Molnupiravir (Lagevrio®)

Sounds like 'mole-new-pear-aveer'

Key points about molupiravir

  • Molnupiravir is no longer recommended as a treatment for COVID-19 in Aotearoa New Zealand
  • Molnupiravir is also called Lagevrio®.
  • Find out about it and possible side effects.
blue unaunahi tile generic

March 2023: Molnupiravir is no longer recommended as a treatment for COVID-19 in Aotearoa New Zealand.

  • Recently completed research did not show any benefit from molnupiravir in stopping people from dying or being admitted to hospital from COVID-19.
  • Discuss with your healthcare provider if there are other antivirals that would be better for you, such as Paxlovid or remdesivir.

Molnupiravir (also called Lagevrio®) reduces the amount of virus in your body. It belongs to a group of medicines called antivirals. 
Note: Paxlovid is the preferred antiviral. Read more about Paxlovid.


Antivirals are only useful when given within the first few days of the start of COVID-19 symptoms appearing. 

 

If you have symptoms that started within the last 5 days, AND have tested positive for COVID-19 or are a household contact of a person with COVID -19 AND at you are at high risk of severe infection, you may be eligible for treatment. Read more about who can get antivirals for COVID-19 infection.

If you're not sure if you qualify for antivirals, talk to your GP, nurse, hauora provider  or pharmacist about COVID-19 antiviral medicines as soon as possible. They will advise you. 

 

You might be eligible to an antiviral from some pharmacies without a prescription. The pharmacist will need to ask you questions to work out if you are eligible for antiviral medicines. It will depend on several factors, including your age, ethnicity, other health conditions and vaccination status. Learn more: Do I need a prescription to get antivirals?

 

In New Zealand molnupiravir is available as capsules (200 mg). 

The dose of molnupiravir is 4 capsules twice a day for 5 days.

  • Timing: Try to space the doses evenly eg, first thing in the morning and at bedtime.
    Ideally these times should be at least 12 hours apart (for example, take 4 capsules at 8am and 4 capsules at 8pm).
  • Food: You can take your capsules with or without food. If molnupiravir gives you nausea (make you feel sick), try taking it with food.
  • Swallow your capsules whole with a glass of water. Do not open, chew, break or crush them. If you cannot swallow capsules whole, tell your doctor or pharmacist. 
  • Missed dose: If you miss a dose of molnupiravir and remember within 10 hours of the time it is usually taken, take it then.
    If you miss a dose by more than 10 hours, skip the missed dose and take the next dose at your regular time. Do not take extra doses of molnupiravir to make up for a forgotten dose.
  • Complete the course of treatment. Do not stop taking molnupiravir without talking to your healthcare provider, even if you feel better. A course of treatment lasts 5 days.

 

Are you pregnant or could you become pregnant?

Contraception is very important for both men and women taking molnupiravir
If you are pregnant, think you may be pregnant, planning to have a baby OR have a partner who may be able to become pregnant, do not take molnupiravir. Ask your doctor for advice as molnupiravir is not recommended during pregnancy.

Effect on pregnancy: There is risk of harm to an unborn child when taking molnupiravir. People taking molnupiravir should avoid becoming pregnant (eg, use contraception or abstain from sexual activity) while taking molnupiravir AND for 4 days after treatment ends. 

Effect on sperm: It is not known if molnupiravir can affect sperm in humans. If you are sexually active with a partner who could become pregnant, you should use a reliable method of contraception (birth control) during treatment AND for 3 months after the last dose of molnupiravir.

 

Are you breastfeeding?

Breastfeeding is not recommended during treatment AND for 4 days after the last dose of molnupiravir. This is because it is not known if molnupiravir gets into breast milk and will be passed to the baby. Tell your healthcare provider you are breastfeeding BEFORE taking this medicine.

 

Tell your healthcare provider about all the medicines you take

Molnupiravir may affect some of your other medicines and cause serious side effects.

  • Tell your doctor or pharmacist if you are taking, or have recently taken, any other medicines, including prescription and over-the-counter medicines, vitamins and herbal supplements.
  • Do not start taking a new medicine while you are taking molnupiravir without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take molnupiravir with other medicines.

 

Like all medicines, molnupiravir can cause side effects, although not everyone gets them. The side effects should pass after completing the course of treatment.

Side effects What should I do?
  • Nausea (feeling sick)
  • Diarrhoea (runny poos)
  • Dizziness
  • Headache
  • This is quite common when you take molnupiravir.
  • If you have nausea, try taking your dose with food.
  • Drink plenty of water to replace the fluids lost.
  • Tell your doctor if they bother you.
  • Signs of an allergic reaction such as skin rash, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, chest tightness and trouble breathing.
  • This is rare.
  • Stop taking molnupiravir and call your healthcare team or Healthline on 0800 611 116 immediately and tell them you are taking molnupiravir.
For more information on side effects, see the Medsafe consumer information leaflet below.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)

Molnupiravir(external link) Patient Information NZ Formulary, NZ 
Lagevrio(external link) Consumer Medicine Information Medsafe, NZ

 

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Credits: Sandra Ponen, Pharmacist. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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