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Molnupiravir Resources

Resources

Background Information

Molnupiravir Patient Selection Criteria

Order Forms and Fact Sheets

Molnupiravir Treatment Order Form
(Order form template that can be used to check for treatment eligibility of symptomatic patients and document ordering the drug in your medical records)

Molnupiravir Medical Director Standing Order Template
(Standing order template that can be used by facility Medical Directors)

Molnupiravir Fact Sheet for Patients and Caregivers
(Patient fact sheet that must be printed and given to the patient or caregiver prior to or at the time of oral administration)

Molnupiravir Fact Sheet for Healthcare Providers
(Fact sheet aimed at providers that contains drug information and answers to other commonly asked questions)

Contact Information

For any questions regarding monoclonal antibodies, Paxlovid, molnupiravir or the request process, please contact Andrew Watkins at Anwatkins@nebraskamed.com or Mounica Soma at msoma@nebraskamed.com

Page last reviewed: April 13, 2022