What You Need to Know About the Merck Covid Antiviral Pill

The panel has recommended the pill for emergency use in patients who are at high risk of serious disease, hospitalization or death.

There are no oral treatments for COVID-19… yet. (Photo by Jakub Porzycki/NurPhoto via Getty Images)

The FDA’s Antimicrobial Drugs Advisory Committee has narrowly voted to endorse an oral antiviral pill called molnpuiravir that is recommended for adults with mild to moderate symptoms of COVID-19 who are high-risk for severe disease, hospitalization or death. The FDA does not have to follow the recommendations of the advisory committee, but it usually does. The pill still needs final authorization from the FDA and CDC in order to be used by the general public.

Here’s what you need to know:

What is the Merck covid antiviral medication and how does it work?

According to information provided to the FDA by Merck, molnpuiravir works by inhibiting the replication of SARS-COV-2, the virus that causes Covid. Unlike other treatments, like monoclonal antibodies and remdesivir, molnpuiravir can be taken in pill form. If it is approved by the FDA, it would come in a pill that would be taken every 12 hours for 5 days, with or without food. For it to be effective, patients should start taking the pill within 5 days of experiencing symptoms. If approved, it would be the first Covid pill authorized for emergency use.

How effective is molnpuiravir?

Initially, Merck said it was 50% effective, but in the data presented to the FDA the company has revised its estimate down to 30%. Even so, the panel has recommended the pill for emergency use in patients who are at high risk of serious disease, hospitalization or death.

Can pregnant women and kids take the Merck covid antiviral pill?

The FDA panel and Merck have both recommended that pregnant women and kids not take molnpuiravir. It was found to be lethal to embryos when given to pregnant rats, but there was no longterm effect on male or female fertility, according to Merck.

What about the other Covid pills?

While no oral Covid treatments have been approved so far, Pfizer is also seeking approval for a pill that it claims was 89% effective when combined with another drug that is typically used to treat HIV.

Will molnpuiravir decrease transmission? Could it cause new variants to emerge?

Merck says that use of molnpuiravir led to a more rapid decline of infectious virus and therefore decreases the likelihood of transmission of variants, but some experts are concerned because of the way the drug works. Molnpuiravir slows down the progression of the disease by causing the Covid virus to mutate and produce errors, which inhibits its ability to replicate itself. Some doctors and scientists are worried that this could cause new variants to emerge, but there is no good data on this at this time. What You Need to Know About the Merck Covid Antiviral Pill