Given its population size, demographic diversity, and geographic location, India has performed well in delivering as many vaccines as it has since its immunisation campaign began in January of this year. However, the risk of more outbreaks in India remains high due to the emergence of several new mutant strains that limit the efficacy of India-approved vaccines, the staggering number of Indians who have yet to complete a full vaccine cycle, and concerns about the longevity of immunity provided by vaccines.

As a result, news that India’s Drugs Controller General (DCGI) is analysing clinical trial data for molnupiravir, the world’s first anti-COVID-19 antiviral medication, with the goal of licencing it in the coming days is encouraging. Sun Pharma announced on Thursday that, once permission is obtained, it plans to launch the medicine under the brand Molxvir at a “affordable price.” Other pharmaceutical companies, such as Hetero, Cipla, Torrent, and Dr Reddy’s, are reportedly planning to follow suit.

Merck, the medicine’s creator, has previously stated that it is in talks with a number of Indian generic pharmaceutical companies to ensure that low- and middle-income countries have equitable access to the drug. MSD’s Indian branch secured non-exclusive licencing deals with five Indian medicine producers — Sun Pharma, Cipla, Hetero, Dr Reddy’s, and Emcure – as early as April this year. Natco and Optimus are apparently developing the medication in separate arrangements.

What is Molnupiravir and how does it work?

Merck, a US-based pharmaceutical company, announced in October that an interim analysis of late-stage Phase III clinical trials for its antiviral medicine molnupiravir (named Lageviro) found that it lowered the risk of hospitalisation by up to 50%. UK regulators approved molnupiravir on November 4th, reacting quickly to the news.

The study included 775 unvaccinated people who all had “at least one risk factor linked with poor disease outcome,” such as obesity, diabetes, or heart disease.

The participants were divided into two groups: one that received the medicine and another that received a placebo. In the placebo group, 53 individuals (14%) were admitted to the hospital or died from the infection, compared to 28 patients (7.3%) in the therapy group.

After 29 days of observation, no deaths were observed in the molnupiravir group, compared to eight deaths in the placebo group.

What is the mechanism behind it?

Molnupiravir works by preventing the virus from reproducing in the first place. It accomplishes this by tampering with the virus’s enzymes, effectively fooling the virus before adding faults into its genetic code.

In terms of treatment, patients will be asked to take four pills twice a day for five days, for a total of 40 pills over the duration of the treatment. According to The New York Times, the US government has purchased the tablets for $700 per treatment cycle.

Despite the fact that this treatment is substantially more expensive than monoclinal antibody treatments, experts have hailed it as a potential gamechanger in the fight against COVID-19 because to the fact that it does not require hospitalisation. The treatment has also been shown to be effective against SARS-CoV-2 strains Gamma, Delta, and Mu.

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