Using molnupiravir in practice

9 February 2022Advice on swallowing difficulties, use in pregnancy and breastfeeding, and signposting to advice to give to patients.
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Lactation Safety Information

No published evidence relating to use in breastfeeding is available, but it is likely to pass into breast milk
Molnupiravir is administered as a short course and has a short half-life, so risk of accumulation in the infant is low
The manufacturer states that breastfeeding is not recommended during treatment and for 4 days after the last dose. This is to ensure infant exposure via breast milk is completely avoided
Long term, high dose studies in infant animals showed toxicity in growing cartilage. Clinical significance of short term exposure during breastfeeding is unknown
If exposed via breast milk, as a precaution, monitor infant for poor feeding, adequate weight gain, vomiting and diarrhoea
Individuals of childbearing potential, including breastfeeding women, should use effective contraception for the duration of treatment and for 4 days after the last dose
Breastfeeding can continue with COVID-19 infection
Further advice is available from the UK Drugs in Lactation Advisory Service
22 December 2021