Intended for healthcare professionals

Letters Covid-19: Molnupiravir effects

Buyer beware: molnupiravir may damage DNA

BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2663 (Published 04 November 2021) Cite this as: BMJ 2021;375:n2663
  1. Johan M van Schalkwyk, perioperative physician
  1. Auckland District Health Board, Auckland City Hospital, Auckland, New Zealand
  1. johanvs{at}adhb.govt.nz

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

Buyer beware.

Footnotes

  • Competing interests: None declared.

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References

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