The third wave of Covid-19 has hit India with full force. In the last 10 -15 days test positivity has shot up real fast. However, cases are reportedly mild with lesser hospitalization and oxygen crisis. Moreover, with a large number of people now vaccinated, the infection is remaining under control in most cases.
In the last two waves, we have seen an array of treatments including pills, injections, and convalescent plasma to tackle the deadly virus. A number of these treatments including – antiparasitic Ivermectin, Hydroxychloroquine, and convalescent plasma therapy – are no longer part of the Indian Council for Medical Research (ICMR)’s protocol.
Rise of Molnupiravir
On the other hand, some new treatments like Molnupiravir are fast becoming popular. Interestingly, Molnupiravir is named after Mjölnir, the hammer of the god of thunder in Norse mythology known as Thor. By viral mutagenesis, Molnupiravir (brand name Lagevrio) interferes with the replication of the coronavirus in our bodies. Mutagenesis is a process that changes the genetic information of an organism by the production of mutation. This helps lower the viral levels and lessens the severity of the infection.
According to Professor Sir Munir Pirmohamed, Chair of the Commission on Human Medicines molnupiravir was “effective in reducing the risk of hospitalization or death for at-risk non-hospitalized adults with mild to moderate COVID-19 by 50%”. All over the world, people are showing more and more interest in Molnupiravir for its promising interim results from clinical trials. The pharmaceutical giant Merck originally developed this experimental antiviral drug for the treatment of influenza (flu). Today, Molnupiravir has become very popular in Covid19 treatment.
The drug works by interfering with how viruses copy their genetic material which is ribonucleic acid (RNA). Molnupiravir prevents the virus from spreading inside the human body. It has the potential to treat individuals with severe viral diseases. Merck recommends that Molnupiravir has to be taken as four 200 milligram capsules orally every 12 hours for five days. A single course of the drug costs Rs 1,500-1,600.
Molnupiravir is one of the first antiviral drugs for COVID-19 that doctors can administer to patients orally. The other antiviral drug, Remdesivir, needs to be given by intravenous injections (IV) over multiple days. A great benefit of Molnupiravir is that patients can take it as a pill at home. It helps in reducing the pressure on healthcare facilities thereby reducing the risk of infecting healthcare workers. However, over the last few months, medical experts have noted that Molnupiravir has proved less effective in patients with advanced cases of COVID-19. This was especially true for patients who needed hospitalization.
Molnupiravir and Ivermectin
Some recent social media posts have claimed that Molnupiravir, is Ivermectin with a different name. However, although Merck produced both drugs, they are different drugs and work in different ways. According to leading virologists, Molnupiravir has not repackaged Ivermectin and the drugs have different chemistry. Moreover, the two drugs are structurally different and have different mechanisms of action.
Ivermectin is a recognized anti-parasite medication. Ever since Covid-19 hit the world, healthcare professionals have debated the drug’s role in treating or preventing coronavirus. Its role continues to be a matter of research even today. It is pertinent to note here that WHO and the European Medicines Agency have announced that doctors cannot administer Ivermectin to patients with Covid-19 except in the context of clinical trials. Doctors and scientists feel that there isn’t sufficient evidence to prove that Ivermectin is a safe and effective treatment for Covid-19.
Recently, The Central Drugs and Standard Control Organisation (CDSCO) has approved Molnupiravir for “restricted emergency use” in infected individuals whose oxygen levels are at 93 percent with a high risk of disease progression. In India, Molnupiravir got the Drug Regulator General of India’s approval on December 28 for restricted use in emergencies. However, on January 12, The Indian Council of Medical Research’s National Task Force for COVID-19 decided against the use of Molnupiravir in the Clinical Management Protocol for COVID-19. According to the experts, Molnupiravir is “not of many benefits in COVID treatment, and there are safety concerns when it comes to the indiscriminate use of Molnupiravir, which could damage bones and muscle, which is why it isn’t part of the national treatment protocol. Moreover, if this drug is given contraception has to be done for three months as a child may have problems.”
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