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Ninervir (Ninervir-200) is an oral generic version of molnupiravir, a nucleoside analogue prodrug developed for the treatment of COVID-19. It is metabolized to the active ribonucleoside analog N4-hydroxycytidine (NHC), which is then phosphorylated to NHC-triphosphate. This active form is incorporated into viral RNA by the SARS-CoV-2 RNA-directed RNA polymerase (RdRp), leading to an accumulation of mutations in the viral genome, a process known as viral error catastrophe or lethal mutagenesis. This mechanism effectively inhibits viral replication. Ninervir is marketed by Niner Pharmaceuticals as a treatment for mild-to-moderate COVID-19 in adults at high risk for progression to severe disease.
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