Liverpool COVID-19 Interactions

No Interaction Expected

Molnupiravir

Abacavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Abatacept

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abatacept is a fusion protein consisting of the extracellular domain of human CTLA-4 linked to a modified Fc portion of human IgG1 and is likely to be eliminated via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Abemaciclib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abemaciclib is primarily metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Abiraterone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abiraterone is metabolized by CYP3A4 and SULT2A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Abrocitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abrocitinib is metabolised predominantly by CYP2C19 and CYP2C9, and to a lesser extent by CYP3A4 and CYP2B6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Acalabrutinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Acalabrutinib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Acarbose

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. After ingestion of acarbose, the majority of active unchanged drug remains in the lumen of the gastrointestinal tract to exert its pharmacological activity and is metabolized by intestinal enzymes and by the microbial flora. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Acenocoumarol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Acenocoumarol is mainly metabolized by CYP2C9 and to a lesser extent by CYP1A2 and CYP2C19. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Acetazolamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Acetazolamide is predominantly excreted unchanged via active renal tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Acetylcysteine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Acetylcysteine is deacetylated before undergoing the normal metabolism of cysteine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aciclovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aciclovir is eliminated renally via glomerular filtration and active renal secretion by OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Acitretin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Acitretin undergoes isomerisation and glucuronidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aclidinium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aclidinium bromide is rapidly and extensively hydrolyzed (non-enzymatic and enzymatic transformation by esterases and butylrylcholineesterases) to its pharmacologically inactive metabolites with only a minor role for CYP metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

Potential Weak Interaction

Molnupiravir

Activated charcoal

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Activated charcoal absorbs substances in the stomach and intestines and may decrease absorption of orally administered medicines. If coadministration is required, administration of activated charcoal and molnupiravir should be separated by 4 hours. [Note: this interaction is not specific for molnupiravir, but for any oral medication taken with activated charcoal.]

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Adalimumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Adalimumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Adefovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Adrenaline (Epinephrine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Adrenaline is rapidly inactivated, mostly in the liver by catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Afatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Afatinib is mainly eliminated unchanged in the faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

African Potato

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. African potato was shown to inhibit CYP3A4 and P-gp in vitro and to activate PXR suggesting that inhibition may occur initially followed by induction of CYP3A4 and P-gp when used for extended periods. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Agomelatine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Agomelatine is metabolized predominantly by CYP1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Albuvirtide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Albuvirtide is a peptide that is eliminated by catabolism to its constituent amino acids. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alcohol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alcohol is metabolized by alcohol dehydrogenase and aldehyde dehydrogenase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alcuronium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alcuronium is predominantly excreted unchanged via the kidneys possibly via active tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aldesleukin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aldesleukin is mainly eliminated by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alectinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alectinib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alemtuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alemtuzumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alendronic acid (Alendronate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alendronate is not metabolised and is cleared from the plasma by uptake into the bone and eliminated via renal excretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Of note, alendronic acid is contraindicated with the inability of the patient to stand or sit upright for at least 30 minutes.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alfentanil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alfentanil undergoes CYP3A4 metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alfuzosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alfuzosin is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alirocumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alirocumab is a monoclonal antibody eliminated through binding to PCSK9 at low concentrations and through a proteolytic pathway at higher concentrations. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aliskiren

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aliskiren is minimally metabolized by CYP450 and is mainly excreted unchanged in faeces. Aliskiren is a substrate of P-glycoprotein. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Allopurinol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Allopurinol is converted to oxipurinol by xanthine oxidase and aldehyde oxidase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Almotriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Almotriptan is partly eliminated unchanged in the urine and partly metabolized mainly via monoamine oxidase-A, and to a lesser extent by CYP3A4, CYP2D6 and flavin monooxygenase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alogliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alogliptin is primarily excreted unchanged in the urine and undergoes negligible CYP-mediated metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alosetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro data indicate that alosetron is metabolized by CYPs 2C9, 3A4 and 1A2, with in vivo data suggesting that CYP1A2 plays a more prominent role. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alpelisib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alpelisib is primarily metabolized by enzymatic hydrolysis to an inactive metabolite, with a minor contribution from CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alprazolam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alprazolam is mainly metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Alprostadil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Following administration, ~80% of circulating alprostadil is rapidly metabolised in the lungs primarily by beta- and omega- oxidation and the resulting metabolites are mainly excreted in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amantadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amantadine is mainly eliminated in the kidney by glomerular filtration and active secretion via OCT2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ambrisentan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ambrisentan is mainly glucuronidated by UGT1A9, UGT2B7, UGT1A3 and is metabolized to a lesser extent by CYP3A4. Ambrisentan is also a substrate of P-gp and OATP1B1. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amikacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amikacin is eliminated by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amiloride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amiloride is eliminated unchanged by the kidney with in vitro data indicating that it is a substrate of OCT2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aminophylline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aminophylline is a complex of theophylline and ethylenediamine and is given for its theophylline activity. Theophylline is mainly metabolized by CYP1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amiodarone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amiodarone is metabolized by CYPs 3A4 and 2C8 and inhibits intestinal P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amisulpride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amisulpride is weakly metabolized and is primarily eliminated renally, possibly via OCT. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amitriptyline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amitriptyline is metabolized predominantly by CYP2D6 and CYP2C19. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amivantamab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amivantamab is a monoclonal IgG1 antibody. Elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amlodipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amlodipine is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amodiaquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amodiaquine is metabolized mainly by CYP2C8 to N-desethylamodiaquine, a metabolite responsible for almost all of the antimalarial effect. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amoxicillin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amoxicillin is mainly excreted in the urine by glomerular filtration and tubular secretion via OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amphetamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amphetamine is metabolized by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amphetamine mixed salts

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amphetamine mixed salts contain both levoamphetamine and dextroamphetamine. Amphetamine mixed salts are metabolized by CYP2D6 to some extent, but a large proportion is excreted unchanged. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Amphotericin B

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amphotericin is not appreciably metabolized and is eliminated to a large extent in the bile. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ampicillin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ampicillin is mainly excreted in the urine by glomerular filtration and tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Anakinra

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Anakinra is an IL-1 receptor antagonist which is predominantly cleared renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Anastrozole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Anastrozole is mainly oxidized to hydroxyanastrozole by CYP3A4 (major) and glucuronidated by UGT1A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Anidulafungin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Anidulafungin is not metabolized hepatically but undergoes chemical degradation at physiological temperature. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Antacids

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Anti-thymocyte globulin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Thymoglobulins are cleared by the reticuloendothelial system. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Apalutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Apalutamide is metabolised by CYP2C8 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Apixaban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Apixaban is metabolized by CYP3A4 and to a lesser extent CYP1A2, CYP2C8, CYP2C9 and CYP2C19. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Apomorphine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Apomorphine is metabolized by several pathways that include mainly glucuronidation and sulfation and to a lesser extent N-demethylation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Apremilast

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Apremilast is metabolized by multiple pathways involving hydrolysis, glucuronidation and oxidation by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aprepitant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aprepitant is mainly metabolized by CYP3A4 and to a lesser extent by CYPs 1A2 and 2C19. Aprepitant is a moderate inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Argatroban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Argatroban undergoes metabolism in the liver via hydroxylation and aromatization. Drug-drug interactions studies performed with substrates of different cytochromes and P-glycoprotein (i.e., acetaminophen, lidocaine, warfarin, digoxin) indicate that argatroban has a low potential to cause drug-drug interactions. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aripiprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aripiprazole is metabolized by CYP3A4 and CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Artemether

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Artemether is rapidly metabolized by CYP3A4 to dihydroartemisinin, an active metabolite which has greater potency than the parent drug and which is further metabolised via UGTs 1A9 and 2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Artesunate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Artesunate is rapidly converted to dihydroartemisinin, an active metabolite which has greater potency than the parent drug and which is further metabolised via UGTs 1A9 and 2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Asciminib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Asciminib is metabolised by several pathways, including CYP3A4, UGT2B7 and UGT2B17 and is a substrate of BCRP and P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Asenapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Asenapine is metabolized by glucuronidation (UGT1A4) and oxidative metabolism (CYP1A2 (major) and CYP3A4, 2D6 (minor)). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aspirin [Acetylsalicylic acid] (Analgesic)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aspirin is rapidly deacetylated to form salicylic acid which is further glucuronidated by several UGTs (major UGT1A6). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Aspirin [Acetylsalicylic acid] (Anti-platelet)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aspirin (acetylsalicylic acid) is rapidly metabolised to salicylic acid, which is further glucuronidated by several UGTs (major UGT1A6). Salicylic acid and its metabolites are predominantly excreted via the kidneys. Aspirin and salicylic acid are extensively bound to plasma proteins, primarily albumin. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atazanavir + ritonavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atazanavir is metabolised by CYP3A4 and is an inhibitor of CYP3A4 and UGT1A1, and is a strong inhibitor of OATP1B1. Ritonavir is extensively metabolized by CYP3A4 (and to a lesser extent by CYP2D6) and inhibits CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atazanavir alone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atazanavir is metabolized by CYP3A4 and is an inhibitor of CYP3A4 and UGT1A1 and is a strong inhibitor of OATP1B1. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atazanavir/cobicistat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atazanavir is metabolised by CYP3A4 and is an inhibitor of CYP3A4 and UGT1A1, and is a strong inhibitor of OATP1B1. Cobicistat is primarily metabolized by CYP3A4 (with a minor contribution from CYP2D6) and inhibits CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atenolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atenolol is mainly eliminated by the kidney, both by glomerular filtration and active secretion via the renal transporters OCT2 and MATE1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atezolizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atezolizumab is eliminated through catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atogepant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atogepant is metabolized primarily by CYP3A4 and is a substrate of OATP. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atomoxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atomoxetine is metabolized by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atorvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atorvastatin is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atovaquone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atovaquone is mainly eliminated unchanged in the faeces, with some possible metabolism by UGTs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Atropine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of atropine has not been fully characterised, although there is little potential for interaction whether it is used systemically or as eye drops. Up to 50% of an atropine dose is excreted unchanged via the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Avanafil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Avanafil is metabolized primarily by CYP3A4 (major route) and CYP2C9 (minor route). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Avapritinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Avapritinib is predominantly mediated by CYP3A4 and to a minor extent by CYP2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Avatrombopag

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Avatrombopag is mainly metabolized by CYP2C9 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Avelumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Avelumab is an IgG1 monoclonal antibody; elimination occurs primarily via intracellular catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Axitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Axitinib is metabolized primarily by CYP3A4 and to a lesser extent by CYP1A2, CYP2C19 and UGT1A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ayahuasca

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ayahuasca preparations contain the hallucinogen N,N-dimethyltryptamine (DMT), which is rapidly metabolised by monoamine oxidases, and may also contain harma alkaloids which act as monoamine oxidase inhibitors (MAOI). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Azacitidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Azacitidine undergoes spontaneous hydrolysis and deamination mediated by cytidine deaminase. Urinary excretion is the primary route of elimination of azacitidine and/or its metabolites. Following cellular uptake, azacitidine is sequentially phosphorylated via phosphokinases activities to azacitidine triphosphate which is able to incorporate into DNA and RNA. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Azathioprine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Azathioprine is converted to 6-mercaptopurine which is metabolized analogously to natural purines. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Azelastine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Azelastine is metabolized to the active metabolite, desmethylazelastine, by CYP3A4 and to a lesser extent CYP2D6 and CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Azilsartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Azilsartan is metabolised mainly by CYP2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Azithromycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Azithromycin is mainly eliminated via biliary excretion and animal data suggest this may occur via P-glycoprotein and MRP2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Baclofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Baclofen is mainly excreted in the urine or deaminated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Baloxavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Baloxavir is primarily metabolised by UGT1A3 with a minor contribution from CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bamlanivimab/ Etesevimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bamlanivimab and etesevimab are IgG1 monoclonal antibodies and are likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Baricitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Baricitinib is mainly eliminated renally, with CYP3A4 contributing to less than 10% of its overall metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Basiliximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Basiliximab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bebtelovimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bebtelovimab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Beclometasone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Beclometasone is a pro-drug which is not metabolized by CYP450 but is hydrolysed via esterase enzymes to the highly active metabolite beclometasone -17-monopropionate. This active metabolite is subsequently converted to inactive metabolites via CYP3A4/5. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bedaquiline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bedaquiline is metabolized by CYP3A4 and mainly eliminated in faeces. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Belatacept

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Belatacept is a protein that undergoes non-CYP mediated metabolism in the liver. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Belimumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Belimumab is a monoclonal antibody; elimination occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bempedoic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bempedoic acid is glucuronidated by UGT2B7 and also converted to an active metabolite by aldo-keto reductase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Benazepril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Benazepril is rapidly hydrolyzed to its active metabolite benazeprilat which is eliminated predominantly renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bendamustine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bendamustine is metabolised by multiple routes including hydrolysis, glutathione conjugation and hepatic metabolism via CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bendroflumethiazide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bendroflumethiazide is eliminated by hepatic metabolism (70%, exact pathway not known) and excreted unchanged in the urine (30%) via OAT1 and OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Benralizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Benralizumab is a humanised IgG1 monoclonal antibody that is degraded by proteolytic enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Benserazide/levodopa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Benserazide is hydroxylated to trihydroxybenzylhydrazine. In the presence of a peripheral dopa-decarboxylase inhibitor such as benserazide, levodopa is metabolised mainly to 3-O-methyldopa by catechol-O-methyltransferase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Benzatropine (Benztropine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Available information on the metabolism of benzatropine is limited but no clinically significant interactions are expected. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Benzonatate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Benzonatate is metabolized by plasma butyrylcholinesterase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bepridil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bepridil is metabolized by CYP2D6 (major) and CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Beta-alanine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Beta-alanine is a non-essential amino acid and dietary supplements enter the same physiological processes as endogenous beta-alanine. Excess beta-alanine is excreted in the urine by the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Betahistine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Betahistine is metabolized by monoamine oxidase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Betamethasone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Betamethasone is metabolized by CYP3A4 and is a moderate inducer of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Betrixaban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Betrixaban is largely eliminated unchanged through biliary secretion via P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bevacizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bevacizumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bexarotene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bexarotene is mainly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bezafibrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Half of a bezafibrate dose is eliminated unchanged in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bicalutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bicalutamide is extensively metabolized in the liver by glucuronidation and oxidation via CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bictegravir/ Emtricitabine/ Tenofovir alafenamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bictegravir is metabolized by CYP3A4 and UGT1A1; emtricitabine and tenofovir alafenamide are eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bilastine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bilastine is mainly excreted unchanged and is a substrate of P-gp and OATP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bimekizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bimekizumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Binimetinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Binimetinib is primarily metabolised by UGT1A1 and the active metabolite M3 is metabolised by CYP1A2 and CYP2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Biperiden

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on limited information concerning the metabolism and clearance of biperiden, there is little potential for clinically significant interaction. Limited human data suggest biperiden undergoes hydroxylation in the liver. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bisacodyl

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bisacodyl is converted to an active metabolite by intestinal and bacterial enzymes. Absorption from the gastrointestinal tract is minimal and the small amount absorbed is excreted in the urine as the glucuronide. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bismuth subsalicylate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bismuth subsalicylate is largely hydrolysed in the stomach to form salicylic acid, which is rapidly absorbed, and insoluble bismuth salts, which are excreted unchanged in faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bisoprolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bisoprolol is partly metabolized by CYP3A4 and CYP2D6 and partly eliminated unchanged in the urine. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Blinatumomab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolic pathway of blinatumomab has not been characterized. Like other protein therapeutics, blinatumomab is expected to be degraded into small peptides and amino acids via catabolic pathways. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bortezomib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bortezomib is mainly metabolized by CYP3A4 and CYP2C19 and to a lesser extent by CYPs 1A2, 2D6 and 2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bosentan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bosentan is a substrate and inducer of CYP3A4 and CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bosutinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bosutinib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Branched chain amino acids (BCAAs; leucine, isoleucine, valine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Branched chain amino acids (BCAAs) mainly undergo intracellular catabolism in skeletal muscle. Excess BCAAs and BCAA-derived metabolic products are excreted in the urine by the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Brentuximab vedotin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brentuximab vedotin is an antibody-drug conjugate comprising a monoclonal antibody and monomethyl auristatin E (MMAE), a potent chemotherapeutic agent. The monoclonal antibody undergoes elimination via intracellular catabolism. MMAE is a substrate of CYP3A4 (and possibly CYP2D6) and P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Brexpiprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brexpiprazole is predominantly metabolised by CYP3A4 and CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Brigatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brigatinib is metabolised by CYP2C8 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Brimonidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brimonidine is metabolised mainly by aldehyde oxidase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Brincidofovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brincidofovir is a prodrug converted to cidofovir which is eliminated renally via glomerular filtration and active renal secretion by OAT1 and OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Brinzolamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brinzolamide is mainly metabolised by CYP3A4, and to a lesser extent by CYPs 2A6, 2C8 and 2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Brivaracetam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brivaracetam is cleared by multiple pathways including renal excretion and non-CYP-mediated hydrolysis, as well as hydroxylation mediated by CYP2C19. It is also an inhibitor of CYP2C19 and OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Brolucizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brolucizumab is primarily metabolised through catabolic pathways and drug-drug interactions are not expected. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bromazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bromazepam undergoes oxidative biotransformation. Drug-drug interaction studies indicate that CYP3A4 plays a minor role in bromazepam metabolism, but other cytochromes such as CYP2D6 or CYP1A2 may also play a role. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bromocriptine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bromocriptine is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Budesonide (inhaled)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Budesonide is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Budesonide (oral/rectal)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bulevirtide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bulevirtide is catabolized by peptidases and elimination occurs through binding to NTCP. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bumetanide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bumetanide is hepatically metabolized and approximately 50-80% of bumetanide is excreted in the urine via OAT1 and OAT3, mainly as unchanged drug (~50%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bupivacaine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bupivacaine is predominantly metabolized via CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Buprenorphine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Buprenorphine is mainly metabolized by CYP3A4 to form the active metabolite norbuprenorphine but is also glucuronidated by UGT2B7 and UGT1A1. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Bupropion

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bupropion is primarily metabolized by CYP2B6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Buspirone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Buspirone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Busulfan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Busulfan is metabolised through conjugation with glutathione (spontaneous and GST mediated) and then by hepatic oxidation (likely CYP3A4-mediated). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Butalbital

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Butalbital is primarily eliminated via the kidney (59-88% of the dose) as unchanged drug or minor metabolites. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

COVID-19 vaccines

Quality of Evidence: Very Low

Summary:

Coadministration has not been formally studied but based on current knowledge of the effect of vaccines on drug disposition a pharmacokinetic interaction is considered unlikely.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cabazitaxel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabazitaxel is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cabergoline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabergoline is extensively metabolized by the liver, predominantly via hydrolysis (non-CYP mediated metabolism), and is a substrate of P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cabotegravir (oral)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabotegravir is mainly metabolized by UGT1A1 and to a lesser extent by UGT1A9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cabotegravir/ rilpivirine (long acting)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabotegravir is mainly metabolized by UGT1A1 and to a lesser extent by UGT1A9. Rilpivirine is primarily metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cabozantinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabozantinib is metabolised by CYP3A4 (major) and CYP2C9 (minor). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Caffeine (anhydrous powder)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Caffeine is mainly metabolised by CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Calcium supplements

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Calcium is eliminated through faeces, urine, and sweat. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Canagliflozin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Canagliflozin is primarily metabolized by UGT1A9 and UGT2B4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Canakinumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Canakinumab is an IL-1 receptor antagonist and is eliminated via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Candesartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Candesartan is mainly eliminated unchanged via urine and bile. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cannabidiol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cannabidiol is mainly metabolized by CYP3A4 and CYP2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cannabis (Marijuana)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tetrahydrocannabinol (THC, the psychoactive component of cannabis) is metabolised mainly by CYP2C9 and to a lesser extent by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Capecitabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Capecitabine is activated by sequential enzyme reactions to fluorouracil. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Capmatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Capmatinib is primarily metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Capreomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Capreomycin is predominantly excreted via the kidneys as unchanged drug, partly by glomerular filtration and possibly partly by tubular secretion (renal transporter not identified). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Captopril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Captopril is largely excreted in the urine by OAT1 (40-50% as unchanged drug, the rest as disulfide and other metabolites). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carbamazepine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carbamazepine is glucuronidated by UGT2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carbidopa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carbidopa is partly metabolized and partly eliminated unchanged (30% of the total urinary excretion). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carbidopa/levodopa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carbidopa is partly metabolized and partly eliminated unchanged (30% of the total urinary excretion). In the presence of a peripheral dopa-decarboxylase inhibitor (such as carbidopa) levodopa is metabolised mainly to 3-O-methyldopa by catechol-O-methyltransferase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carbimazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Carbimazole is a pro-drug which undergoes rapid and virtually complete metabolism to the active metabolite, thiamazole (also known as methimazole). Despite this potential hepatic metabolism very few data exist on carbimazole drug interactions and a marked interaction is not expected.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carbocisteine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carbocisteine is metabolized in the liver via acetylation, decarboxylation and sulfoxidation with up to 60% excreted unchanged in the urine. The likelihood of a clinically significant drug interaction is low and no studies have been performed. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carboplatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carboplatin is excreted primarily by renal glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carfentanil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carfentanil is expected to be metabolized by CYP3A4/5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. However, carfentanil is an extremely strong opiate, reported to be up to 10,000 times more potent than morphine, and multiple deaths have resulted from its use. Advise patients to avoid.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carfilzomib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carfilzomib is rapidly metabolized, mainly by peptidase cleavage and epoxide hydrolysis with CYP-mediated metabolism representing a minor pathway. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cariprazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of cariprazine and its major active metabolites is mediated mainly by CYP3A4 with a minor contribution of CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Carvedilol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carvedilol undergoes glucuronidation via UGTs 1A1, 2B4 and 2B7, and additionally metabolism via CYP2D6 and to a lesser extent CYPs 2C9 and 1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Casirivimab/ Imdevimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Casirivimab and imdevimab are IgG1 monoclonal antibodies and are likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Caspofungin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Caspofungin undergoes spontaneous chemical degradation and metabolism via a non-CYP-mediated pathway. In vitro data indicate that caspofungin is a substrate of the hepatic transporter OATP1B1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cat's Claw (Uncaria tomentosa)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cat’s claw was demonstrated to be a strong inhibitor of CYP3A4 in vitro but has also been shown to induce CYP3A4 activity in vitro. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cedazuridine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cedazuridine is eliminated renally and converted to its epimer (which is then renally excreted). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cefalexin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cefalexin is predominantly eliminated unchanged via the kidneys (by glomerular filtration and tubular secretion via OAT1 and MATE1). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cefazolin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cefazolin is predominantly excreted unchanged in the urine, mainly by glomerular filtration with some renal tubular secretion via OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cefepime

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cefepime is minimally metabolized with 85% of the administered dose eliminated unchanged. It is renally cleared predominantly by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cefixime

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cefixime is renally excreted predominantly by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cefotaxime

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cefotaxime is partially metabolized by non-specific esterases. Most of a dose of cefotaxime is excreted in the urine (about 60% as unchanged drug and a further 24% as desacetyl-cefotaxime, an active metabolite). In vitro studies indicate that OATs participate to the renal elimination of cefotaxime. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ceftazidime

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ceftazidime is excreted predominantly by renal glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ceftriaxone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ceftriaxone is eliminated mainly as unchanged drug, approximately 60% of the dose being excreted in the urine predominantly by glomerular filtration and the remainder via the biliary and intestinal tracts. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cefuroxime

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cefuroxime is not metabolised and mainly excreted in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Celecoxib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Celecoxib is metabolized mainly by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cemiplimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cemiplimab is primarily metabolised through catabolic pathways and drug-drug interactions are not expected. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cenobamate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cenobamate is primarily glucuronidated by UGT2B7 and to a lesser extent by UGT2B4. CYP3A4 contributes to cenobamate metabolism but to a minor extent. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ceritinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ceritinib is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Certolizumab pegol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Certolizumab pegol is an antibody Fab’ fragment conjugated with polyethylene glycol (PEG). The Fab’ fragment is expected to be degraded to peptides and amino acids by proteolysis; the PEG moiety is mainly excreted in urine without further metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cetirizine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cetirizine is only metabolised to a limited extent and is eliminated unchanged in the urine through both glomerular filtration and tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cetuximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cetuximab is a monoclonal IgG antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Chlorambucil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlorambucil is almost completely metabolized (little is known about chlorambucil metabolism in humans, but it is most likely non CYP mediated) and has extremely low urinary excretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Chloramphenicol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chloramphenicol is predominantly metabolized by glucuronidation via UGT2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Chlordiazepoxide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlordiazepoxide is extensively metabolized by hepatic microsomal enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Chloroquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chloroquine undergoes CYP mediated metabolism by CYPs 2C8, 3A4 and 2D6, and is also eliminated unchanged via the kidney (50%). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Chlorphenamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlorphenamine is predominantly metabolized in the liver by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Chlorpromazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlorpromazine is metabolized mainly by CYP2D6, but also by CYP1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Chlortalidone (Chlorthalidone)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlortalidone is mainly excreted unchanged in the urine and faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ciclesonide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ciclesonide is a pro-drug activated by esterases in the lungs to des-ciclesonide which then undergoes CYP3A4 mediated metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ciclosporin (Cyclosporine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ciclosporin is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cidofovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cidofovir is eliminated renally via glomerular filtration and active renal secretion by OAT1 and OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cilazapril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cilazapril is mainly eliminated unchanged by the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cilostazol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cilostazol is extensively metabolised by CYP3A4 and CYP2C19 and to a lesser extent CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cimetidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cimetidine is primarily eliminated by the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cinacalcet

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cinacalcet is metabolized by multiple CYP enzymes, mainly CYP3A4, CYP2D6 and CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ciprofloxacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ciprofloxacin is primarily eliminated unchanged through the kidneys (by glomerular filtration and tubular secretion via OAT3). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cisapride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cisapride is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cisatracurium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cisatracurium undergoes mainly (80% of overall elimination) spontaneous degradation in plasma and tissues at physiological pH and temperature. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Citalopram

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Citalopram is metabolized by CYPs 2C19 (38%), 2D6 (31%) and 3A4 (31%). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cladribine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. Cladribine is transported by ENT1, CNT3, and BCRP and is eliminated in the urine via active transport. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Note: It is recommended to separate the administration of cladribine with any other oral therapies by at least three hours.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clarithromycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clarithromycin is metabolized by CYP3A4 and is a strong inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clavulanic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clavulanic acid is extensively metabolized (likely non CYP mediated pathway) and excreted in the urine by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clindamycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clindamycin is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clobazam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clobazam is metabolized by CYP3A4 (major) and CYP2B6 and CYP2C19 (minor) to the active metabolite N-desmethylclobazam, which is metabolized by CYP2C19. Clobazam is a weak inducer. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clobetasol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with the topical use of clobetasol. Clobetasol is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clofazimine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clofazimine is largely excreted unchanged in the faeces, both as unabsorbed drug and via biliary excretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clofibrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clofibrate is hydrolyzed to an active metabolite, clofibric acid. Excretion of clofibric acid glucuronide is possibly performed via OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clomifene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro studies have suggested that transformation of clomifene to its active metabolite is likely to be mediated via CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clomipramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clomipramine is metabolized by CYPs 3A4, 1A2 and 2C19 to desmethylclomipramine, an active metabolite which has a higher activity than the parent drug. In addition, clomipramine and desmethylclomipramine are metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clonazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clonazepam is metabolized by CYP3A4 and does not induce metabolizing enzymes. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clonidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Approximately 70% of administered clonidine is excreted in the urine, mainly in form of the unchanged parent drug (40-60% of the dose). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clopidogrel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clopidogrel is a prodrug that is converted to its active metabolites via CYPs 3A4, 2B6, 2C19 and 1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clopidogrel (recently stented patients)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clorazepate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clorazepate is rapidly converted to nordiazepam, which is then metabolized to oxazepam by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clotrimazole (pessary, troche)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clotrimazole undergoes rapid hepatic metabolism (likely via CYP3A4) and is a moderate inhibitor of CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clotrimazole (topical)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clotrimazole absorption is minimal following topical application. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cloxacillin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cloxacillin is metabolized to a limited extent, and the unchanged drug and metabolites are excreted via glomerular filtration and tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Clozapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clozapine is metabolized by CYPs 1A2, 2C19, 3A4, and to a lesser extent by CYPs 2C9 and 2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cobimetinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cobimetinib is mainly metabolized by CYP3A and UGT2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cocaine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cocaine is metabolised by several pathways with metabolism to norcocaine by CYP3A4 being less than 10% of the overall metabolic clearance. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Codeine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Codeine undergoes predominantly direct glucuronidation. Codeine is also a substrate of CYP2D6 (major) and CYP3A4 (10-15% of the overall metabolism). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Coenzyme Q10 (Ubidecarenone)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The major route of elimination for coenzyme Q10 is by biliary and faecal excretion; only a small fraction is eliminated in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Colchicine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Colchicine is a CYP3A4 and P-gp substrate. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

Potential Weak Interaction

Molnupiravir

Colesevelam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. Colesevelam is not metabolised and does not interfere with P450 enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. However, given that colesevelam can reduce the gastrointestinal absorption of some drugs, colesevelam should be administered at least four hours before or after molnupiravir to minimize the risk of reduced absorption.

Description:

(See Summary)

Potential Weak Interaction

Molnupiravir

Colestyramine (cholestyramine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. Colestyramine is not absorbed systemically. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. However, given that colestyramine can reduce the gastrointestinal absorption of some drugs, molnupiravir should be administered at least 1 hour before or 4-6 hours after colestyramine to minimize the risk of reduced absorption.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Collagen hydrolysate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Collagen hydrolysate is digested and absorbed as essential amino acids for use in physiological processes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Conjugated estrogens (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of conjugated estrogens is complex and involves CYP3A4, CYP1A2 and glucuronidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Convalescent Plasma

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Convalescent plasma is a biological therapy and is unlikely to affect the pharmacokinetics of any coadministered drug.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Copanlisib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Copanlisib is metabolised by CYP3A (~90%) and CYP1A1 (~10%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Creatine monohydrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Creatine monohydrate is not degraded during normal digestion and nearly 99% of orally ingested creatine monohydrate is either taken up by muscle or excreted in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Crizanlizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Crizanlizumab is primarily metabolised through catabolic pathways and drug-drug interactions are not expected. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Crizotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Crizotinib is mainly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cubeb pepper (Piper cubeba)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Several constituents of Piper cubeba were shown to inhibit CYP3A4 in vitro. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cyclizine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of cyclizine has not been fully described but may involve CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cyclobenzaprine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cyclobenzaprine is primarily metabolized by CYP3A4 and CYP1A2 and to a lesser extent by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cyclophosphamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cyclophosphamide is metabolized by two pathways. Activation (major, 75%) to 4-hydroxycyclophosphamide is metabolized by CYPs 2B6 (major), 2C9 and 3A4. Inactivation (minor, 10%) to the neurotoxic chloroacetaldehyde metabolite is performed mainly by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cycloserine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cycloserine is predominantly excreted renally via glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Cytisine (Cytisinicline)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cytisine is primarily excreted renally as unchanged drug. There are no reports of CYP or transporter involvement and significant pharmacokinetic interactions are unlikely. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dabigatran

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dabigatran is not metabolized by CYP450 enzymes and is mainly cleared by glomerular filtration. The prodrug of dabigatran is a substrate of P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dabrafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dabrafenib is metabolized by CYP3A4 and CYP2C8 and the active metabolites are metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dacarbazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dacarbazine undergoes activation to MTIC primarily via CYP1A2 and to a lesser extent by CYP2E1, with CYP1A1 having a role in extrahepatic metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dacomitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dacomitinib is metabolised by CYP2D6 (~26%) to O-desmethyl dacomitinib, an active metabolite with similar activity to dacomitinib, whilst CYP3A4 (~6%) contributes to the formation of other minor metabolites. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dactinomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dactinomycin is minimally metabolised. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dalteparin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dalteparin is excreted largely unchanged by the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dantrolene sodium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dantrolene sodium is metabolized by the liver via non-CYP mediated pathways. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dapagliflozin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dapagliflozin is primarily metabolized by UGT1A9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dapsone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dapsone is mainly metabolized by N-acetylation with a component of N-hydroxylation and is via multiple CYP P450 enzymes. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Daratumumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Daratumumab, is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Daridorexant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Daridorexant is mainly metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Darifenacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Darifenacin is metabolized by CYP3A4 and CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Darolutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Darolutamide is primarily metabolised by CYP3A4, and to a lesser extent by UGT1A9 and UGT1A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Darunavir + ritonavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Darunavir/ritonavir is metabolized by and inhibits CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Darunavir/Cobicistat/ Emtricitabine/ Tenofovir alafenamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Darunavir/cobicistat is metabolized by CYP3A4; emtricitabine and tenofovir alafenamide are eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Darunavir/cobicistat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Darunavir/cobicistat is metabolized by and inhibits CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dasatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dasatinib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Decitabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Decitabine is a prodrug and is activated intracellularly through sequential phosphorylation via phosphokinases activities to the active triphosphate. The primary route of decitabine metabolism is likely by cytidine deaminase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Deferasirox

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Deferasirox is mainly glucuronidated by UGT1A1 and to a lesser extent by UGT1A3; CYP-mediated metabolism appears to be minor (~8%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Deflazacort

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Deflazacort is immediately metabolised by plasma esterases to the active metabolite (21-desdeflazacort) which is then metabolised mainly by CYP3A4 to several inactive metabolites which are excreted in the urine (~70%) and faeces (~30%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Delamanid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Delamanid is primarily metabolized by albumin to DM-6705; metabolism of DM-6705 to other metabolites is thought to involve pathways mediated by CYP enzymes, including CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Denosumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Denosumab is a monoclonal antibody; elimination occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Desflurane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desflurane is almost exclusively eliminated unchanged by the lungs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Desipramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desipramine is metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Desloratadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desloratadine is metabolized to the active metabolite 3-hydroxydesloratadine, which is subsequently glucuronidated. The enzyme(s) responsible for the formation of the active metabolite have not been identified, but no clinically relevant interactions have been observed with inhibitors of CYP enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Desmopressin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desmopressin undergoes no significant hepatic metabolism and is not a substrate for CYP enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Desogestrel (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a desogestrel-containing combined oral contraceptive (COC) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desogestrel is a prodrug that is activated to etonogestrel by CYP2C9 (and possible CYP2C19) which is then metabolized by CYP3A4. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Desogestrel (POP)

Quality of Evidence: Very Low

Summary:

Coadministration with a desogestrel-containing progestogen-only pill (POP) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desogestrel is a prodrug that is activated to etonogestrel by CYP2C9 (and possible CYP2C19) which is then metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Desvenlafaxine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desvenlafaxine is mainly metabolised by glucuronidation (several UGTs) and to a lesser extent by CYP3A4 and CYP2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dexamethasone (doses above 16 mg)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexamethasone is a substrate of CYP3A4. Dexamethasone is a dose-dependent inducer of CYP3A4 and is a moderate CYP3A4 inducer at doses above 16 mg. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dexamethasone (low dose; 16 mg or less)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexamethasone is a substrate of CYP3A4 and a weak CYP3A4 inducer at a low dose. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dexamfetamine (Dextroamphetamine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexamfetamine is metabolized by CYP2D6 to some extent, whereas a large part is excreted unchanged. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dexketoprofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexketoprofen is mainly excreted as glucuronide conjugates; CYP2C8/9 plays a minor role in metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dexlansoprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexlansoprazole is mainly metabolized by CYP2C19 (major) and CYP3A4 (minor). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dexmedetomidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexmedetomidine undergoes extensive hepatic metabolism through direct glucuronidation (mainly via UGTs 1A4 and 2B10) and cytochrome P450 (mainly CYP2A6). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dexmethylphenidate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexmethylphenidate is metabolized by de-esterification. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dextromethorphan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dextromethorphan is metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dextropropoxyphene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dextropropoxyphene has been withdrawn from most European and North American countries due to the risk of arrhythmias and fatalities. Dextropropoxyphene is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Diamorphine (diacetylmorphine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diamorphine is rapidly metabolized by sequential deacetylation to morphine which is then mainly glucuronidated to morphine-3-glucuronide (UGT2B7>UGT1A1) and, to a lesser extent, to the pharmacologically active morphine-6-glucuronide (UGT2B7>UGT1A1). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Diazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diazepam is metabolized to nordiazepam (by CYPs 3A4 and 2C19) and to temazepam (mainly by CYP3A4). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Diclofenac

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diclofenac is partly glucuronidated by UGT2B7 and partly oxidized by CYP2C9 (catalyzes the major route of diclofenac oxidative metabolism). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dicycloverine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dicycloverine is eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Difluprednate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Difluprednate undergoes deacetylation to its active metabolite. Drug-drug interactions are not anticipated due to limited systemic absorption of difluprednate following ocular instillation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Digoxin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Digoxin is eliminated unchanged in the kidney via the renal transporters OATP4C1 and P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dihydrocodeine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dihydrocodeine is converted to dihydromorphine (active metabolite) via CYP2D6, to dihydrocodeine-6-glucuronide via UGT2B7 (major pathway) and to nordihydrocodeine via CYP3A4. The analgesic effect appears to be primarily due to the parent compound. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dihydroergotamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dihydroergotamine is a substrate and inhibitor of CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Diltiazem

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diltiazem is metabolized by CYP3A4 and CYP2D6 and is a moderate inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dimethyl fumarate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dimethyl fumarate is metabolized by esterases before entering the blood stream. Further metabolism occurs though the TCA cycle. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Diphenhydramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diphenhydramine is mainly metabolized by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dipyridamole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dipyridamole is glucuronidated by many UGTs, specifically those of the UGT1A subfamily. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Disopyramide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Disopyramide is metabolized by CYP3A4 (25%) whereas 50% of the drug is eliminated unchanged in the urine (possibly via OCT2). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Disulfiram

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Disulfiram is converted to an active metabolite by mainly by CYP3A4, with UGTs also involved in its metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dobutamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dobutamine is metabolized by catechol-O-methyltransferase (COMT) and UGT. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Docetaxel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Docetaxel is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Docusate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Docusate has been reported to undergo extensive first-pass metabolism and metabolism in the liver, but the metabolic pathway remains unclear. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dofetilide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dofetilide is metabolized to a small degree by CYP3A4 and is mainly excreted unchanged in urine. Renal elimination involves both glomerular filtration and active tubular secretion (via cation transport system). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dolasetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dolasetron is converted by carbonyl reductase to its active metabolite, hydrodolasetron, which is mainly glucuronidated (60%) and metabolized by CYP2D6 (10-20%) and CYP3A4 (<1%). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dolutegravir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dolutegravir is primarily metabolized by UGT1A1, with some contribution from CYP3A. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dolutegravir/ Lamivudine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dolutegravir is primarily metabolized by UGT1A1, with some contribution from CYP3A; lamivudine is eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dolutegravir/ Rilpivirine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dolutegravir is primarily metabolized by UGT1A1, with some contribution from CYP3A4; rilpivirine is metabolized by CYP3A. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dolutegravir/Abacavir/ Lamivudine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dolutegravir is primarily metabolized by UGT1A1, with some contribution from CYP3A; abacavir is metabolized by alcohol dehydrogenase and UGTs; lamivudine is eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Domperidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Domperidone is mainly metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Donepezil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Donepezil is metabolized by CYP3A4 and CYP2D6 (minor). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dopamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dopamine is metabolized in the liver, kidneys, and plasma by monoamine oxidase (MAO) and catechol-O-methyltransferase to inactive compounds. About 25% of a dose of dopamine is metabolized to norepinephrine within the adrenergic nerve terminals. There is little potential for drug-drug interactions with dopamine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Doravirine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doravirine is primarily metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Doravirine/ Lamivudine/ Tenofovir-DF

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doravirine is primarily metabolized by CYP3A4; lamivudine and tenofovir disoproxil fumarate are eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Doxazosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doxazosin is metabolized mainly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Doxepin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doxepin is metabolized to nordoxepin (a metabolite with comparable pharmacological activity as the parent compound) mainly by CYP2C19. In addition, doxepin and nordoxepin are metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Doxorubicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doxorubicin is mainly eliminated in the bile by P-gp and BCRP and does not undergo CYP-mediated metabolism. (Some product labels suggest doxorubicin is a substrate of CYP3A4, however, there are no strong data supporting the role of CYP3A4 in doxorubicin metabolism.) Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Doxycycline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. No significant metabolism of doxycycline occurs, and it is cleared intact by renal and biliary mechanisms. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Doxylamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doxylamine is metabolised primarily by CYP2D6, CYP1A2 and CYP2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dronabinol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dronabinol is mainly metabolized by CYP2C9 and to a lesser extent by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dronedarone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dronedarone is primarily metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Drospirenone (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a drospirenone-containing combined oral contraceptive (COC) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Drospirenone is metabolized to a minor extent via CYP3A4. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Drospirenone (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with drospirenone as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Drospirenone is metabolized to a minor extent via CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Drotaverine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Drotaverine is metabolised in the liver by O-deethylation. Clinically relevant pharmacokinetic interactions have not been reported. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dulaglutide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dulaglutide is presumed to be degraded by general protein catabolism pathways. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Duloxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Duloxetine is metabolized by CYP2D6 and CYP1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dupilumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dupilumab is a monoclonal antibody; elimination occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Durvalumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Durvalumab is a monoclonal IgG1k antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dutasteride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dutasteride is mainly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Duvelisib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Duvelisib is primarily metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Dydrogesterone (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with dydrogesterone as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dydrogesterone is metabolized to dihydrodydrogesterone (possibly via CYP3A4). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ecdysterone (20-hydroxyecdysone, 20E)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ecdysterone has poor bioavailability and is predominantly metabolised once it reaches the gut microbiota. Unchanged ecdysterone and ecdysterone metabolites are excreted in both urine and faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Echinacea

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ecstasy (MDMA)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ecstasy (MDMA) is mainly metabolized by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Edoxaban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Edoxaban is minimally metabolized by hydrolysis (mediated by carboxylesterase 1), conjugation, or oxidation by CYP3A4/5 (<10%) and is eliminated primarily as unchanged drug in urine. Edoxaban is a substrate for P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Efavirenz

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Efavirenz is primarily metabolized by CYP2B6 and CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Elbasvir/Grazoprevir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Elbasvir and grazoprevir are substrates of CYP3A4 and P-gp. Grazoprevir is also a substrate of OATP1B and possibly BCRP. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Eletriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eletriptan is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Elotuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Elotuzumab is a monoclonal IgG antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Eltrombopag

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eltrombopag is metabolized by cleavage conjugation (UGTs 1A1 and 1A3) and oxidation (CYPs 1A2 and 2C8) and in vitro data indicate it is an inhibitor of UGTs 1A1 and 1A3. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Elvitegravir/Cobicistat/ Emtricitabine/ Tenofovir alafenamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Elvitegravir/cobicistat is metabolized by CYP3A; emtricitabine and tenofovir alafenamide are eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Elvitegravir/Cobicistat/ Emtricitabine/ Tenofovir-DF

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Elvitegravir/cobicistat is metabolized by CYP3A4; emtricitabine and tenofovir disoproxil fumarate are eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Emicizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Emicizumab is an IgG4 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Empagliflozin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Empagliflozin is mainly glucuronidated by UGTs 1A3, 1A8, 1A9 and 2B7. It is a substrate of P-gp and BCRP, and also a substrate of the renal transporter OAT3 and the hepatic transporters OATP1B1 and OATP1B3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Emtricitabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Emtricitabine is eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Emtricitabine/ Tenofovir alafenamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Emtricitabine and tenofovir alafenamide are eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Emtricitabine/ Tenofovir-DF

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Emtricitabine and tenofovir disoproxil fumarate are eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Enalapril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enalapril is hydrolysed to enalaprilat which is eliminated renally (possibly via OATs). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Enasidenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enasidenib is metabolized by multiple CYP and UGT enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Encorafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Encorafenib is mainly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Enflurane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enflurane is predominantly metabolized by CYP2E1. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Enfortumab vedotin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enfortumab vedotin is an antibody-drug conjugate comprising a monoclonal antibody and monomethyl auristatin E (MMAE), a potent chemotherapeutic agent. The monoclonal antibody undergoes elimination via intracellular catabolism. MMAE is a substrate of CYP3A4 (and possibly CYP2D6) and P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Enobosarm (Ostarine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enobosarm is primarily excreted in faeces as unchanged drug, with CYP3A4, UGT1A1 and UGT2B7 having a minor role in enobosarm metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Enoxaparin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enoxaparin does not undergo cytochrome metabolism but is desulphated and depolymerised in the liver and is excreted predominantly renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ensitrelvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ensitrelvir is metabolized by multiple CYP enzymes with the major contribution being from CYP3A4/5. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Entacapone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Entacapone undergoes isomerization followed by glucuronidation of both the E and Z isomers; ~90% of the dose is then excreted in faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Entecavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Entecavir is eliminated renally via glomerular filtration and active renal secretion by both organic anion and cation transporters. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Enteral feeds

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Entrectinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Entrectinib is predominantly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Enzalutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enzalutamide is primarily metabolized by CYP2C8 and to a lesser extent by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Epcoritamab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Epcoritamab is a IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ephedrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ephedrine is predominantly excreted unchanged via renal pathways. There are no available data to determine whether excretion is via active tubular secretion or glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Epirubicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Epirubicin is extensively metabolized in the liver to epirubicinol; both epirubicin and epirubicinol are glucuronidated to inactive metabolites by UGT2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Eplerenone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eplerenone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Epoprostenol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Epoprostenol is rapidly hydrolyzed in the blood. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Eprosartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eprosartan is largely excreted in bile and urine as unchanged drug. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Eptinezumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eptinezumab is a monoclonal IgG1 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Erdafitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Erdafitinib is primarily metabolised by CYP2C9 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Erenumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Erenumab is a monoclonal IgG2 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ergometrine (Ergonovine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ergometrine is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ergotamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ergotamine is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Eribulin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eribulin is minimally metabolised and primarily eliminated via biliary excretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Erlotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Erlotinib is metabolised primarily by CYP3A4 and, to a lesser extent, by CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ertapenem

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ertapenem is mainly eliminated through the kidneys by glomerular filtration with tubular secretion playing a minor role. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Erythromycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Erythromycin is a moderate inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Escitalopram

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Escitalopram is metabolized by CYPs 2C19 (37%), 2D6 (28%) and 3A4 (35%) to form N-desmethylescitalopram. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Eslicarbazepine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eslicarbazepine is partly eliminated unchanged renally and partly glucuronidated by UGT2B4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Esomeprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Esomeprazole is mainly metabolized by CYP2C19 (major) and CYP3A4 (minor). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Estazolam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Estazolam is metabolized to its major metabolite 4-hydroxyestazolam via CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Estradiol

Quality of Evidence: Very Low

Summary:

Coadministration with estradiol as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Estradiol is metabolized by CYP3A4, CYP1A2 and is glucuronidated. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Eszopiclone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eszopiclone is metabolized by CYP3A4 and CYP2E1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Etanercept

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etanercept is eliminated via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ethambutol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ethambutol is partly metabolized by alcohol dehydrogenase (20%) and partly eliminated unchanged in the faeces (20%) and in the urine (50%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ethinylestradiol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ethionamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ethionamide is extensively metabolized in the liver with animal studies suggesting involvement of flavin-containing monooxygenases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ethosuximide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ethosuximide is mainly metabolized by CYP3A4 and does not induce metabolizing enzymes. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Etidocaine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etidocaine is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Etonogestrel (implant)

Quality of Evidence: Very Low

Summary:

Coadministration with an etonogestrel-containing progestogen-only implant has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etonogestrel is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Etonogestrel (vaginal ring)

Quality of Evidence: Very Low

Summary:

Coadministration with etonogestrel as a combined vaginal ring (CVR) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etonogestrel is metabolized by CYP3A4. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Etoposide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etoposide is partly metabolized by CYP3A4 and partly glucuronidated by UGT1A1 to reactive catechol metabolites. Conversion to reactive metabolites can also be mediated by prostaglandin synthase or myeloperoxidase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Etoricoxib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etoricoxib is metabolised by CYPs 3A4 (main), 2D6, 2C9, 1A2 and 2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Etravirine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etravirine is primarily metabolized by CYP3A4, CYP2C19 and CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Everolimus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Everolimus is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Evolocumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Evolocumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Exemestane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Exemestane is metabolised by CYP3A4 and aldoketoreductase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Exenatide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Exenatide is cleared mainly by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ezetimibe

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ezetimibe is glucuronidated by UGTs 1A1 and 1A3 and to a lesser extent by UGTs 2B15 and 2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Famciclovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Famciclovir is converted to penciclovir by aldehyde oxidase. Penciclovir is secreted in the urine possibly by OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Famotidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Famotidine is eliminated by renal excretion via OAT3 (65-70%) and by metabolic routes (30-35%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fampridine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fampridine is eliminated mainly via the kidneys with active renal secretion by the renal OCT2 transporter accounting for approximately 60%. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Favipiravir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Favipiravir is mainly metabolized by aldehyde oxidase and undergoes no CYP-mediated metabolism. Favipiravir inhibits CYP2C8 and is a moderate inhibitor of OAT1 and OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Febuxostat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Febuxostat is extensively metabolized by multiple CYP (CYPs 1A1, 1A2, 2C8 and 2C9) and UGT enzymes (UGTs 1A1, 1A8, and 1A9). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fedratinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fedratinib is mainly metabolized by CYP3A4 and to a lesser extent by CYP2C19 and FMO3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Felodipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Felodipine is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fenofibrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fenofibrate is hydrolyzed to an active metabolite, fenofibric acid. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fentanyl

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fentanyl undergoes extensive CYP3A4 metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ferrous fumarate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Iron passes into the blood, where it is bound to transferrin and passed into the iron stores (liver, spleen, and bone marrow). Iron is lost from the body through loss of cells in urine, faeces, hair, skin, sputum, nails, and mucosal cells, and through blood loss. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ferrous sulfate

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fesoterodine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fesoterodine is rapidly hydrolysed to its active metabolite which is subsequently metabolized by CYP2D6 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fexofenadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fexofenadine undergoes negligible metabolism and is mainly eliminated unchanged in the faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fezolinetant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fezolinetant is primarily metabolised by CYP1A2 and to a lesser extent by CYP2C9 and CYP2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolised by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Filgotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Filgotinib is primarily metabolised by CES2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Filgrastim

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. CYP involvement has not been displayed with filgrastim and it is mainly eliminated by neutrophil-mediated clearance. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Finasteride (1 mg)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Finasteride is metabolized mainly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Finasteride (5 mg)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Finerenone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Finerenone is metabolized mainly by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fingolimod

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fingolimod is metabolized mainly by CYP4F2 (>80%) with only a minor contribution from other CYP enzymes including CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fish oils

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flecainide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flecainide is metabolized mainly via CYP2D6, with a proportion of the parent drug also eliminated unchanged renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flibanserin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flibanserin is primarily metabolized by CYP3A4 and, to a lesser extent, by CYP2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flucloxacillin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flucloxacillin is mainly eliminated renally partly by glomerular filtration and partly by active secretion via OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fluconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluconazole is mainly eliminated renally by glomerular filtration and is a moderate inhibitor of CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flucytosine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flucytosine is metabolized to 5-flurouracil which is further metabolized by dihydropyrimidine dehydrogenase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fludrocortisone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fludrocortisone is metabolized in the liver to inactive metabolites, possibly via CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flunisolide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flunisolide is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flunitrazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flunitrazepam is metabolized mainly via CYPs 3A4 and 2C19. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fluocinolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with the topical use of fluocinolone. Fluocinolone undergoes hepatic metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fluorouracil (5-FU)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluorouracil is metabolised by the same mechanisms as endogenous uracil, including via dihydropyrimidine dehydrogenase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fluoxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluoxetine is metabolized by CYPs 2D6 and 2C9 and to a lesser extent by CYPs 2C19 and 3A4 to form norfluoxetine. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flupentixol (Flupenthixol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flupentixol is metabolised by sulfoxidation and dealkylation and is a substrate of UGT. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fluphenazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluphenazine is metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flurazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of flurazepam is most likely CYP-mediated. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Flutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flutamide is predominantly metabolised by CYP1A2 and to a lesser extent by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fluticasone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluticasone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fluvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluvastatin is mainly metabolized by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fluvoxamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluvoxamine is extensively metabolized, mainly by CYP2D6 and to a lesser extent by CYP1A2, and inhibits CYPs 1A2, 2C19, 2C9, 2D6 and 3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Folic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Folic acid is metabolized to dihydrofolic acid and tetrahydrofolic acid with the aid of reduced diphosphopyridine nucleotide and folate reductases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fondaparinux

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fondaparinux does not undergo cytochrome metabolism but is eliminated predominantly renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Formoterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Formoterol is eliminated primarily by direct glucuronidation, with O-demethylation (by CYPs 2D6, 2C19, 2C9, and 2A6) followed by further glucuronidation being another pathway. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Foscarnet

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Foscarnet is eliminated renally by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fosfomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fosfomycin is excreted unchanged mainly via the kidney by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fosinopril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fosinopril is hydrolysed by esterases in the GI mucosa and liver. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fostamatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fostamatinib is metabolised in the gut by alkaline phosphatase to the major active metabolite, R406, which is then metabolised by CYP3A4 and UGT1A9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fostemsavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fostemsavir is a prodrug and is hydrolysed to the active compound temsavir in the small intestine. Temsavir is mainly metabolized by esterase-mediated hydrolysis with a small contribution of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fremanezumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fremanuzemab is a monoclonal IgG2 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Frovatriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Frovatriptan is metabolized by CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fulvestrant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of fulvestrant has not been fully evaluated: in vitro studies suggest the involvement of CYP3A4, however, non-P450 routes appear to be more predominant in vivo. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Furazolidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Furazolidone is primarily metabolised by nitro-reduction to an aminofuran derivative. Detoxification and subsequent renal excretion occur mainly via glutathione conjugation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Furosemide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Furosemide is glucuronidated mainly in the kidney (UGT1A9) and to a lesser extent in the liver (UGT1A1). A large proportion of furosemide is also eliminated unchanged renally (via OATs). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fusidic acid (oral or IV)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro studies suggest fusidic acid is metabolised by CYP3A4, CYP2D6 and UGT1A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Fusidic acid (topical)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

GHB (Gamma-hydroxybutyrate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gamma-hydroxybutyrate undergoes first pass metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Gabapentin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gabapentin is cleared mainly by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Galantamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Galantamine is metabolised mainly by CYP2D6 and CYP3A4, but is also glucuronidated and excreted in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Galcanezumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Galcanezumab is a monoclonal IgG4 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ganciclovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ganciclovir is primarily eliminated by the kidney and in vitro data suggest that it is a substrate of the renal transporter OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Garlic

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Garlic has been shown to induce intestinal CYP3A4 and/or P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Gefitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gefitinib is mainly metabolized by CYP3A4 and to a lesser extent CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Gemcitabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gemcitabine is metabolized in the liver by cytidine deaminase to an inactive metabolite. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Gemfibrozil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gemfibrozil is mainly glucuronidated by UGT2B7 and in vitro data suggest that it inhibits UGT1A1 and UGT1A3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Gentamicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gentamicin is eliminated unchanged predominantly via glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Gestodene (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a gestodene-containing combined oral contraceptive (COC) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gestodene is metabolized by CYP3A4 and to a lesser extent by CYP2C9 and CYP2C19. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Gilteritinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gilteritinib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ginger (Zingiber officinale)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ginkgo biloba

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ginkgo biloba induces CYP3A4 likely via activation of PXR. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ginseng (Panax ginseng, Panax quinquefolis)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ginseng is metabolized by intestinal microflora. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glasdegib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glasdegib is mainly metabolized by CYP3A4 and to a lesser extent by CYP2C8 and UGT1A9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glatiramer acetate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glatiramer acetate is highly bound to plasma proteins. Following subcutaneous administration, the active substance is readily absorbed and a substantial fraction of the dose is hydrolysed locally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glecaprevir/Pibrentasvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glecaprevir and pibrentasvir are metabolized by CYP3A4 and are substrates of P-gp and/or BCRP. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glibenclamide (Glyburide)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glibenclamide is mainly metabolized by CYP3A4 and to a lesser extent by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Gliclazide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gliclazide is metabolized mainly by CYP2C9 and to a lesser extent by CYP2C19. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glimepiride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glimepiride is metabolized by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glipizide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glipizide is metabolized mainly by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glucosamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glucosamine has been reported to undergo metabolism in the liver, but the metabolic pathway remains unclear. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glyceryl trinitrate (Nitroglycerin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glyceryl trinitrate is metabolised by aldehyde dehydrogenase-2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Glycopyrronium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glycopyrronium bromide is mainly eliminated renally (active secretion via organic cation transporter) and is also partly hydroxylated via multiple CYPs. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Golimumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Golimumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Goserelin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Goserelin is mainly hydrolyzed, no clinically relevant accumulation occurs with higher doses of the implant. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Granisetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Granisetron is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Grapefruit juice

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Grapefruit juice inhibits intestinal CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Griseofulvin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Griseofulvin is metabolized by CYP3A4 and glucuronidation. Less than 1% of a griseofulvin dose is excreted unchanged via the kidneys. Griseofulvin is a liver microsomal enzyme inducer. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Guaifenesin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Guaifenesin undergoes oxidation and demethylation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Guanfacine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Guanfacine is metabolized by CYP3A4/5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Guggulsterone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro studies suggest that guggulsterone activates PXR and induces CYP3A4 metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Guselkumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Guselkumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Halofantrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Halofantrine is extensively metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Haloperidol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Haloperidol has a complex metabolism as it undergoes glucuronidation (UGT2B7>1A4, 1A9), carbonyl reduction as well as oxidative metabolism (CYP3A4, CYP2D6). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Halothane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro data indicate that halothane undergoes oxidation (mainly via CYP2E1 and to a lesser extent CYP2A6) and reduction (via CYP2A6 and CYP3A4). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Heparin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Heparin is thought to be eliminated via the reticuloendothelial system. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Heroin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Heroin is rapidly metabolized by sequential deacetylation to morphine which is then mainly glucuronidated to morphine-3-glucuronide (UGT2B7>UGT1A1) and, to a lesser extent, to the pharmacologically active morphine-6-glucuronide (UGT2B7>UGT1A1). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Homeopathic remedies

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. There is no evidence that homeopathic remedies interact with conventional medicines, provided they are from a reputable source, and of the strength stated. However, caution may be required as some remedies termed “low potency” are less dilute, and some remedies may contain alcohol.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hops (Humulus lupulus)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro data indicate that extracts of hops activate PXR and induce expression of CYP3A4, CYP2B6 and MDR1 genes to a degree similar to that of St John's wort. However, a pharmacokinetic study showed a standardised hop extract had no clinically relevant effect on CYPs 2C9, 1A2, 2D6 or 3A4/5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydralazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydralazine is metabolized via primary oxidative metabolism and acetylation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydrochlorothiazide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydrochlorothiazide is not metabolized and is cleared by the kidneys via OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydrocodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydrocodone is metabolized by CYP2D6 to hydromorphone and by CYP3A4 to norhydrocodone, both of which have analgesic effects. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydrocortisone (oral or IV)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydrocortisone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydrocortisone (topical)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with the topical use of hydrocortisone. Hydrocortisone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydromorphone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydromorphone is eliminated via glucuronidation, mainly by UGT2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydroxycarbamide (Hydroxyurea)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydroxycarbamide undergoes metabolism via non-CYP mediated metabolism and is not a substrate of P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydroxychloroquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydroxychloroquine undergoes CYP mediated metabolism by CYPs 2C8, 3A4 and 2D6. Elimination is mainly via the urine, with 3% of the administered dose recovered over 24 hours. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hydroxyzine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydroxyzine is partly metabolized by alcohol dehydrogenase and partly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hyoscine (Scopolamine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hyoscine is metabolized by multiple pathways including CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hyoscine butylbromide (Butylscopolamine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hyoscine butylbromide has poor systemic absorption and acts locally in the intestine. The main metabolic pathway is the hydrolytic cleavage of the ester bond. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Hyoscine hydrobromide (Scopolamine hydrobromide)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hyoscine, derived from hyoscine hydrobromide, is metabolized by multiple pathways including CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ibalizumab-uiyk

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. No drug interaction studies have been conducted with ibalizumab: based on ibalizumab’s mechanism of action and target-mediated drug disposition, drug-drug interactions are not expected. Ibalizumab is likely to be eliminated via intracellular catabolism similarly to other monoclonal antibodies. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ibandronic acid (Ibandronate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ibandronic acid is eliminated unchanged renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Of note, ibandronic acid is contraindicated in patients unable stand or sit upright for at least 60 minutes.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ibrutinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ibrutinib is metabolised primarily by CYP3A4 and to a minor extent by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ibuprofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ibuprofen is metabolized mainly by CYP2C9 and to a lesser extent by CYP2C8 and direct glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Icosapent ethyl

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Icosapent ethyl is eliminated via beta-oxidation similar to dietary fatty acids. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Idarubicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Idarubicin is converted to idarubicinol by aldo-keto reductase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Idelalisib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Idelalisib is metabolised primarily by aldehyde oxidase, and to a lesser extent by CYP3A4 and UGT1A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Iloperidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Iloperidone is metabolized by CYP3A4 and CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Iloprost

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Iloprost is extensively metabolized via beta oxidation of the carboxyl side chain with only a minor role for CYP metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Imatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Imatinib is metabolised mainly by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Imatinib (14 days for COVID-19)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Imipenem/Cilastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Imipenem/cilastatin are eliminated by glomerular filtration and, to a lesser extent, by active tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Imipramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Imipramine is metabolized by CYPs 3A4, 2C19 and 1A2 to desipramine. Imipramine and desipramine are both metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Inclisiran

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Inclisiran is primarily metabolised by nucleases and drug-drug interactions are not anticipated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Indacaterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Indacaterol is eliminated partly unchanged (33%) and partly metabolized by CYP3A4 and UGT1A1. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Indapamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Indapamide is extensively metabolized by CYP450. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Indometacin (Indomethacin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Indometacin is metabolized predominantly by acylation followed by glucuronidation (mainly UGT2B7 and partly by UGT1A9). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Infigratinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Infigratinib is mainly metabolized by CYP3A4 and to a lesser extent by FMO3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Infliximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Infliximab is a TNF-alpha inhibitor and is eliminated via its target antigen. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Inotuzumab ozogamicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Inotuzumab ozogamicin is a humanized monoclonal antibody; elimination occurs primarily via intracellular catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Insulin

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Interferon beta

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Interferon beta is mainly metabolized and excreted by the liver and the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Iodine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Iodine is converted to iodide, which is trapped in the thyroid gland. Iodides are excreted mainly in the urine with smaller amounts excreted in the faeces, sweat and saliva. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ipilimumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ipilimumab is a monoclonal antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ipratropium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. A small proportion of an inhaled ipratropium dose is systemically absorbed (6.9%). Metabolism is via ester hydrolysis and conjugation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Irbesartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Irbesartan is metabolized by glucuronidation and oxidation (mainly CYP2C9). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Irinotecan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Irinotecan is converted to its active metabolite SN38 via tissue carboxylesterase and to inactive metabolites (APC, NPC) via CYP3A4. SN38 is further inactivated by several UGTs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Iron supplements

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Isatuximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isatuximab is a IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Isavuconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isavuconazole is metabolized by CYP3A4/5 and UGTs. Isavuconazole is a moderate inhibitor of CYP3A4/5 and a mild inducer of CYP2B6. Isavuconazole is a mild inhibitor of P-gp, BCRP, OCT2 and UGT. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Isoflurane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isoflurane is almost exclusively eliminated unchanged by the lungs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Isoniazid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Isosorbide dinitrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isosorbide dinitrate undergoes extensive first past metabolism, predominantly in the liver, with less than 30% of a dose undergoing subsequent glucuronidation. In vitro studies suggest that CYP3A4 has a role in nitric oxide formation from isosorbide dinitrate. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Isosorbide mononitrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isosorbide mononitrate is completely absorbed and is not subject to first pass metabolism by the liver. It is denitrated and glucuronidated to inactive metabolites before being excreted mainly in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Isotretinoin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isotretinoin is metabolised mainly by CYP2C8 and CYP3A4 with some participation from CYP2B6 and CYP2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ispaghula husk

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Ispaghula husk passes predominantly unchanged through the gastrointestinal tract and there is little opportunity for marked absorption into or metabolism by the body. The mode of action of ispaghula husk is physical and does not depend on absorption into the systemic circulation. However, ispaghula husk may delay or reduce gastrointestinal absorption of other drugs and it is advisable to separate administration of ispaghula husk and orally administered drugs by 1 hour.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Itraconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Itraconazole is metabolized by CYP3A4 and is a strong inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ivabradine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ivabradine is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ivacaftor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ivacaftor is primarily metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ivacaftor/lumacaftor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lumacaftor is primarily excreted unchanged in the faeces. Ivacaftor is primarily metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ivacaftor/tezacaftor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ivacaftor is primarily metabolized by CYP3A4, and tezacaftor by CYP3A4 and CYP3A5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ivacaftor/tezacaftor/elexacaftor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ivacaftor is primarily metabolized by CYP3A4. Tezacaftor and elexacaftor are primarily metabolized by CYP3A4 and CYP3A5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ivermectin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ivermectin is a substrate of CYP3A4 and P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ivosidenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ivosidenib is primarily metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ixazomib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ixazomib is extensively metabolised by multiple CYP and non-CYP enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ixekizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ixekizumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Kanamycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Kanamycin is eliminated unchanged predominantly via glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ketamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ketamine is mainly metabolized by CYP3A4 and to a lesser extent by CYPs 2B6 and 2C9 in the range of concentrations used in anaesthesia. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ketoconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ketoconazole is metabolized by CYP3A4 and is a strong inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ketoprofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ketoprofen is mainly metabolized by multiple UGTs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ketorolac

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ketorolac is partly eliminated renally and by hepatic metabolism via CYP2C8, CYP2C9 and UGT2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

LSD (Lysergic acid diethylamide)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. LSD (lysergic acid diethylamide) is metabolized to O-H-LSD and N-desmethyl-LSD partly by CYP (unknown isoenzyme). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Labetalol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Labetalol is mainly glucuronidated by UGTs 1A1 and 2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lacidipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lacidipine is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lacosamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lacosamide is metabolized to O-desmethyl-lacosamide mainly by CYP2C19 (approximatively 30% of the dose) and is eliminated unchanged through the kidneys (approximately 40% of the dose). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lactulose

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of lactulose to lactic acid occurs via gastro-intestinal microbial flora only. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lamivudine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lamivudine is eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lamotrigine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lamotrigine is mainly glucuronidated by UGT1A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lansoprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lansoprazole is mainly metabolized by CYP2C19 (major) and CYP3A4 (minor). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lapatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lapatinib is predominantly metabolised by CYP3A4 and CYP3A5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Larotrectinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Larotrectinib is mainly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Latanoprost

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Latanoprost, an isopropyl ester prodrug, is hydrolysed by esterases in the cornea to the biologically active acid. The active acid is primarily metabolized in the liver via fatty acid beta-oxidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ledipasvir/Sofosbuvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ledipasvir and sofosbuvir are substrates of P-gp and BCRP. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Leflunomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Leflunomide is primarily metabolized to the active metabolite A771726. Metabolism is not controlled by a single enzyme and has been shown to occur in microsomal and cytosolic cellular fractions. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lenacapavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lenacapavir is mainly cleared as unchanged drug and is a substrate of CYP3A4 and UGT1A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lenalidomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lenalidomide undergoes limited metabolism and is eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lenvatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lenvatinib is extensively metabolised by multiple enzymes, mainly CYP3A4 and aldehyde oxidase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lercanidipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lercanidipine is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Letermovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Letermovir is a substrate of OATP1B1/B3 and is mainly excreted unchanged. Glucuronidation by UGT1A1 and 1A3 forms a minor pathway. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Letrozole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Letrozole is metabolised by CYP3A4 and CYP2A6 to carbinol, an inactive metabolite. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Leuprorelin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Leuprorelin acetate is a peptide that is primarily degraded by peptidases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levetiracetam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levetiracetam undergoes enzymatic hydrolysis (non CYP) and is eliminated unchanged in the urine by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levocetirizine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Less than 14% of a levocetirizine dose is metabolised. Levocetirizine is mainly eliminated unchanged in the urine through both glomerular filtration and tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levodopa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. In the presence of a peripheral dopa-decarboxylase inhibitor (carbidopa or benserazide) levodopa is metabolised mainly to 3-O-methyldopa by catechol-O-methyltransferase.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levofloxacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levofloxacin is eliminated renally mainly by glomerular filtration and active secretion (possibly OCT2). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levomepromazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levomepromazine is metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levonorgestrel (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a levonorgestrel-containing combined oral contraceptive (COC) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levonorgestrel (Emergency Contraception)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levonorgestrel (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with levonorgestrel as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levonorgestrel (IUD)

Quality of Evidence: Very Low

Summary:

Coadministration with a levonorgestrel intra-uterine device (IUD) has not been studied but there is little potential for an interaction given the local mechanism of action of levonorgestrel.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levonorgestrel (POP)

Quality of Evidence: Very Low

Summary:

Coadministration with a levonorgestrel progestogen-only pill (POP) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levonorgestrel (implant)

Quality of Evidence: Very Low

Summary:

Coadministration with a levonorgestrel progestogen-only implant has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Levothyroxine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levothyroxine is metabolized by deiodination (by enzymes of deiodinase family) and glucuronidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lidocaine (Lignocaine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. CYP1A2 is the predominant enzyme involved in lidocaine metabolism in the range of therapeutic concentrations with a minor contribution from CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Linaclotide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Linaclotide is metabolised locally within the gastrointestinal tract and extensive studies have shown no CYP or transporter interactions occur. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Linagliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Linagliptin is mainly eliminated as the parent compound in faeces, with metabolism by CYP3A4 representing a minor elimination pathway. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Linezolid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Linezolid undergoes non-CYP mediated metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Liothyronine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Liothyronine is metabolised by sequential deiodination, glucuronidation and sulfation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Liquorice (Glycyrrhiza glabra)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glycyrrhizin, the main active component of Glycyrrhiza glabra, is a modest inducer of CYP3A4. Whereas glycyrrhetinic acid, the main active metabolite of glycyrrhizin, was shown to be a strong inhibitor of P-gp in vitro. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Liraglutide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Liraglutide is degraded by endogenous endopeptidases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lisdexamfetamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lisdexamfetamine is a prodrug of dexamfetamine. Dexamfetamine is metabolized by CYP2D6 to some extent, whereas a large part is excreted unchanged. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lisinopril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lisinopril is eliminated unchanged renally via glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lithium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lithium is mainly eliminated unchanged through the kidneys and is freely filtered at a rate that is dependent upon the glomerular filtration rate. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lomitapide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lomitapide is predominantly metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lomustine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lomustine is extensively metabolised by CYPs, with animal studies suggesting involvement of CYP2C19, CYP2D6 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Loperamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Loperamide is metabolized by CYP2C8 and CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lopinavir/ritonavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lopinavir/ritonavir is metabolized by CYP3A and inhibits CYP3A, P-gp, BCRP and OATP1B1. Lopinavir/ritonavir also induces CYP3A, CYP2C9, CYP2C19 and UGTs. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Loratadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Loratadine is metabolized by CYP3A4 and CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lorazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lorazepam is mainly glucuronidated (by UGTs 2B15, 2B4, 2B7, 1A7, 1A10). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lorlatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lorlatinib is primarily metabolised by CYP3A4 and UGT1A4 and, to a lesser extent, by CYP2C8, CYP2C19, CYP3A5 and UGT1A3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lormetazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lormetazepam is mainly glucuronidated (possibly by UGTs 2B15, 1A9 and 2B7). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Losartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Losartan is converted to its active metabolite mainly by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lovastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lovastatin is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lumateperone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lumateperone is metabolized by UGT1A1, UGT1A4, UGT2B15, aldoketoreductase and CYP3A4, 2C8 and CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lumefantrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lumefantrine is metabolized predominantly by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lurasidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lurasidone is primarily metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Lymecycline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lymecycline is not metabolised and is excreted unchanged by renal and biliary routes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Macitentan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Macitentan is metabolized mainly by CYP3A4 and to a lesser extent by CYPs 2C19, 2C9 and 2C8. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

Potential Weak Interaction

Molnupiravir

Macrogol (Polyethylene glycol, PEG 3350, PEG 4000)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Macrogol is unabsorbed from the gastrointestinal tract and is excreted, unaltered, in faeces. Any macrogol that does enter the circulation is excreted in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. However, the absorption of other oral medications may be reduced due to increased gastrointestinal transit with macrogol. Do not take macrogol within two hours of taking another oral medication. [Note: this interaction is not specific for molnupiravir, but for any oral medication taken with macrogol.]

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Magnesium salts (oral)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Magnesium is eliminated in the kidney, mainly by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Magnesium sulfate (IV)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Malabar nut tree (Justicia adhatoda, Adhatoda vasica)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Limited data is available on the effect of malabar nut tree on drug metabolism. In vitro data with leaf extracts suggest it could act as an inducer of phase I and phase II metabolic enzymes although the clinical relevance has not been evaluated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Maprotiline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Maprotiline is mainly metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Maraviroc

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Maraviroc is primarily metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Maribavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Maribavir is primarily eliminated by CYP3A4 (at least 35%), with secondary contribution from CYP1A2 (no more than 25%), and some contribution from multiple UGTs (low). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mebeverine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mebeverine is mainly metabolized by esterases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Meclizine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Meclizine is mainly metabolized by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Medroxyprogesterone (depot injection)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Medroxyprogesterone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Medroxyprogesterone (oral)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mefenamic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mefenamic acid is metabolized by CYP2C9 and additionally glucuronidated by UGT2B7 and UGT1A9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mefloquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mefloquine is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Megestrol acetate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Megestrol acetate is mainly eliminated in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Melatonin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Melatonin is metabolized by CYP1A2 and CYP1A1. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Meloxicam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Meloxicam is metabolised mainly by CYP2C9, with a minor contribution from CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Memantine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Memantine is eliminated by active renal secretion via the organic cationic transport system (OCT2). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mepolizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mepolizumab is a monoclonal IgG1 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mercaptopurine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mercaptopurine is predominantly metabolised by xanthine oxidase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Meropenem

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Meropenem is primarily eliminated by the kidney and in vitro data suggest that it is a substrate of the renal transporters OAT3/OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mesalazine (mesalamine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mesalazine is metabolized by NAT-1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Metamizole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metamizole is a pro-drug that undergoes hydrolysis to 4-methylaminoantipyrine (MAA) which is then metabolized by CYPs 3A4, 2B6, 2C8 and 2C9. Metamizole is a moderate inducer of CYP3A4 and CYP2B6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Metformin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metformin is mainly eliminated unchanged in the urine via OCT2 and MATE1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methadone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methadone is metabolized by CYP2B6 and CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methamphetamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methamphetamine is metabolized by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methimazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methimazole is likely to be metabolized by CYP enzymes and FMO. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methocarbamol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methocarbamol is metabolized in the liver by dealkylation, hydroxylation, and glucuronidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methotrexate (cancer therapy)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methotrexate is minimally metabolised and is predominantly eliminated unchanged in the kidneys by active tubular secretion via OAT1 and OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methotrexate (immunosuppressant)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methotrexate is mainly eliminated renally via glomerular filtration and active renal secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methyldopa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methyldopa is excreted in urine largely by glomerular filtration, primarily unchanged, and as the mono-O-sulfate conjugate. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methylergometrine (Methylergonovine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methylergometrine is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methylphenidate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methylphenidate is metabolized by de-esterification. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methylprednisolone (oral or IV)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methylprednisolone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Methylprednisolone (topical)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with the topical use of methylprednisolone. Methylprednisolone is metabolized by CYP3A4, but neither induces nor inhibits CYPs. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Metoclopramide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metoclopramide is partially metabolized by the CYP450 system (mainly CYP2D6). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Metolazone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metolazone is largely excreted unchanged in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Metoprolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metoprolol is mainly metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Metronidazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metronidazole is eliminated via glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mexiletine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mexiletine is metabolized mainly by CYP2D6 and to a lesser extent CYP1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mianserin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mianserin is metabolized by CYPs 2D6 and 1A2, and to a lesser extent by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Micafungin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Micafungin has a low potential for CYP3A-mediated interactions as CYP3A is not a major pathway for micafungin metabolism in vivo. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Miconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Miconazole is largely metabolized and less than 1% of an administered dose is excreted unchanged in the urine. Miconazole inhibits CYP2C9 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Midazolam (buccal)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Midazolam is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Midazolam (oral)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Midazolam (parenteral)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Midodrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Midodrine is a prodrug converted to its active metabolite desglymidodrine in various tissues. Desglymidodrine is mainly metabolized by CYP2D6 and to a lesser extent by CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Midostaurin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Midostaurin is metabolised mainly by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Milk thistle (Silybum marianum, Silymarin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Drug-drug interaction studies suggest that milk thistle has limited clinical impact on substrates of CYP3A, P-gp, UGT and OATP. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Milnacipran

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Milnacipran is mainly eliminated unchanged (50%), and as glucuronides (30%) and oxidative metabolites (20%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Minocycline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Minocycline is almost completely absorbed with one third excreted as unchanged drug. Unlike other tetracyclines, there is evidence that partial metabolism by CYPs (including CYP3A4) occurs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Minoxidil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Minoxidil is a substrate of UGTs (the specific UGTs have not been well described). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mirabegron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mirabegron is metabolized by multiple pathways including hydrolysis, glucuronidation, and oxidation by CYP2D6 and CYP3A4. It is also a substrate of P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mirtazapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mirtazapine is metabolized to 8-hydroxymirtazapine by CYP2D6 and CYP1A2, and to N-desmethylmirtazapine mainly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Misoprostol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Misoprostol is predominantly metabolized via fatty acid oxidising systems and does not affect CYP enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mitomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mitomycin is hepatically metabolized but the enzymes involved are unclear; modulation of CYP450 is unlikely to be significant. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mitotane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mitotane is primarily metabolized in adrenal cells. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mobocertinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mobocertinib is mainly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Moclobemide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Moclobemide is metabolised via multiple pathways, including in part by CYP2C19 and CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Modafinil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Modafinil is largely metabolized by hydrolysis (esterase-mediated) and to a lesser extent by CYP3A4-mediated oxidative metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mometasone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mometasone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Montelukast

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Montelukast is mainly metabolized by CYP2C8 and to a lesser extent by CYPs 3A4 and 2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Morphine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Morphine is mainly glucuronidated to morphine-3-glucuronide (UGT2B7>UGT1A1) and, to a lesser extent, to the pharmacologically active morphine-6-glucuronide (UGT2B7>UGT1A1). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Moxifloxacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Moxifloxacin is predominantly glucuronidated by UGT1A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Moxonidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Moxonidine is only minimally metabolized and is eliminated renally, mainly as unchanged moxonidine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Multivitamins

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Mycophenolate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mycophenolate is mainly glucuronidated by UGTs 1A9 and 2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nabumetone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nabumetone undergoes extensive first pass metabolism via multiple CYPs (major enzyme CYP1A2) to the active metabolite 6-MNA. 6-MNA is metabolised by CYP2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Naftidrofuryl

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naftidrofuryl is metabolized to 3 major metabolites primarily by plasma pseudo-choline esterases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Naloxegol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naloxegol is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Naloxone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naloxone is mainly glucuronidated by UGT2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Naltrexone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro studies have shown that neither naltrexone, nor its main metabolite (6-beta-naltrexol), is metabolized by CYP450 enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nandrolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nandrolone is metabolized in the liver by alpha-reductase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Naproxen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naproxen is mainly glucuronidated by UGT2B7 (major) and demethylated to desmethylnaproxen by CYP2C9 (major) and CYP1A. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Naratriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naratriptan is metabolised by a wide range of CYP enzymes and is mainly excreted in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Natalizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Natalizumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nateglinide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nateglinide is mainly metabolized by CYP2C9 (70%) and to a lesser extent CYP3A4 (30%). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nebivolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nebivolol metabolism involves CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Necitumumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Necitumumab is an IgG1 monoclonal antibody and is eliminated via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nefazodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nefazodone is metabolized mainly by CYP3A4 and is also an inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nefopam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nefopam undergoes extensive hepatic metabolism and both unchanged nefopam and metabolites are excreted principally in the urine. Limited data suggest that CYP and UGT enzymes may have a role in the metabolism of nefopam. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Neostigmine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Neostigmine metabolism has not been well characterised but limited data suggests partial metabolism occurs via hydrolysis by cholinesterase and up to 50% of a dose is excreted unchanged via the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Neratinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Neratinib is metabolised mainly by CYP3A4 and to a lesser extent by flavin-containing monooxygenase (FMO). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Netupitant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Netupitant is metabolized primarily by CYP3A4 and to a lesser extent by CYP2C9 and CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nevirapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nevirapine is primarily metabolized by CYP3A4 and is an inducer of CYPs. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nicardipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nicardipine is metabolized mainly by CYP3A4 and to a lesser extent by CYP2D6 and CYP2C8. Nicardipine inhibits CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Niclosamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Niclosamide is metabolized by CYP1A2 and UGT1A1 and does not inhibit or induce CYPs. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nicorandil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of nicorandil occurs mainly via denitration with the denitrated product then merging into the nicotinamide pathway. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nicotinamide (Niacinamide)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nicotinamide is metabolized by nicotinamide methyltransferase to N-methylnicotinamide which is then metabolized by xanthine oxidase and aldehyde oxidase. Renal elimination of unchanged nicotinamide is minimal. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nicotine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nicotine is mainly metabolised by CYP2A6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nifedipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nifedipine is metabolized mainly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nilotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nilotinib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nimesulide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nimesulide is extensively metabolized in the liver following multiple pathways including CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nintedanib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nintedanib is primarily metabolised by esterases to the active metabolite BIBF 1202, with CYP3A4 contributing to a minor extent. BIBF 1202 is subsequently glucuronidated by UGTs 1A1, 1A7, 1A8 and 1A10. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Niraparib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Niraparib is metabolized by carboxylesterases and UGTs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nirmatrelvir/ritonavir (5 days)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nirmatrelvir/ritonavir is metabolized by CYP3A. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nirmatrelvir/ritonavir (extended administration; 10 days or longer)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nisoldipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nisoldipine is metabolized mainly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nitazenes

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nitazenes are a family of synthetic opioids with a potency several hundred times stronger than morphine. Little is known about nitazene metabolism but it is likely to involve CYP metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nitazoxanide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nitazoxanide is rapidly hydrolyzed to an active metabolite, tizoxanide. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nitrendipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nitrendipine is extensively metabolized mainly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nitrofurantoin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nitrofurantoin is partly metabolized in the liver via glucuronidation and N-acetylation and partly eliminated in the urine as unchanged drug. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nitrous oxide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Most inhaled nitrous oxide is rapidly eliminated unchanged through the lungs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nivolumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nivolumab is a monoclonal IgG4 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nizatidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nizatidine is primarily eliminated via tubular secretion and glomerular filtration in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Noradrenaline (Norepinephrine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Noradrenaline is metabolized by catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO), with up to 16% of an intravenous dose is excreted unchanged in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Norelgestromin (patch)

Quality of Evidence: Very Low

Summary:

Coadministration with transdermally delivered norelgestromin/ethinylestradiol has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norelgestromin is metabolized to norgestrel (possibly by CYP3A4). Ethinylestradiol is mainly metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Norethisterone [Norethindrone] (COC)

Quality of Evidence: Very Low

Summary:

Coadministration of a combined oral contraceptive (COC) containing norethisterone and ethinylestradiol has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norethisterone is metabolized by CYP3A4 and is also glucuronidated. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Norethisterone [Norethindrone] (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with norethisterone as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norethisterone is metabolized by CYP3A4 and is also glucuronidated. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Norethisterone [Norethindrone] (IM depot injection)

Quality of Evidence: Very Low

Summary:

Coadministration of a norethisterone IM depot injection has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norethisterone is metabolized by CYP3A4 and is also glucuronidated. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Norethisterone [Norethindrone] (POP)

Quality of Evidence: Very Low

Summary:

Coadministration with a norethisterone progestogen-only pill (POP) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norethisterone is metabolized by CYP3A4 and is also glucuronidated. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Norgestimate (COC)

Quality of Evidence: Very Low

Summary:

Coadministration of a combined oral contraceptive (COC) containing norgestimate has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norgestimate is deacetylated to the active metabolite norelgestromin which is then metabolized to norgestrel, possibly by CYP3A4. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Norgestrel (COC)

Quality of Evidence: Very Low

Summary:

Coadministration of a combined oral contraceptive (COC) containing norgestrel/ethinylestradiol has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norgestrel is a racemic mixture with levonorgestrel being biologically active. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Ethinylestradiol is metabolized by hydroxylation and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Norgestrel (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with norgestrel as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norgestrel is a racemic mixture with levonorgestrel being biologically active. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nortriptyline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nortriptyline is metabolized mainly by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Nystatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Systemic absorption of nystatin from oral or topical dosage forms is not significant, therefore no drug interactions are expected. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Obinutuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Obinutuzumab is a monoclonal IgG antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ocrelizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ocrelizumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Octreotide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Octreotide has been reported to be heavily metabolized in the liver but the metabolic pathway is unclear. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ofatumumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ofatumumab is a fully human monoclonal antibody; elimination occurs primarily via intracellular catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. No interactions are expected with ofatumumab and substrates, inhibitors or inducers of CYP enzymes, other metabolising enzymes or transporters.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ofloxacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ofloxacin is eliminated unchanged in the kidneys by glomerular filtration and active tubular secretion via both cationic and anionic transport systems. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Olanzapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Olanzapine is metabolized mainly by CYP1A2, but also by glucuronidation (UGT1A4). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Olaparib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Olaparib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Olaratumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Olaratumab is a monoclonal IgG1 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Olmesartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Olmesartan medoxomil is de-esterified to the active metabolite olmesartan, which is eliminated in the faeces and urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Olodaterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Olodaterol is metabolized by CYP2C8, CYP2C9, is glucuronidated via several UGTs, and is a substrate of P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Omalizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cytochrome P450 enzymes, efflux pumps and protein-binding mechanisms are not involved in the metabolism and clearance of omalizumab and drug-drug interactions are not expected. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ombitasvir/Paritaprevir/r

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Multiple CYP enzymes and drug transporters, including P-gp, BCRP, and OATP1B are involved in the metabolism of ombitasvir/paritaprevir/ritonavir. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ombitasvir/Paritaprevir/r + Dasabuvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Multiple CYP enzymes and drug transporters, including P-gp, BCRP, and OATP1B are involved in the metabolism of ombitasvir/paritaprevir/ritonavir + dasabuvir. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Omega-3 fatty acids

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Omega-3 fatty acids are eliminated via oxidation similar to dietary fatty acids. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Omeprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Omeprazole is mainly metabolized by CYP2C19 (major) and CYP3A4 (minor). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ondansetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ondansetron is metabolized mainly by CYP1A2 and CYP3A4 and to a lesser extent by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Opipramol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Opipramol is metabolized by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oral nutritional supplements

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Oral nutritional supplements contain polyvalent cations but no interaction is expected with molnupiravir.

Description:

(See Summary)

Potential Weak Interaction

Molnupiravir

Orlistat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Orlistat is minimally absorbed after oral doses with about 97% of a dose excreted in the faeces, 83% of which as unchanged orlistat. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. A clinically significant pharmacokinetic interaction is unlikely with molnupiravir, however, because of orlistat’s effect on fat absorption in the GI tract, it cannot be ruled out that absorption of molnupiravir could be reduced. [Note: this interaction is not specific for molnupiravir but for any oral medication taken with orlistat.]

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Orphenadrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Orphenadrine is extensively metabolized (limited information on metabolic pathway). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oseltamivir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oseltamivir is converted to oseltamivir carboxylate by esterases. The latter is excreted in the urine by glomerular filtration and tubular secretion by OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Osimertinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Osimertinib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ospemifene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ospemifene is primarily metabolised by CYP3A4 and CYP2C9; CYP2C19 and UGTs 1A3, 2B7, 1A1 and 1A8 also contribute to its metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolised by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oxaliplatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxaliplatin undergoes non enzymatic biotransformation and is eliminated renally via OCT2 and MATE2-K. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oxandrolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxandrolone is mainly eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oxazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxazepam is mainly glucuronidated (by UGTs 2B15, 1A9 and 2B7). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oxcarbazepine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxcarbazepine is rapidly reduced by cytosolic arylketone reductases to its active metabolite, 10-hydroxycarbazepine. Oxcarbazepine is a moderate inducer of CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oxprenolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxprenolol is largely metabolized by glucuronidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oxybutynin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxybutynin is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oxycodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxycodone is metabolized principally by CYP3A and CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Oxymetholone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxymetholone undergoes oxidation, reduction and hydroxylation; CYP enzymes are unlikely to be involved. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ozanimod

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ozanimod is metabolized by multiple enzymes, including CYP3A4 and CYP1A1, and no single pathway dominates. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Paclitaxel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Paclitaxel is primarily metabolized by CYP2C8 and to a lesser extent by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Palbociclib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Palbociclib is metabolised by CYP3A and SULT2A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Paliperidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Paliperidone is primarily eliminated renally (possibly OCT), with minimal metabolism occurring via CYPs 2D6 and 3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Palonosetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Palonosetron is mainly metabolised by CYP2D6, with minor contributions from CYP3A4 and CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pancreatic enzymes (Creon)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with pancreatic enzyme preparations (e.g., Creon). Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Panitumumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Panitumumab is a monoclonal IgG2 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Panobinostat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Panobinostat is metabolized by non-CYP and CYP mediated routes. Approximately 40% of panobinostat is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pantoprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pantoprazole is mainly metabolized by CYP2C19 (major) and CYP3A4 (minor). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Para-aminosalicylic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Para-aminosalicylic acid and its acetylated metabolite are mainly excreted in the urine by glomerular filtration and tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Paracetamol (Acetaminophen)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Paracetamol is mainly metabolized by glucuronidation (via UGT1A9 (major), UGT1A6, UGT1A1, UGT2B15) and sulfation and, to a lesser extent, by oxidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Paroxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Paroxetine is mainly metabolized by CYPs 2D6 and 3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pazopanib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pazopanib is metabolized by CYP3A4 and to a lesser extent by CYPs 1A2 and 2C8. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Peginterferon beta-1a

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Renal clearance is likely to be a major excretory pathway for peginterferon beta-1a. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pembrolizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pembrolizumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pemetrexed

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pemetrexed is not appreciably metabolised and is primarily eliminated unchanged renally (70-90% recovered in 24 hours). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pemigatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pemigatinib is mainly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Penicillins

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Penicillins are mainly eliminated in the urine (20% by glomerular filtration and 80% by tubular secretion via OAT). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pentosan polysulfate sodium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pentosan polysulfate sodium is metabolised by desulfation in the liver and depolymerisation in the kidney. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pentoxifylline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of pentoxifylline has not been well described but some studies indicate oxidation by CYP1A2, reduction by carbonyl reductase, and oxidation by carboxylase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Perampanel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Perampanel is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Perazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Perazine is demethylated by CYP3A4 and to a lesser extent by CYP2C9, and oxidated by FMO3. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Periciazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of periciazine has not been well characterized but is likely to involve CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Perindopril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Perindopril is hydrolysed to the active metabolite perindoprilat and is metabolized to other inactive metabolites. Elimination occurs predominantly via the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Perphenazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Perphenazine is metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pertuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pertuzumab is an IgG1 monoclonal antibody and is eliminated via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pethidine (Meperidine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pethidine is metabolized mainly by CYP2B6 and to a lesser extent by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pexidartinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pexidartinib is metabolized by CYP3A4 and UGT1A4 and is a moderate inducer of CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Phenelzine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phenelzine is primarily metabolized by oxidation via monoamine oxidase and to a lesser extent by acetylation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Phenobarbital (Phenobarbitone)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phenobarbital is metabolized by CYP2C19 and CYP2C9 (major), and to a lesser extent by CYP2E1. Phenobarbital induces CYP3A4 and UGTs. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Phenprocoumon

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phenprocoumon is metabolized by CYP2C9 and CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Phentermine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phentermine is partly metabolised by CYP3A4, with 70-80% of the dose excreted unchanged in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Phenylephrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phenylephrine is metabolised by MAO. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Phenytoin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phenytoin is mainly metabolized by CYP2C9 and to a lesser extent by CYP2C19. Phenytoin induces CYP3A4 and UGTs. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pilocarpine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pilocarpine is primarily metabolized by CYP2A6 and serum esterases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pimavanserin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pimavanserin is predominantly metabolized by CYP3A4/5 and to a lesser extent by CYP2J2, CYP2D6, and various other CYP and FMO enzymes. CYP3A4 is the major enzyme responsible for the formation of the major active metabolite (AC-279). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pimozide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pimozide is metabolized mainly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pindolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pindolol is partly metabolized to hydroxymetabolites (possibly by CYP2D6) and partly eliminated unchanged in the urine. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pioglitazone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pioglitazone is metabolized by mainly CYP2C8 and to a lesser extent by CYPs 3A4, 1A2 and 2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Piperacillin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Piperacillin is eliminated renally via glomerular filtration and active secretion by OAT1/3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Piperaquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Piperaquine is mainly metabolised by CYP3A4 and to a lesser extent by CYP2C9 and CYP2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pipotiazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of pipotiazine has not been well described but may involve CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pirfenidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pirfenidone is mainly metabolized by CYP1A2 (70-80%) with minor contributions from CYPs 2C9, 2C19, 2D6, and 2E1. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Piribedil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Piribedil is extensively metabolised, primarily by demethylation, p-hydroxylation and N-oxidation, which may be mediated by CYP enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Piroxicam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Piroxicam is primarily metabolized by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pitavastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pitavastatin is metabolized by UGTs 1A3 and 2B7 with minimal metabolism by CYPs 2C9 and 2C8. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pitolisant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pitolisant is primarily metabolised by CYP2D6 and to a lesser extent by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pizotifen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pizotifen is glucuronidated by UGT2B10. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Polatuzumab vedotin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Polatuzumab vedotin is an antibody-drug conjugate comprising a monoclonal antibody and monomethyl auristatin E (MMAE), a potent chemotherapeutic agent. The monoclonal antibody undergoes elimination via intracellular catabolism. MMAE is a substrate of CYP3A4 (and possibly CYP2D6) and P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pomalidomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pomalidomide is metabolised by CYP1A2 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ponatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ponatinib is metabolized mainly by CYP3A4 and to a lesser extent by CYP2C8, CYP2D6 and CYP3A5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Poppers (Amyl nitrate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amyl nitrate is metabolized rapidly by hydrolytic denitration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Posaconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Posaconazole is eliminated mainly unchanged in the faeces and only a minimal amount undergoes biotransformation (mainly glucuronidation by UGT1A4). Posaconazole is a strong inhibitor of CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Potassium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Potassium is eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pralsetinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pralsetinib is metabolized by CYP3A4 and UGT1A4 and to a lesser extent by CYP2D6 and CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pramipexole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pramipexole undergoes minimal metabolism and is primarily eliminated by the kidney. In vitro data suggest that it is a substrate of the renal transporter OCT2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Prasugrel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prasugrel is a prodrug and is converted to its active metabolite mainly by CYP3A4 and CYP2B6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pravastatin

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Prazosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prazosin undergoes extensive hepatic metabolism primarily by demethylation and conjugation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Prednisolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prednisolone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Prednisone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prednisone is converted to the active metabolite prednisolone by 11-B-hydroxydehydrogenase. Prednisolone is then metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pregabalin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pregabalin is cleared mainly by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Primaquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Primaquine is metabolised mainly through a non-CYP mediated mechanism and only a small fraction of the drug is believed to be metabolised through CYP450. The oxidative metabolites rather than the parent drug are primarily responsible for the haemolytic effects of primaquine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Primidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Primidone is metabolized by CYP3A4 to the active metabolite phenobarbital. Phenobarbital induces CYP3A4 and UGTs. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Probenecid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Probenecid is metabolised by CYP enzymes to a limited extent. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Prochlorperazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prochlorperazine is metabolized by CYP2D6 and CYP2C19. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Procyclidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Little is known about procyclidine metabolism but it is likely to be metabolized by P450 and glucuronidated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Progesterone (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Progesterone is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Proguanil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Proguanil is partly excreted unchanged and partly metabolized to its more active metabolite cycloguanil by CYP2C19 and to a lesser extent by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Promethazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Promethazine is metabolized mainly by CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Propafenone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Propafenone is metabolized mainly by CYP2D6 and to a lesser extent CYP1A2 and CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Propofol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Propofol is glucuronidated via UGT1A9 and UGT1A8 and is oxidized mainly via CYP2B6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Propranolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Propranolol is metabolized by 3 routes (aromatic hydroxylation by CYP2D6, N-dealkylation followed by side-chain hydroxylation via CYPs 1A2, 2C19, 2D6, and direct glucuronidation). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Propylthiouracil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Propylthiouracil is extensively metabolized, predominantly via glucuronidation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Prucalopride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prucalopride is minimally metabolized and mainly eliminated renally, partly by active secretion by renal transporters. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pseudoephedrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pseudoephedrine is minimally metabolised by N-demethylation and ~70% is excreted unchanged in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Psilocybin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Psilocybin is rapidly dephosphorylated to psilocin which is responsible for the hallucinogenic effects. Psilocin is deactivated to multiple metabolites by alcohol dehydrogenase and monoamine oxidase or glucuronidated to psilocin-O-glucuronide by UGT1A9 in the liver or UGT1A10 in the small intestine before excretion in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Psyllium husk

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Psyllium husk passes predominantly unchanged through the gastrointestinal tract and there is little opportunity for marked absorption into or metabolism by the body. The mode of action of psyllium husk is physical and does not depend on absorption into the systemic circulation. However, psyllium husk may delay or reduce gastrointestinal absorption of other drugs and it is advisable to separate administration of psyllium husk and orally administered drugs if possible.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pyrazinamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pyrazinamide is mainly metabolized by xanthine oxidase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pyridostigmine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pyridostigmine is mainly eliminated unchanged by the kidney with up to 74% of renal clearance attributed to active tubular secretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Pyrimethamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pyrimethamine is predominantly metabolized by the liver with some contribution from CYP2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Quercetin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Quercetin has the ability to modulate CYP/P-gp activities but is unlikely to affect molnupiravir Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Quetiapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Quetiapine is metabolized mainly by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Quinapril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Quinapril is de-esterified to the active metabolite quinaprilat, which is eliminated primarily by renal excretion via OAT3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Quinidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Quinidine is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Quinine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Quinine is extensively metabolized by CYP3A4 and is a substrate of P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rabeprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rabeprazole is mainly metabolized by CYP2C19 (major) and CYP3A4 (minor). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Raloxifene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Raloxifene undergoes hepatic glucuronidation (by UGT1A1 and UGT1A9) and extra-hepatic glucuronidation (by UGT1A8 and UGT1A10). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Raltegravir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Raltegravir is primarily metabolized by UGT1A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ramipril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ramipril is hydrolysed to the active metabolite ramiprilat and is metabolized to the diketopiperazine ester, diketopiperazine acid and the glucuronides of ramipril and ramiprilat. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ranibizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ranibizumab is a monoclonal antibody fragment and is expected to undergo catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ranitidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ranitidine is excreted via the kidney, partially by the cationic system. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ranolazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ranolazine is primarily metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rasagiline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rasagiline is metabolized predominantly by CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Reboxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Reboxetine is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Red yeast rice

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Red yeast rice contains monacolin K (a natural component with the same chemical structure as lovastatin) which is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Regorafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Regorafenib is metabolized by CYP3A4 and UGT1A9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Relugolix

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Relugolix is mainly metabolized by CYP3A4 and to a lesser extent by CYP2C8. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Remdesivir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Remdesivir is a substrate of CYP2C8, CY2D6, CYP3A4, OATP1B1 and P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Remifentanil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Remifentanil is metabolized by non-specific blood and tissue esterases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Repaglinide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Repaglinide is metabolized by CYPs 2C8 and 3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Retigabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Retigabine is metabolized primarily by glucuronidation (mainly UGT1A4, with contributions from UGTs 1A1, 1A3 and 1A9) and acetylation (mainly by NAT2). There is no evidence of CYP-mediated metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ribavirin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ribavirin is partly metabolized (non-CYP mediated) and partly excreted in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ribociclib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ribociclib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rifabutin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rifabutin is mainly metabolized by CYP3A4 and cholinesterase. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rifampicin (Rifampin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rifampicin is metabolized via deacetylation. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rifapentine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rifapentine is deacetylated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rifaximin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rifaximin is mainly excreted in faeces, almost entirely as unchanged drug. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rilpivirine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rilpivirine is primarily metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rilpivirine/ Emtricitabine/ Tenofovir alafenamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rilpivirine is primarily metabolized by CYP3A4; emtricitabine and tenofovir alafenamide are eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rilpivirine/ Emtricitabine/ Tenofovir-DF

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rilpivirine is primarily metabolized by CYP3A4; emtricitabine and tenofovir-DF are eliminated renally. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Riluzole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Riluzole is mainly metabolized by CYP1A2 and the major active metabolite is then glucuronidated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rimantadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rimantadine is both hydroxylated and glucuronidated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rimegepant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rimegepant is primarily metabolized by CYP3A4 and to a lesser extent by CYP2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Riociguat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Riociguat is metabolized by CYP1A1, CYP3A4, CYP2C8, CYP2J2 and is also eliminated unchanged in the bile and renally. Riociguat is a substrate of P-gp and BCRP. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ripretinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ripretinib is mainly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Risankizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Risankizumab is primarily metabolised through catabolic pathways similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Risedronic acid (Risedronate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Risedronate is not metabolized and is excreted unchanged primarily by the kidney. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Risperidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Risperidone is metabolized by CYP2D6 and to a lesser extent by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rituximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rituximab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rivaroxaban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rivaroxaban is partly metabolized in the liver (by CYP3A4, CYP2J2 and hydrolytic enzymes) and partly eliminated unchanged in urine (by P-gp and BCRP). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rivastigmine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rivastigmine is extensively metabolised by cholinesterase-mediated hydrolysis with minimal involvement of CYP450 enzymes. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rizatriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rizatriptan is eliminated primarily by metabolism mediated by monoamine oxidase A. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rocuronium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rocuronium is mostly cleared in the bile although up to 30% may be excreted renally. P-gp was shown to mediate biliary excretion of rocuronium in a rat model. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Roflumilast

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Roflumilast is metabolized by CYP3A4 and CYP1A2 to form roflumilast N-oxide, with both roflumilast and roflumilast N-oxide having PDE4 inhibitory activity. Roflumilast N-oxide is subsequently dealkylated by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Romidepsin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Romidepsin is mainly metabolised by CYP3A4 with a minor contribution from CYPs 3A5, 1A1, 2B6 and 2C19, and is a substrate of P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ropinirole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ropinirole is metabolized predominantly by CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ropivacaine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ropivacaine is mainly metabolised by CYP1A2, with CYP3A4 having a minor role. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rosiglitazone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rosiglitazone is metabolized mainly by CYP2C8 and to a lesser extent by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rosuvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rosuvastatin is largely excreted unchanged via the faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rotigotine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rotigotine is extensively metabolized via multiple CYPs, UGTs, and sulfotransferases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rucaparib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rucaparib is primarily metabolised by CYP2D6 and to a lesser extent by CYP1A2 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Rufinamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rufinamide is metabolized by hydrolysis and does not undergo significant CYP-mediated metabolism. Rufinamide is a moderate inducer of CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ruxolitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ruxolitinib is metabolized by CYP3A4 (major) and CYP2C9 (minor). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sacubitril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sacubitril is rapidly converted to LBQ657 (active metabolite) by carboxylesterases and the active metabolite is not further metabolized to a significant extent. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Safinamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Safinamide is metabolised by high-capacity amidases which are yet to be fully characterised; CYP enzymes are unlikely to be involved. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Salbutamol (Albuterol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Salbutamol is metabolized to the inactive salbutamol-O-sulphate. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Salmeterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Salmeterol is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sarilumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sarilumab is an IL-6 receptor monoclonal antibody and likely undergoes elimination via binding to its target antigen. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Saxagliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Saxagliptin is mainly metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Secukinumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Secukinumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Selegiline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Selegiline is metabolised mainly by CYP2B6 with some contribution from CYP3A4 and CYP2A6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Selexipag

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Selexipag is hydrolysed to its active metabolite by carboxylesterase 1 (CES1). Both selexipag and its active metabolite undergo oxidative metabolism by CYP2C8 and CYP3A4. The active metabolite is also glucuronidated by UGT1A3 and UGT2B7. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Selinexor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Selinexor is metabolised by CYP3A4, multiple UGTs and GSTs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Selpercatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Selpercatinib is predominantly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Semaglutide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Semaglutide is metabolized by the enzyme neutral endopeptidase. Semaglutide delays gastric emptying and has the potential to impact the rate of absorption of concomitantly administered oral medicinal products. However, based on available interaction studies, a clinically relevant effect is not expected with molnupiravir. Note: food, beverages and oral medicinal products can interfere with the absorption of oral semaglutide. Therefore, patients must wait at least 30 minutes after taking oral semaglutide before taking any other oral medicinal product.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Senna

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Senna glycosides are hydrolysed by colonic bacteria in the intestinal tract and the active anthraquinones liberated into the colon. Excretion occurs in the urine and the faeces and also in other secretions. No clinically significant drug interactions are known. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sertraline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sertraline is mainly metabolized by CYP2B6 and to a lesser extent by CYPs 2C9, 2C19, 2D6 and 3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

Potential Weak Interaction

Molnupiravir

Sevelamer

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Sevelamer is a locally acting resin not absorbed from the GI tract that may affect the bioavailability of other medicinal products. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. In the absence of data, when administering any medicinal product orally where a reduction in the bioavailability could have a clinically significant effect on safety or efficacy, the medicinal product should be administered at least one hour before or three hours after sevelamer. [Note: this interaction is not specific for molnupiravir, but for any medication taken with sevelamer.]

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sevoflurane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sevoflurane is almost exclusively eliminated unchanged by the lungs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sildenafil (Erectile Dysfunction)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sildenafil is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sildenafil (Pulmonary Arterial Hypertension)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sildenafil is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Silodosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Silodosin is a substrate of CYP3A4 and P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Simvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Simvastatin is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Siponimod

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Siponimod is metabolized by CYP2C9 (major) and CYP3A4 (minor). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sirolimus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sirolimus is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sitagliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sitagliptin is primarily eliminated in urine as unchanged drug (active secretion by OAT3, OATP4C1, P-gp), with metabolism by CYP3A4 representing a minor elimination pathway. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sodium nitroprusside

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sodium nitroprusside is rapidly metabolized, likely by interaction with sulfhydryl groups in the erythrocytes and tissues. Cyanogen (cyanide radical) is produced which is converted to thiocyanate in the liver by the enzyme thiosulfate sulfurtransferase. There is little potential for drug-drug interactions with sodium nitroprusside. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sodium valproate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sodium valproate circulates in plasma as the valproate ion. Valproate is mainly glucuronidated by UGTs 1A6, 1A9 and 2B7 and metabolized by CYP2C9 and CYP2C19. Valproate has no inducing effects on metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sodium zirconium cyclosilicate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sodium zirconium cyclosilicate is not absorbed or metabolised by the body and is eliminated via the faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sofosbuvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sofosbuvir is a prodrug and the formation of its active metabolite is unlikely to be affected by comedications. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sofosbuvir/Velpatasvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sofosbuvir and velpatasvir are substrates of P-gp and BCRP. Velpatasvir is also a substrate of OATP1B and CYPs 2B6, 2C8 and 3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sofosbuvir/Velpatasvir/Voxilaprevir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sofosbuvir, velpatasvir, and voxilaprevir are substrates of P-gp and BCRP. Velpatasvir and voxilaprevir are also substrates of OATP1B. In vitro, slow metabolic turnover of velpatasvir primarily by CYP2B6, CYP2C8, and CYP3A4 and of voxilaprevir primarily by CYP3A4 was observed. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Solifenacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Solifenacin is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sonidegib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sonidegib is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sorafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sorafenib is metabolized by CYP3A4, UGT1A9 and UGT1A1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sotalol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sotalol is excreted unchanged via renal elimination. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sotorasib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sotorasib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sotrovimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sotrovimab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Spectinomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Spectinomycin is predominantly eliminated unchanged by the kidneys via glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Spironolactone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Spironolactone is partly metabolized by the flavin-containing monooxygenases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

St John's Wort

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. St John’s Wort is an inducer but is unlikely to affect molnupiravir. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Stanozolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Stanozolol is extensively hydroxylated and conjugated followed by renal excretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Streptokinase

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Like other proteins, streptokinase is metabolized proteolytically in the liver and eliminated via the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Streptomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Streptomycin is excreted rapidly in the urine by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sucralfate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Sucralfate is only minimally absorbed from the gastrointestinal tract. Sucralfate may reduce gastrointestinal absorption of other drugs and administering other orally administered drugs 2 hours before sucralfate could be considered.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sufentanil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sufentanil undergoes extensive CYP3A4 metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sulfadiazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro studies suggest that sulfadiazine is metabolized in part by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sulfadoxine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sulfadoxine is primarily cleared renally through glomerular filtration and is partly metabolized by CYP2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sulfasalazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Multiple mechanisms are thought to be involved in the metabolism of sulfasalazine including acetylation, hydroxylation, and glucuronidation and there is low potential for interactions with molnupiravir via modulation of, or competition for these metabolic pathways. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sulpiride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sulpiride is mainly excreted in the urine and faeces as unchanged drug. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sultiame

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of sultiame has been poorly characterised but it is thought to undergo moderate metabolism in the liver. Sultiame is an inhibitor of CYP2C9 and CYP2C19. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sumatriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sumatriptan is eliminated primarily by metabolism mediated by monoamine oxidase A. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Sunitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sunitinib is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Suvorexant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Suvorexant is metabolised predominantly by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Suxamethonium (Succinylcholine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Suxamethonium is hydrolysed by plasma cholinesterase. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tacrolimus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tacrolimus is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tadalafil (BPH)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tadalafil is predominantly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tadalafil (Erectile Dysfunction)

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tadalafil (Pulmonary Arterial Hypertension)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tadalafil is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Talazoparib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Talazoparib undergoes minimal hepatic metabolism and is primarily excreted renally via P-gp and BCRP. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tamoxifen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tamoxifen metabolism is mainly by CYP3A4 (to N-desmethyltamoxifen) and CYP2D6 (to 4-hydroxytamoxifen, an active metabolite); further metabolism of these by CYP3A4 and CYP2D6 results in the formation of endoxifen, which is thought to be the most important metabolite contributing to the pharmacologic activity of tamoxifen. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tamsulosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tamsulosin is metabolized mainly by CYP3A4 and to a lesser extent by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tapentadol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tapentadol is mainly glucuronidated by UGT1A6, UGT1A9 and UGT2B7. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tazobactam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tazobactam is only minimally metabolized and is eliminated renally via glomerular filtration and active secretion by OAT1/3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tecovirimat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tecovirimat is metabolized by hydrolysis (major) and glucuronidation by UGT1A1 and UGT1A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tegafur/ Gimeracil/ Oteracil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tegafur is metabolised to the active compound 5-fluorouracil by CYP2A6; gimeracil and oteracil are not metabolised by CYPs. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Teicoplanin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Teicoplanin is primarily excreted via urine as unchanged drug. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Telbivudine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Telbivudine is eliminated primarily via urinary excretion of the unchanged drug by passive diffusion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Telithromycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Telithromycin is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Telmisartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Telmisartan is mainly glucuronidated by UGT1A3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Temazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Temazepam is mainly glucuronidated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Temsirolimus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Temsirolimus is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tenapanor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tenapanor is minimally absorbed following oral administration and is eliminated mainly unchanged in the faeces. Limited metabolism to M1, an inactive metabolite, occurs by primarily by CYP3A4/5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tenofovir alafenamide (HBV)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tenofovir alafenamide is metabolized to tenofovir (major metabolite) by carboxylesterase-1 and cathepsin. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tenofovir-DF

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tenofovir disoproxil fumarate is eliminated renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tepotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tepotinib is metabolized by CYP3A4 and CYP2C8. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Terazosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Terazosin is extensively metabolized in the liver possibly via CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Terbinafine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Terbinafine is metabolized by CYPs 1A2, 2C9, 3A4 and to a lesser extent by CYPs 2C8 and 2C19. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Terbutaline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Terbutaline is eliminated primarily as sulfate and glucuronide conjugates with oral dosing and excreted mainly unchanged with inhalation dosing. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Teriflunomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Teriflunomide is moderately metabolised, primarily by hydrolysis, and eliminated mainly through direct biliary excretion of unchanged drug. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Testosterone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Testosterone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tetracaine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Absorbed tetracaine is predominantly metabolized by pseudocholinesterases in the plasma. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tetracyclines

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tetracyclines are eliminated unchanged primarily by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Thalidomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Thalidomide is cleared by non-enzymatic hydrolysis. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Theophylline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Theophylline is mainly metabolized by CYP1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Thiopental

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The isoenzymes involved in thiopental metabolism have not been identified. Although pentobarbital (a potent inducer of hepatic microsomal drug metabolism) is formed during thiopental metabolism, levels do not reach the therapeutic range. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Thioridazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Thioridazine is metabolized by CYP2D6 and to a lesser extent by CYP3A4. Thioridazine is a moderate inducer of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Thiotepa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Thiotepa is rapidly metabolised by CYP3A4 and CYP2B6 to the active alkylating metabolite TEPA. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tiagabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tiagabine is metabolized by CYP3A4/5. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tiapride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tiapride is excreted largely unchanged in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ticagrelor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ticagrelor undergoes extensive CYP3A4 metabolism and is only a mild inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ticlopidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ticlopidine is a prodrug, formation of the active metabolite involves CYP2D6, CYP2B6, CYP2C19, CYP1A2 (first step) and mainly CYP2B6 (second step. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tildrakizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tildrakizumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Timolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Timolol is predominantly metabolized by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tinidazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tinidazole is partly metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tinzaparin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tinzaparin is partially metabolised by desulfation and depolymerization, and then renally excreted. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tiotropium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tiotropium bromide is predominantly excreted unchanged in the urine. Metabolism by CYP2D6 and CYP3A4 is only a minor role in its elimination. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tirzepatide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tirzepatide is metabolized by proteolytic cleavage, therefore no metabolic interaction is expected. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Tirzepatide delays gastric emptying, and has the potential to impact the absorption of concomitantly administered oral medications. However, based on available interaction studies, a clinically relevant effect is not expected with molnupiravir.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tisotumab vedotin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tisotumab vedotin is an antibody-drug conjugate comprising a monoclonal antibody and monomethyl auristatin E (MMAE), a potent chemotherapeutic agent. The monoclonal antibody undergoes elimination via intracellular catabolism. MMAE is a substrate of CYP3A4 (and possibly CYP2D6) and P-gp. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tivozanib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tivozanib is metabolised mainly by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tixagevimab/ Cilgavimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tixagevimab and cilgavimab are IgG1 monoclonal antibodies and are likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tizanidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tizanidine is metabolized by CYP1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tobramycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tobramycin is not metabolised and is primarily eliminated unchanged by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tocilizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tocilizumab is an IL-6 receptor monoclonal antibody and likely undergoes elimination via binding to its target antigen. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tofacitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tofacitinib undergoes hepatic metabolism (70%) mainly by CYP3A4 and is eliminated renally (30%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tolbutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tolbutamide is mainly metabolized by CYP2C9, and to a lesser extent by CYPs 2C8 and 2C19. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tolterodine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tolterodine is primarily metabolised by CYP2D6 with CYP3A4 having a major role in CYP2D6 poor metabolisers. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tolvaptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tolvaptan is extensively metabolised in the liver almost exclusively by CYP3A. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Topiramate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Topiramate is mainly eliminated by renal elimination in unchanged form (up to 60% of the dose) and partly by oxidation. Weak induction of CYP isozymes has been observed with higher doses of topiramate. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Topotecan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Topotecan undergoes both hepatic and renal elimination. Hepatic elimination involves mainly non-enzymatic hydrolysis and, to a minor extent, CYP mediated N-demethylation as well as glucuronidation. Renal elimination is by both active secretion (mainly via OAT3) and glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Torasemide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Torasemide is metabolized mainly by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Toremifene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Toremifene is mainly metabolised by CYP3A4 to N-desmethyltoremifene. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tramadol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tramadol is metabolized by CYPs 3A4, 2B6, and 2D6. Metabolism by CYP2D6 is to a metabolite more potent than the parent compound. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trametinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trametinib is metabolised by non-CYP450 mediated deacetylation (major) and CYP3A4 (minor). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trandolapril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trandolapril is hydrolysed to trandolaprilat. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tranexamic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tranexamic acid is mainly cleared by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Tranylcypromine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tranylcypromine is hydroxylated and acetylated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trastuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trastuzumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trastuzumab emtansine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trastuzumab emtansine is a monoclonal antibody-drug conjugate. Trastuzumab does not undergo CYP mediated metabolism, whereas DM1 (an active component of emtansine) is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Travoprost

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Travoprost is hydrolysed by esterases to its biologically active free acid which is then metabolised to inactive metabolites. Drug-drug interactions are not anticipated. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trazodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trazodone is primarily metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trenbolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trenbolone is mainly excreted in urine as glucuronide conjugates. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Treprostinil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Treprostinil is mainly metabolized by CYP2C8 and to a lesser extent by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Triamcinolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Triamcinolone is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Triamterene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Triamterene is metabolized mainly by CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Triazolam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Triazolam is metabolized by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Triclabendazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Triclabendazole is primarily metabolised by CYP1A2 (approximately 64%) and to a lesser extent by CYPs 2C9, 2C19, 2D6 and 3A. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trifluridine/Tipiracil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trifluridine is mainly metabolised by TPase to form the inactive metabolite 5-(trifluoromethyl) uracil (FTY); tipiracil is not metabolised. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trimethoprim/Sulfamethoxazole (Co-trimoxazole)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trimethoprim is primarily eliminated by the kidneys through glomerular filtration and tubular secretion. Approximately 30% of trimethoprim is metabolized by CYPs (in vitro data suggest CYPs 3A4, 1A2 and 2C9). Sulfamethoxazole is metabolized by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trimipramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trimipramine is metabolized mainly by CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Triptorelin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Triptorelin metabolism in humans is unknown but possibly involves degradation by peptidases. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Trospium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trospium is minimally metabolized and is mainly eliminated unchanged renally, in part by OCT2. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Turmeric (Curcumin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Data from pharmacokinetic studies suggest that turmeric and curcuminoids (derived from turmeric extract) are unlikely to affect CYP or UGT mediated metabolism. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ubrogepant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ubrogepant is metabolized mainly by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ulipristal

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolic profiles of both drugs there is little potential for pharmacokinetic interaction. Ulipristal is metabolized mainly by CYP3A4 and to a lesser extent by CYPs 1A2 and 2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Umbralisib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Umbralisib is metabolized by CYP2C9, CYP3A4 and CYP1A2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Umeclidinium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Umeclidinium bromide is mainly metabolized by CYP2D6 and is a substrate of P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Upadacitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Upadacitinib is metabolized by CYP3A4 with a potential minor contribution from CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ursodeoxycholic acid (Ursodiol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ursodeoxycholic acid is conjugated with glycine or taurine in the liver and secreted into bile. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ustekinumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ustekinumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Valaciclovir (Valacyclovir)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Valaciclovir is converted to aciclovir which is eliminated renally via glomerular filtration and active renal secretion by OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Valerian

Quality of Evidence: Very Low

Summary:

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Valganciclovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Valganciclovir is rapidly hydrolysed to ganciclovir. Ganciclovir is primarily eliminated by the kidney and in vitro data suggest that it is a substrate of the renal transporter OAT1. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Valproate semisodium (Divalproex sodium)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Valproate semisodium (divalproex semisodium) is a stable coordination compound comprised of sodium valproate and valproic acid and dissociates to the valproate ion in the gastrointestinal tract. Valproate is mainly glucuronidated by UGTs 1A6, 1A9 and 2B7 and metabolized by CYP2C9 and CYP2C19. Valproate has no inducing effects on metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Valproic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Valproic acid circulates in plasma as the valproate ion. Valproate is mainly glucuronidated by UGTs 1A6, 1A9 and 2B7 and metabolized by CYP2C9 and CYP2C19. Valproate has no inducing effects on metabolism. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Valsartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Valsartan is eliminated unchanged mostly through biliary excretion. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vancomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vancomycin is excreted unchanged via renal glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vandetanib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vandetanib is primarily metabolised by CYP3A4, FMO1 and FMO3. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vardenafil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vardenafil is metabolized primarily by CYP3A4/5, and to a lesser degree by CYP2C9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Varenicline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Varenicline is eliminated unchanged by the kidneys via glomerular filtration and active tubular secretion by OCT2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vasopressin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vasopressin is predominantly metabolized in the liver and kidney by serine protease, carboxipeptidase and disulfide oxido-reductase. Only about 6% of the dose is excreted unchanged in urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vecuronium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vecuronium is partly deacetylated and partly cleared in the bile as the parent compound. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vedolizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vedolizumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vemurafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vemurafenib is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Venetoclax

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Venetoclax is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Venlafaxine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Venlafaxine is mainly metabolized by CYP2D6 and to a lesser extent by CYPs 3A4, 2C19 and 2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Verapamil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Verapamil is metabolized mainly by CYP3A4 and to a lesser extent by CYPs 1A2, 2C8 and 2C9. Verapamil is a moderate inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vigabatrin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vigabatrin is cleared mainly by glomerular filtration. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vilanterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vilanterol is metabolized by CYP3A4 and is a substrate of P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vilazodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vilazodone is metabolized mainly by CYP3A4 with minor contributions from CYP2C19 and CYP2D6. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vildagliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vildagliptin is inactivated via non-CYP mediated hydrolysis. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vilobelimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vilobelimab is an IgG4 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vinblastine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vinblastine is metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vincristine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vincristine is metabolized by CYP3A4/5. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vinorelbine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vinorelbine is metabolised by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin A (Retinol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vitamin A esters are hydrolysed by pancreatic enzymes to retinol, which is then absorbed and re-esterified. Some retinol is stored in the liver. Retinol not stored in the liver undergoes glucuronide conjugation and subsequent oxidation to retinal and retinoic acid. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin B1 (Thiamine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vitamin B1 is absorbed from the GI tract and is widely distributed to most body tissues. It is not stored to any appreciable extent in the body and amounts in excess of requirements are excreted in the urine as unchanged vitamin B1 or metabolites. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin B12 (Cyanocobalamin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vitamin B12 undergoes enterohepatic recycling and is excreted almost entirely in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin B2 (Riboflavin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vitamin B2 is absorbed from the GI tract and is bound to plasma proteins in the circulation. Although widely distributed, little is stored in the body, and amounts in excess of requirements are excreted in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin B3 (Niacin, nicotinic acid)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Physiologic amounts of vitamin B3 are metabolized to nicotinamide adenine dinucleotide. Some excess vitamin B3 is taken up by red blood cells to form a circulating reserve pool and any remaining excess is methylated and excreted in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin B6 (Pyridoxine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pyridoxine is absorbed from the GI tract and is converted to the active form pyridoxal phosphate. It is excreted in the urine as 4-pyridoxic acid. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin B7 (Biotin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Following absorption, vitamin B7 is stored in the liver, kidney and pancreas. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin C (Ascorbic Acid)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vitamin C is oxidised to dehydroascorbic acid where some is metabolised to oxalic acid and the inactive ascorbate-2-sulphate. Large doses are rapidly excreted in the urine when in excess of the requirements of the body. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin D2 (Ergocalciferol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of vitamin D2 occurs in the liver and kidneys and involves several CYP enzymes. Formation of active metabolites is by CYP2R1 and CYP27B1, with inactivation being by CYP24A1 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin D3 (Colecalciferol, cholecalciferol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of vitamin D3 occurs in the liver and kidneys and involves several CYP enzymes. Formation of active metabolites is by CYP2R1 and CYP27B1, with inactivation being by CYP24A1 and CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin E (Tocopherol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vitamin E is mostly slowly excreted in the bile and the remainder is eliminated in the urine as glucuronides of tocopheronic acid or other metabolites. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vitamin K (Phytomenadione)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of vitamin K is thought to involve CYP4F2 and glucuronidation. Renal elimination of vitamin K is minimal. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Voclosporin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Voclosporin is predominantly metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vorapaxar

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vorapaxar is metabolized by CYP3A4 and CYP2J2. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Voriconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Voriconazole is metabolized by CYPs 2C19, 2C9 and 3A4. Voriconazole is a strong inhibitor of CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Vortioxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vortioxetine is mainly metabolized by CYP2D6 and to a lesser extent by CYP2C9 and CYP3A4/5. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Warfarin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. Warfarin is a mixture of enantiomers which are metabolized by different cytochromes. R-warfarin is primarily metabolized by CYPs 1A2 and 3A4. S-warfarin (more potent) is metabolized by CYP2C9. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Although a pharmacokinetic interaction is not expected, more frequent INR monitoring may be appropriate in patients with COVID-19.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Whey protein

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Whey protein is rapidly digested and absorbed as essential amino acids for use in physiological processes. Excess whey protein can be excreted in the urine by the kidneys. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Xipamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Approximately 90% of xipamide is excreted in the urine, mainly as unchanged drug (50%) and glucuronides (30%). Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zaleplon

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zaleplon is mainly metabolized by aldehyde oxidase and to a lesser extent by CYP3A4. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zanamivir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zanamivir is not extensively metabolised and only a small amount of the orally inhaled drug is systemically absorbed. Absorbed zanamivir is excreted unchanged in the urine whereas unabsorbed zanamivir is excreted in the faeces. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zanubrutinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zanubrutinib is primarily metabolized by CYP3A4. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zidovudine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zidovudine is metabolized by UGT2B7 and UGT1A9. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zinc

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zinc is poorly absorbed from the gastro-intestinal tract. It is widely distributed throughout the body. It is excreted in the faeces with traces appearing in the urine. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Ziprasidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Approximately two-thirds of ziprasidone metabolic clearance are by reduction, with less than one third by CYP enzymes (mainly CYP3A4). Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zoledronic acid (Zoledronate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zoledronic acid is eliminated unchanged renally. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zolmitriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zolmitriptan is metabolized by CYP1A2 and the N-desmethylated metabolite (active) undergoes further metabolism by MAO-A. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zolpidem

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zolpidem is metabolized mainly by CYP3A4 and to a lesser extent by CYP2C9 and CYP1A2. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zonisamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zonisamide is metabolized partly by CYP3A4 and also by N-acetyl-transferases and conjugation. Zonisamide is a weak inhibitor of P-gp. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zopiclone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zopiclone is metabolized mainly by CYP3A4 and to a lesser extent by CYP2C8. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zotepine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zotepine is mainly metabolized by CYP3A4 and to a lesser extent by CYP1A2 and CYP2D6. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)

No Interaction Expected

Molnupiravir

Zuclopenthixol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zuclopenthixol is metabolized by sulphoxidation, N-dealkylation (by CYP2D6 and CYP3A4) and glucuronidation. Molnupiravir does not inhibit or induce CYPs and is unlikely to have significant drug-drug interactions with other therapies. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate.

Description:

(See Summary)