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Zabek, Magdalene ; Western University,2024.
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Abstract: Molnupiravir and nirmatrelvir are effective COVID-19 therapeutics, however there is limited data on their safety during pregnancy. The objective is to quantify the placental transfer of nirmatrelvir and β-D-N4-hydroxycytidine (NHC), the metabolite of molnupiravir found in plasma. A systematic review on the pharmacokinetics of nirmatrelvir found no data in pregnant subjects, though several studies reported parameters in non-pregnant individuals such as CL, VD, and fu. Using the ex vivo human placental perfusion model, nirmatrelvir showed a fetal-maternal concentration ratio (F:M) of 0.34 at therapeutic doses (2.21 μg/mL) and 0.46 (22.1 μg/mL) at supratherapeutic doses. Adjusted F:M for non-placental physiological factors ranged from 0.26-0.35 (2.21 μg/mL) and 0.38-0.51 (22.1 μg/mL). For NHC, the F:M was (2.97μg/mL) and (29.7 μg/mL). Results suggest that therapeutic and supratherapeutic doses of nirmatrelvir and NHC can passively cross the placental barrier. This data can be considered to create better safety recommendations regarding their use in pregnancy.
Keywords: COVID-19 ; placental perfusion ; pregnancy ; nirmatrelvir ; molnupiravir ; pharmacokinetics ; placental transfer ; drug safety ; nucleoside analogue ; main protease inhibitor
Purchased from AmBeed: 3258-02-4 ; 155213-67-5
CAS No. : | 3258-02-4 | MDL No. : | |
Formula : | C9H13N3O6 | Boiling Point : | - |
Linear Structure Formula : | - | InChI Key : | XCUAIINAJCDIPM-XVFCMESISA-N |
M.W : | 259.22 | Pubchem ID : | 197020 |
Synonyms : |
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Chemical Name : | 1-((2R,3R,4S,5R)-3,4-Dihydroxy-5-(hydroxymethyl)tetrahydrofuran-2-yl)-4-(hydroxyimino)-3,4-dihydropyrimidin-2(1H)-one |
Signal Word: | Danger | Class: | 4.1 |
Precautionary Statements: | P240-P210-P241-P264-P280-P302+P352-P370+P378-P337+P313-P305+P351+P338-P362+P364-P332+P313 | UN#: | 1325 |
Hazard Statements: | H315-H319-H228 | Packing Group: | Ⅱ |
GHS Pictogram: |