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- Ease of Synthesis. Below are the chemical structures of Merck's molnupiravir (left) and Pfizer's nirmatrelvir (right). (Nirmatrelvir is now the generic name for what used to be called PF-07321332, the antiviral drug component in Paxlovid.
- Mechanism of Action. Both drugs inhibit viral replication, but in very different ways. Molnupiravir interferes with the assembly of new viral RNA, without which the virus cannot replicate.
- Efficacy. My celebration of molnupiravir's 50% reduction in hospitalization, which was based on interim data, was premature. Once the final data were analyzed, that number plummeted to 30%.
- Baggage. No matter how efficacious or safe, every drug has something wrong with it. The same holds true with both molnupiravir and Paxlovid, but they have a different brand of baggage.
Dec 23, 2021 · The U.S. Food and Drug Administration has authorized the second antiviral pill to treat COVID-19 at home. The medicine, called molnupiravir and made by Merck and Ridgeback Biotherapeutics,...
Mar 25, 2022 · Updated. March 25, 2022, 9:37 a.m. ET. There are two oral antiviral therapies currently available to treat Covid-19 in the United States. One, called Paxlovid, was developed by Pfizer and was...
Oct 24, 2023 · Sotrovimab “Anti-SARS-CoV-2 monoclonal antibodies”. Sotrovimab is recommended by the NICE for the treatment of COVID-19 as an alternative to Paxlovid in patients with increased risk for disease progression only if they do not need supplemental O 2. Single mAb that binds to and blocks S-protein of SARS-CoV-2.
- 10.1186/s12985-023-02210-z
- 2023
- Virol J. 2023; 20: 241.
- Chloroquine and Hydroxychloroquine
- Lopinavir and Ritonavir
- Nafamostat and Camostat
- Famotidine
- Umifenovir
- Nitazoxanide
- Ivermectin
- Corticosteroids
- Tocilizumab and Sarilumab
- Bevacizumab
The drugs being tested for repurposing to treat COVID-19 tend to fall into two categories: those that target the viral replication cycle, and those that aim to control the symptoms of the disease. The aminoquinolones chloroquine and hydroxychloroquine are polymerase inhibitors classically used as anti-malarial medications. In malaria, they inhibit ...
The human immunodeficiency virus protease inhibitors lopinavir and ritonavir work against coronaviruses via inhibition of 3-chymotrypsin-like protease. In vitro tests have shown the drugs to be effective against SARS-CoV-1 and the coronavirus that causes Middle East respiratory syndrome, but no tests have confirmed that same mechanism of action aga...
Nafamostat and camostat are serine protease inhibitors both approved in Japan for use against pancreatitis in humans. Camostat was previously found in vitro to block the entry of SARS-CoV by acting as an antagonist to the serine protease TMPRSS2, and researchers believe both nafamostat and camostat could have a similar effect in inhibiting SARS-CoV...
The over-the-counter H2 receptor antagonist heartburn medication famotidine is also been investigated as a possible treatment, after Michael Callahan and colleagues in China reported that patients in Wuhan who happened to be taking heartburn medication seemed less likely to die from or to be intubated during severe COVID-19. These observations have...
Umifenovir is a small indole-derivative molecule licensed for use only in Russia and China as prophylaxis for influenza virus A and B and is thought by some to have broad-spectrum anti-viral properties, although the evidence of its beneficial effects for human health is still under debate. Because it is a hydrophobic molecule that is thought to int...
Nitazoxanide is a thiazolide used as an anti-infective with efficacy in parasitic, bacterial and viral infections. In viral infections, such as infection with the coronavirus MERS-CoV, it acts by blocking maturation of the viral nucleocapsid N protein that promotes production of the viral particles. This drug is being tested in clinical trials agai...
Ivermectin is a lipophilic macrolide usually used as a broad-spectrum anti-parasitic drug that also affects many invertebrates. In parasites, it acts by binding glutamate-gated chloride ion channels, which leads to depolarization of the cells and paralysis or death of the parasite. When directed against COVID-19, is thought to work by binding and d...
Researchers are also testing molecules to offset the potential ‘cytokine storm’ that leads to lung injury and acute respiratory distress syndrome (ARDS) in some patients. Along with efficacy, safety is the main concern with these types of drugs, says Cutrell, adding that immunomodulators can have negative downstream consequences, such as increasing...
In a retrospective study of some 200 patients with COVID-19, those experiencing severe forms of the illness had elevated levels of the inflammatory cytokine IL-6. It is thought that cytokine-release syndrome is involved in the exacerbation of severe reactions to the virus, causing ARDS even as viral loads diminish. A variety of drugs that block dif...
Researchers in China and Italy are recruitingfor clinical trials to test bevacizumab, a monoclonal antibody that serves as a medication directed against the signaling protein VEGF (vascular endothelial growth factor) in a variety of cancer treatments. The drug suppresses tumors by inhibiting the growth of blood vessels that feed the tumor. By suppr...
- Leah Shaffer
- 2020
Jan 28, 2022 · Molnupiravir is not FDA-approved for any use including for use for the treatment of COVID-19. Prior to initiating treatment with molnupiravir, carefully consider the known and potential risks and benefits.
Dec 23, 2021 · JOE PALCA, BYLINE: Yes, it's called Paxlovid or Pax-lovid (ph), if you prefer. It works by messing with a key enzyme in the coronavirus called a protease. If you inhibit the protease, the...
