.

How much does it cost?

In the US the price US$713 (about £520) but the cost to the NHS has not been announced.

What does JVT think?

Announcing the deal to buy Molnupiravir last month, England’s deputy chief medical officer Professor Jonathan Van-Tam said: “They will be particularly vital in protecting those who may not get the same antibody response to the vaccines as the majority of the population.”

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