Molnupiravir Oral Antiviral Treatment
Mercy Urgent Care is pleased to now offer Merck’s oral antiviral treatment, Molnupiravir, for the treatment of mild-to-moderate COVID-19 in adults ages 18 and up with positive COVID-19 test results. The five-day treatment course will be available for patients who are at high risk for severe progression, including hospitalization or death, and within five days of symptom onset.
Prioritization of Patients at Highest Risk of Progression to Severe COVID-19
The National Institutes of Health (NIH) prioritized the following risk groups for based on 4 key elements: age, vaccination status, immune status, and clinical risk factors. The groups are listed by tier in descending order of priority.
| Tier | Risk Group |
|---|---|
| 1 | Immunocompromised individuals not expected to mount an adequate immune response to COVID-19 vaccination or SARS-CoV-2 infection due to their underlying conditions, regardless of vaccine status (Immunocompromising Conditions); OR Unvaccinated individuals at the highest risk of severe disease (anyone aged ≥75 years or anyone aged ≥65 years with additional risk factors). |
| 2 | Unvaccinated individuals at risk of severe disease not included in Tier 1 (anyone aged ≥65 years or anyone aged <65 years with clinical risk factors). |
| 3 | Vaccinated individuals at high risk of severe disease (anyone aged ≥75 years or anyone aged ≥65 years with clinical risk factors). Vaccinated individuals who have not received a COVID-19 vaccine booster dose are likely at higher risk for severe disease; tier 3 patients in this situation should be prioritized for treatment. |
People are considered to be moderately or severely immunocompromised if they have:
- Been receiving active cancer treatment for tumors or cancers of the blood
- Received an organ transplant and are taking medicine to suppress the immune system
- Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
- Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
Molnupiravir is taken orally as four 200 mg capsules (800 mg) every 12 hours for five days, with or without food. The capsules must be swallowed whole—do not open, break, or crush capsules. If a dose is missed within ten hours of the time it is usually taken, take as soon as possible and resume the normal dose schedule. If a dose is missed by more than ten hours, do not take the missed dose and instead take the dose at the next regularly scheduled time. Treatment must be taken within five days.
Molnupiravir is not authorized for:
• Use in patients less than 18 years of age
•. Use in patients currently hospitalized for requiring hospitalization for COVID-19
•. Use longer than five days
•. Prevention of COVID-19
•. Use during pregnancy
The most adverse reactions to Molnupiravir are diarrhea, nausea and dizziness, but are rare. Molnupiravir is not recommended during pregnancy or breastfeeding. A negative pregnancy test is required for patients of childbearing potential (ages 18-50) prior to prescription. Molnupiravir is available to patients at no cost, but patients will be responsible for provider visit and required tests. Check with your insurance prior to treatment for coverage information.
