【藥品庫存】 口服抗病毒藥品Molnupiravir本院備有庫存，請參閱說明書，本品需先下載病人同意書，填寫完畢後交給感染控制部，即可醫囑，因為政府規定，目前暫不開放交付調劑(他院領藥或藥師送藥) <2022/5/20更新>。 【藥品訊息】 Molnupiravir 衛教單張 病人用藥安全指引 致醫療人員函

適用於發病5天內、未使用氧氣、具有重症風險因子*之成人輕度至中度COVID-19確診者，且臨床上不適用其他COVID-19治療選擇時
COVID-19, mild to moderate [FDA emergency use authorization (EUA)]

*重症風險因子：≥65歲、BMI≥25、糖尿病、慢性肺部疾病(含氣喘)、慢性腎病、高血壓、心血管疾病、其他影響免疫功能之疾病或已知重症風險因子者。

Antiviral Agent
Molnupiravir is metabolized to the cytidine nucleoside analog, NHC, which is further phosphorylated to the active ribonucleoside triphosphate (NHC-TP). NHC-TP is incorporated into SARS-CoV-2 RNA by viral RNA polymerase, resulting in errors in viral genome and subsequently inhibition of replication.

Distribution:
1.Vd: (NHC) 142 L
2. Protein binding: (NHC) Does not appear to be protein bound
Metabolism:
Molnupiravir is metabolized to NHC; NHC undergoes phosphorylation to pharmacologically active ribonucleoside triphosphate
Excretion:
Urine (3%); Half-life elimination: (NHC) 3.3 hours
Pharmacodynamic:
Time to peak: (NHC) 1.5 hours

1. There are no contraindications listed in the FDA EUA fact sheet.
2. Molnupiravir is not authorized:(1) For use in patients <18 years of age (may affect bone and cartilage growth)
(2) For initiation of treatment in patients requiring hospitalization due to COVID-19. (Benefit of treatment with molnupiravir has not been observed in subjects when treatment was initiated after hospitalization due to COVID-19)
(3) For use for longer than 5 consecutive days (the safety and efficacy have not been established)
(4) For pre-exposure or post-exposure prophylaxis for prevention of COVID-19

Molnupiravir is not recommended for use during pregnancy.

Due to the potential for serious adverse reactions, breastfeeding is not recommended by the manufacturer during therapy and for 4 days after the last molnupiravir dose

Diarrhea, nausea, dizziness

1. Dosage: 800 mg (four 200 mg capsules) orally Q12H for 5 days, with or without food
2. Administration: Take molnupiravir as soon as possible after a diagnosis of COVID19 has been made, and within 5 days of symptom onset; Completion of the full 5-day treatment course and continued isolation in accordance with public health recommendations are important

Molnupiravir is not authorized for use in patients less than 18 years of age

No dosage adjustment necessary (FDA 2021)

No dosage adjustment necessary (FDA 2021)