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An expert panel advising the US Food and Drug Administration (FDA) has backed Merck's Covid-19 antiviral pill but warned against its use in pregnant women. The FDA usually follows the panel's recommendations but is not bound to do so.

Tell me more:

• Merck's antiviral pill, called molnupiravir, reduces the risk of hospitalisation or death among adults with mild to moderate disease by 30%, full results from a late-stage study showed, less than a previous estimate.
• Easy-to-use pills such as this and another developed by Pfizer could be a gamechanger in controlling the pandemic. The UK had already approved the Merck pill.

Does it work against Omicron?

• Antiviral pills are not designed to target the spike protein but curtail the ability of the virus to replicate in our body. Therefore, mutations in spike proteins would not be a concern like they are for treatments such as monoclonal antibodies or vaccines.

A caveat:

• Merck's antiviral pill works by hijacking the virus’s RNA genome and creating faulty mutations until the virus population dies out. This gene manipulation has raised some concerns, and the FDA's expert panel stressed the pill should not be used by anyone who is pregnant. The panel also recommends extra precautions before the drug is prescribed, such as pregnancy tests for women of child-bearing age.

And Pfizer?

• Pfizer's antiviral do not alter the gene, instead, block an enzyme the coronavirus needs to multiply in the body. This is given in combination with an older antiviral called ritonavir. The pill reduced hospitalisation by 89% and death by 100%, preliminary results showed. Pfizer has also sought approval from FDA.

Availability:

• Both Merck and Pfizer have shared the patent with the UN-backed Medicines Patent Pool, which sub-licences to other manufacturers. Merck has also shared the licence to the drug with eight Indian generic drug makers.