The Maharashtra government on January 17 issued a letter to the district, civic administrations and health departments in the state asking them to use oral anti-viral drug 'Molnupiravir' for treatment of symptomatic, adult COVID-19 patients with "abundant caution and in certain conditions".

Dr Pradeep Vyas, additional chief secretary (health), in the letter, requested district and civic authorities to use Molnupiravir with "abundant caution and in certain conditions and in full advised dose". He said this drug has received emergency use authorization (from the Drug Controller General of India) and based on the opinion of some experts it has also been included in treatment protocol circulated on January 6, 2022, in the state subject to certain conditions.

"Subsequently, certain state governments like Odisha have withdrawn this drug from the market. ICMR has also not recommended its use in the treatment of SARS-CoV-2 infection (which causes COVID-19). Molnupiravir has not been included in the Standard Treatment Protocol released by the Government of India on January 17, 2022," Dr Vyas said in the letter.

Molnupiravir has been shown to reduce hospitalization in a clinical trial and thus has received emergency use authorization, not an FDA approval, the letter stated. "Till further clarity is received, you are requested to please use Molnupiravir with abundant caution and in certain conditions and that also in full advised dose," the senior bureaucrat stated.

The letter-cum advisory said the drug may be "prescribed for the treatment of COVID-19 in patients who have mild illness not requiring oxygen, one or more risk factors that will cause hospitalization and impending severe disease, in whom there are no other options available, where there are no contra-indications to the use of Molnupiravir' and in the first five days of the illness".

However, patients under the age of 18 and pregnant women should not be given this drug, it maintained. Besides district and civic heads and health departments, the letter has been marked to district civil surgeons and health officers.