Molnupiravir

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Date: December 2021, Version 1.0

What is it?

Molnupiravir is an antiviral medicine that can stop early COVID-19 infection from developing into more serious illness. It is taken in tablet form by people with a positive COVID-19 PCR test and mild to moderate symptoms, who are at risk of severe COVID-19.

Benefits

What are the benefits of using molnupirivir in pregnancy?

Molnupiravir is not recommended in pregnancy. Women of childbearing potential are recommended to use effective contraception whilst being treated with molnupiravir, and for four days after treatment ends.

This is a precautionary approach because of the way the medication works, and because of some studies in animals that suggested that molnupiravir might cause birth defects.

Molnupiravir is a new medicine and there is not yet any information about its use in humans.

Risks

What are the risks of using molnupiravir in pregnancy?

It is not yet known whether there are any risks of using molnupiravir in human pregnancy. Over the coming months, this situation may change as more information is gathered.

If you have taken molnupiravir in pregnancy, or you became pregnant shortly after you finished taking it, you should tell your doctor or midwife. If you live in the UK, you can also speak to UKTIS (telephone 0344 892 0909, available Monday to Friday excluding Bank Holidays, 9am to 5pm) for help and advice.

Alternatives

Are there any alternatives to using molnupiravir in pregnancy?

Yes. Other medicines can help prevent severe COVID-19 infection. Synthetic (manmade) antibodies like casirivimab/imdevimab (Ronapreve®) and sotrovimab (Xevudy®) are also new but because they only target the COVID-19 virus, it is thought unlikely to be harmful in pregnancy.

Vaccination against COVID-19 is strongly encouraged for all pregnant women in the UK. It can reduce the chance of infection and help to prevent serious illness, and may reduce the need for other medicines. For more information, please see here.

No treatment

What if I prefer not to take medicines to treat COVID-19 during pregnancy?

Pregnant women are at increased risk of severe COVID-19 illness and higher risks of premature delivery and stillbirth as a consequence. Your doctor will only offer medicines to treat COVID-19 when necessary and will be happy to talk to you about any concerns that you might have.

Will I or my baby need extra monitoring?

As part of routine antenatal care, most women will be offered a scan at 12 weeks of pregnancy and a more detailed scan at around 20 weeks to check the baby’s development. Women who have used molnupiravir in early pregnancy may be offered further scans in a Fetal Medicine Unit, to check the baby’s development in detail.

Are there any risks to my baby if the father has used molnupiravir?

The manufacturer of molnupiravir does not detail any concerns about its use in men whose partners are trying to conceive. However, molnupiravir is a new medicine and because of the way it works, it could temporarily affect sperm around the time of use and for up to three months afterwards.

Please report any pregnancies that were conceived around the time that the male partner was using molnupiravir to UKTIS so that information on use of this drug can be collected to help couples in the future (telephone 0344 892 0909, available Monday to Friday excluding Bank Holidays, 9am to 5pm).

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your healthcare provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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