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Objective: Diarrhea, nausea, and vomiting are the most commonly reported mild side effects of Molnupiravir. However, this case shows that it may indirectly cause acute renal failure.
Case: 67-Year-old male patient diagnosed with hypertension and chronic obstructive pulmonary disease developed severe nausea, vomiting, and diarrhea with the use of drugs. In the patient's examinations, severe deterioration in kidney functions occurred. The patient who developed acute tubular necrosis was taken to hemodialysis twice. Intravenous hydration and supportive treatments were started. In the follow-up, clinical and renal functions improved. In patients over 65 years of age and with comorbidities, the adverse effects of Molnupiravir should be considered and followed closely.
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Vicenti I, Zazzi M, Saladini F. SARS-CoV-2 RNA-dependent RNA polymerase as a therapeutic target for COVID-19. Expert Opin Ther Pat. 2021;31(4):325-337. DOI: https://doi.org/10.1080/13543776.2021.1880568
Shu B, Gong P. Structural basis of viral RNA-dependent RNA polymerase catalysis and translocation. Proc Natl Acad Sci U S A. 2016 . 12;113(28):E4005-14 DOI: https://doi.org/10.1073/pnas.1602591113
Ghasemnejad-Berenji M, Pashapour S. Favipiravir and COVID-19: A Simplified Summary. Drug Res (Stuttg). 2021 ;71(3):166-170. DOI: https://doi.org/10.1055/a-1296-7935
Imran M, Alshrari AS, Asdaq SMB, Abida. Trends in the development of remdesivir based inventions against COVID-19 and other disorders: A patent review. J Infect Public Health. 2021 ;14(8):1075-1086. DOI: https://doi.org/10.1016/j.jiph.2021.06.013
Fischer W, Eron JJ, Holman W, Cohen MS, Fang L, Szewczyk LJ, et al. Molnupiravir, an Oral Antiviral Treatment for COVID-19. Update in: Sci Transl Med. 2022 19;14(628):eabl7430 DOI: https://doi.org/10.1101/2021.06.17.21258639
Painter GR, Natchus MG, Cohen O, Holman W, Painter WP. Developing a direct acting, orally available antiviral agent in a pandemic: the evolution of molnupiravir as a potential treatment for COVID-19. Curr Opin Virol. 2021 ;50:17-22 DOI: https://doi.org/10.1016/j.coviro.2021.06.003
Painter WP, Holman W, Bush JA, Almazedi F, Malik H, Eraut NCJE, et al. Human Safety, Tolerability, and Pharmacokinetics of Molnupiravir, a Novel Broad-Spectrum Oral Antiviral Agent with Activity Against SARS-CoV-2. Antimicrob Agents Chemother. 2021. 1;65(5):e02428-20. DOI: https://doi.org/10.1128/AAC.02428-20
MERCK. Merck and Ridgeback Biotherapeutics provide update on progress of clinical development program for molnupiravir, an investigational oral therapeutic for the treatment of mild-to-moderate COVID-19. Press release, provide-update-on-progress-of-clinical-development-program-for molnupiravir-an-investigational-oral-therapeutic-for-the-treatment-of-mild-to-moderate-covid-19/ (Merck & Ridgeback Biotherapeutics, 15 April 2021).
Ridgeback’s Ma. Merck and Ridgeback’s investigational oral antiviral molnupiravir reduced the risk of hospitalization or death by approximately 50 percent compared to placebo for patients with mild or moderate COVID-19 in positive interim analysis of phase 3 study. Accessed . 2021
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al; CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med. Ann Intern Med. 2011 20;155(6):408. DOI: https://doi.org/10.7326/0003-4819-155-6-201109200-00024
Jayk Bernal A, Gomes da Silva MM, Musungaie DB, Kovalchuk E, Gonzalez A, Delos Reyes V,et al. MOVe-OUT Study Group. Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients. N Engl J Med. 2022 .10;386(6):509-520. DOI: https://doi.org/10.1056/NEJMoa2116044
Schrier RW, Shchekochikhin D, Ginès P. Renal failure in cirrhosis: prerenal azotemia, hepatorenal syndrome and acute tubular necrosis. Nephrol Dial Transplant. 2012 ;27(7):2625-8. DOI: https://doi.org/10.1093/ndt/gfs067
Agrawal M, Swartz R. Acute renal failure. Am Fam Physician. 2001. 1;63(3):445.