Covid-19 | Molnupiravir shows more gains than risks, say experts

Molnupiravir, an oral antiviral pill approved for treating Covid-19, has been questioned over its safety, but Indian health experts say the benefits outweigh the risks in the case of high-risk patients.

On Monday, health professionals treating coronavirus patients across the country reported that the Covid antiviral drug has reduced hospitalisation by 30 to 50 percent, as well as severity of the disease.

Developed by US-based drug company Merck, Molnupiravir is approved by the US Food and Drug Administration against Covid-19. It is approved by the UK Medicines and Healthcare Products Regulatory Agency (MHRA) for the treatment of mild-to-moderate Covid-19 in adults with a high risk of progression to severe disease, mainly those with pre-existing (comorbid) conditions.

"The question is can a medicine cause cancer in humans after using it for only five days? There should not be any hesitation in using the drug among patients above 45-50 years with co-morbidities. "It's a trade-off and it's more in favour of benefits." Dr Vasant Nagvekar, a task force member, said the drug should be used at a clinician's discretion. 

India approved the drug amid rising cases of new Covid variant Omicron. An expert panel of the Central Drugs Standard Control Organisation had recently approved the antiviral Molnupiravir for restricted use in emergency situations. The antiviral drug will be manufactured by 13 companies in India.

"Here is drug which I am sure both CDSCO and DCGI have analysed before approving for use," said Dr Govindarajan Padmanaban, a key member of the national Covid task force. "Any anti-viral at this stage is useful, and molnupiravir should be used taking all precautions as Covid cases are dangerously multiplying," he said.

The reassurance by experts comes days after ICMR chief Dr Balram Bhargava said that molnupiravir has major health safety concerns. Dr Bhargava said that the drug in question is not included in the national Covid taskforce treatment as it has major safety concerns like teratogenicity, mutagenicity, muscle and bone damage among others.

The experts say as there are very limited options of medicines to treat Covid patients, hence the new approved medicines should be given a try under strict treatment regime protocols.

"We have to use the available therapy rather than counting its side-effects, that too which are potential, but not known," said Dr Deepak Talwar, Senior Consultant, Pulmonology and Sleep Medicine, and Chairman, Metro Respiratory Centre. 

Dr Dhruva Chaudhry, nodal officer for Covid for Haryana, said so far only animal studies have shown some side-effects.