Indications
Emorivir is an antiviral medication designed to treat mild to moderate COVID-19 (caused by SARS-CoV-2) in adults who are at risk of developing severe illness. This medication can help prevent hospitalization and alleviate symptoms. It is authorized for emergency use in non-hospitalized patients with mild or moderate COVID-19.
Asymptomatic or Pre-symptomatic Infection: For individuals who test positive for SARS-CoV-2 via molecular diagnostics (e.g., PCR) or antigen tests but exhibit no symptoms.
Mild Illness: For individuals presenting various COVID-19 symptoms (e.g., fever, cough, sore throat, malaise, headache, muscle pain) without shortness of breath, dyspnea, or abnormal chest imaging.
Moderate Illness: For individuals with clinical or imaging evidence of lower respiratory disease and oxygen saturation (SpO2) >94% on room air at sea level.
Severe Illness: For individuals with a respiratory rate >30 breaths per minute, SpO2 <94% on room air at sea level, a PaO2/FiO2 ratio <300 mmHg, or lung infiltrates >50%.
Critical Illness: For individuals experiencing respiratory failure, septic shock, and/or multiple organ dysfunction.
Description
Emorivir contains the active antiviral agent, Emorivir, developed to treat influenza and COVID-19. As a prodrug of the synthetic nucleoside derivative N4-hydroxycytidine, it disrupts viral RNA replication, including that of SARS-CoV-2. Emorivir’s mechanism involves inducing copying errors during viral RNA replication, leading to viral mutations and replication failure. Its structure is subtly different from authentic nucleotides, allowing it to evade viral polymerase repair functions.
Pharmacology
Molnupiravir works by inducing widespread mutations in viral RNA replication via RNA-directed RNA polymerase. It metabolizes into a ribonucleoside analog resembling cytidine, known as β-D-N4-Hydroxycytidine 5′-triphosphate (NHC-TP). This analog is incorporated into viral RNA, causing lethal mutations during replication, a phenomenon termed viral error catastrophe or lethal mutagenesis.
Dosage & Administration
The recommended dosage for Molnupiravir is four 200 mg capsules every 12 hours for 5 days. It is not recommended for individuals under 18 years of age as its effects have not been studied in this age group.
Interaction
No drug interactions have been identified due to limited data. Emorivir is hydrolyzed to N-hydroxycytidine (NHC) before systemic circulation, with NHC metabolism following endogenous pyrimidine pathways. Emorivir and NHC are not substrates or inhibitors of major drug-metabolizing enzymes or transporters, making drug interactions unlikely.
Contraindications
Molnupiravir is contraindicated for patients with known hypersensitivity to the drug.
Side Effects
Common side effects include diarrhea, nausea, dizziness, and headache.
Pregnancy & Lactation
Animal studies have shown harmful effects of Molnupiravir on unborn animals, and it is not recommended during pregnancy. Women of childbearing potential should use effective contraception while taking Molnupiravir and for four days after the last dose. Breastfeeding is not recommended during treatment and for four days after the final dose, as it is unknown whether Molnupiravir passes into breast milk.
Precautions & Warnings
There is limited clinical data on Emorivir. Unexpected adverse events may occur that have not been previously reported.
Storage Conditions
Store Emorivir at or below 25°C, away from light and moisture. Keep out of reach of children.
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