Buyer beware: molnupiravir may damage DNABMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2663 (Published 04 November 2021) Cite this as: BMJ 2021;375:n2663
- Johan M van Schalkwyk, perioperative physician
Although the Ingelfinger rule seems to have dissolved into dust with the coming of covid-19,1 I was a little disappointed that your journal seems to have mirrored Merck’s press release about molnupiravir without substantial critical comment.2
Molnupiravir clearly induces intense mutagenesis in SARS-CoV-2,3 and this accounts for its efficacy. But β-d-N4-hydroxycytidine, the active metabolite of molnupiravir, is not only cytotoxic but also mutagenic in mammalian cells.4 The drug may damage DNA.
There is a certain irony that vaccine shy people who have believed the untruth that vaccines against SARS-CoV-2 alter DNA seem poised to reach for a perceived “alternative” that may actually alter their DNA adversely. This worry is supported by the rise in Merck’s share price and Moderna’s corresponding drop, as reported by Reuters.5
Competing interests: None declared.
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