On Thursday, the Food and Drug Administration approved a second COVID-19 at-home antiviral medication. The medicine, known as molnupiravir, was approved a day after the FDA approved Pfizer’s COVID-19 antiviral, known as Paxlovid. Both medications help persons with COVID-19 who are at risk of developing a severe case of the disease avoid hospitalization and death.

Molnupiravir, a drug manufactured by Merck, is approved for adults aged 18 and above who are at a high risk of becoming extremely unwell if they get the coronavirus. Because molnupiravir may impact bone and cartilage formation, the FDA set a higher age cutoff than Paxlovid, which is approved for people aged 12 and up.

Patients must begin taking Merck’s medicine within a few days after having symptoms in order for it to be most successful, similar to Paxlovid. That may be challenging in the United States, as COVID-19 testing is sometimes sluggish and limited, especially during spikes in case numbers when therapies are most needed.

In a clinical experiment, molnupiravir appeared to reduce the risk of hospitalization and death by about half. However, further testing revealed that it was only about 30% effective. That’s significantly less effective than Paxlovid, which is a clinical trial that decreased hospitalizations and deaths in high-risk groups by 89 percent.

Despite its lesser efficacy, the US may soon be dependant on molnupiravir: the Biden administration expects 3 million courses of Merck medicine to be available by the end of January, but only 265,000 courses of Paxlovid. Following its approval yesterday, the federal government began awarding Paxlovid courses to states.

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