With limited options, doctors and hospitals start prescribing Molnupiravir for high-risk patients

Doctors and hospitals have gradually begun prescribing Covid antiviral drug molnupiravir citing that the benefits of the drug outweigh the potential risks it may have for high-risk patients. Several doctors ET spoke to said that there was some initial hesitancy, but given the limited option in terms of medicines to treat high-risk Covid patients, they have decided to prescribe the drug in some cases while adhering to protocols.

Doctors are prescribing molnupiravir irrespective of the variant. The latest surge of Covid cases is largely fuelled by the Omicron variant, even as the Delta is spreading albeit at a lower intensity. Pfizer's more effective antiviral Paxlovid is not yet available in India. Paxlovid cuts the risk of hospitalization and death by up to 88% compared to 30% for molnupiravir.

Vasant Nagvekar, an infectious diseases specialist at Lilavati Hospital and member of the Maharashtra government's Covid-19 task force said he is prescribing the drug for people over 60 years and for those with multiple comorbidities. Nagvekar said he has prescribed it to 30 patients since it became available in the market.


"Symptoms with fever, and if fever persists 48-72 hours then molnupiravir for 5 days is also receptive. Molnupiravir should be administered as soon as possible after a diagnosis of Covid-19 has been made, and within five days of symptom onset," Nagvekar said.

"..not treating when the disease is mild or moderate can take extreme turns, putting the patient at risk of hospitalisation and as we have seen at the time of the Delta variant, even possible death. We have to use the available therapy rather than counting its side-effects, that, too, which are potential, but not known," said Deepak Talwar, senior consultant and chairman of Metro Respiratory Centre, pulmonology and sleep medicine.

Another specialist Amitabh Parti, Director and Unit head, Department of internal medicine, Fortis Memorial Research Institute, Gurugram echoed the views of the earlier two doctors.

"The choice of patient and appropriate time of administration are the two key features if this drug is to be prescribed," Parti said.

Molnupiravir has been approved by the DCGI for the treatment of mild-to-moderate Covid-19 in adults with a high risk of progression to severe disease. It is the only such medicine currently available in India and that has been approved for the treatment of adult patients with Covid-19 and with oxygen saturation greater than 93% and who have a high risk of progression of the disease including hospitalization or death.