Paxlovid and Molnupiravir: Corona drugs in comparison - which one is better?
Created: 01/17/2022, 19:03
By: Dominik Jahn
Paxlovid and Molnupiravir: Corona drugs in comparison.
© dpa/ Klaus-Dieter Esser
Paxlovid and Molnupiravir for the fight against Corona.
One of the drugs has the possibility of dangerous side effects.
The great hope in the fight against the corona virus is still focused on the vaccines.
In addition to the mRNA vaccines from Biontech, Moderna and the vector vaccine AstraZeneca*, as
reports, Novavax* and soon the inactivated vaccine from Valneva* or the protein-based vaccine Sanofi* are also available.
But research is now also looking at drugs.
There are promising candidates with Paxlovid* and Molnupiravir (Lagevrio)*.
But which corona drug is better?
Corona drugs: Abandonment of Paxlovid and Molnupiravir
writes about Paxlovid, the drug from the manufacturer Pfizer is based on
"a combination therapy of two oral antiviral agents".
One of them is from Germany.
The Tübingen company Atriva originally used the active ingredient ATR-002 as a remedy for flu*.
Paxlovid inhibits the multiplication of the corona virus.
According to the definition, the genome - or the genetic material of a living being or a virus - is the entirety of the material carriers of the hereditary information of a cell or a virus particle.
The genetic information (genetic material) can be stored in a chromosome, an entire set of chromosomes or directly in the form of DNA or RNA.
The same applies to molnupiravir.
The Federal Union of German Associations of Pharmacists (ABDA)
writes in an article on the field
of action of the drug from the US pharmaceutical company Merck & Co .:
"...its primary mechanism of action via inhibition of viral RNA replication through incorporation of the triphosphate metabolite into the viral RNA genome runs"
Means: Molnupiravir inhibits the spread of RNA viruses by attacking the genetic material of the virus.
Taking Paxlovid and Molnupiravir: Things to watch out for
In order to be prepared for the correct handling of corona drugs, the Drug Commission of German Pharmacists (AMK) has developed guidelines in cooperation with the Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital.
writes, it is very important that Paxlovid and Molnupiravir are taken no later than five days after the onset of symptoms.
"both preparations should be taken for five days"
The report points out that a doctor must “
exclude serious Covid-19 disease”
in advance .
For molnupiravir, the guidelines stipulate that the patient "takes
four capsules of 200 mg each (that is, 800 mg twice a day) in the morning (e.g. at 8 a.m.) and in the evening (e.g. at 8 p.m., i.e. every twelve hours) for five days ), must be taken whole with a glass of water, regardless of meals.
He must not open the capsules.”
According to the report, Paxlovid is two film-coated tablets of nirmatrelvir (300 mg) plus one film-coated tablet of ritonavir (100 mg) in the morning and evening for five days with or without a whole meal (not chewed, broken or crushed).
Who are the corona drugs Paxlovid and Molnupiravir for?
The current recommendations by the European Medicines Agency (EMA) stipulate that Pfizer's Paxlovid should be considered for positively tested corona patients aged 12 and over if they have mild to moderate symptoms and are also at high risk of the disease getting worse .
With molnupiravir, according to the EMA, risk patients from the age of 18 should be considered for treatment with the corona drug.
Paxlovid and molnupiravir: the effectiveness of the corona drugs
According to Paxlovid's Phase II/III study, Pfizer's corona drug "reduces
the risk of hospitalization or death by 89% in non-hospitalized high-risk adults with COVID-19."
According to the results from November 2021, it is very successful in preventing a severe course.
In contrast, the values determined for molnupiravir are significantly lower.
Studies show that the US manufacturer's drug can only prevent 30 percent of hospital admissions and deaths.
Nevertheless, the German Society for Neurology
in a report on the phase 3 study:
"The authors' conclusion is that early therapy with molnupiravir reduces the risk of hospitalization and mortality in unvaccinated people with SARS-Cov-2 and an increased risk for severe cases."
Side effects of paxlovid and molnupiravir: risk of birth defects
In addition to the effectiveness, the studies on the corona drugs also looked at the possible side effects. With Paxlovid, there were isolated cases of high blood pressure, diarrhea and muscle pain. The temporary impairment of the sense of taste cannot yet be clearly attributed to the drug or the corona disease.
There are some concerns about molnupiravir.
The Deutsche Apotheker-Zeitung already wrote in an article from December 2021 about the possibility of a mutagenic effect.
Although the possibility is assessed as very low by the researchers, the article also clarifies that
"molnupiravir is not recommended in pregnancy due to this possible mutagenic potential"
In addition, it can hinder the growth of bones and cartilage and is therefore only approved for adults on recommendation.
Approval of Paxlovid and Molnupiravi
Despite a lack of final approval by the European Medicines Agency, molnupiravir has been on the market in Germany since the beginning of 2022.
The reason for this is a decision by the Federal Institute for Drugs and Medical Devices (BfArM) and an emergency approval from the EMA from November 2021.
The EMA included Paxlovid in the rolling review process as early as November 2021.
Federal Health Minister Karl Lauterbach in particular is still hoping for emergency approval for Pfizer's drug network.
He even relies on a loophole for release for Germany*.
is an offer from IPPEN.MEDIA.