Molnupiravir and EIDD-1931: personal experiences and recommendations

Overview

Feline infectious peritonitis (FIP) has evolved from a nearly universally fatal disease to one that is now treatable with antiviral therapy. As treatment options expand, veterinarians are increasingly faced with decisions regarding drug selection, dosing strategies, monitoring, management of adverse effects, and treatment of challenging cases. This lecture will provide a practical, evidence-based overview of the use of molnupiravir (EIDD-2801) and its active metabolite EIDD-1931 for the treatment of FIP. Drawing on published clinical evidence and extensive personal clinical experience, attendees will gain practical recommendations for making decisions when to use molnupiravir or EIDD-1931, initiating therapy, monitoring response, managing relapses and adverse effects, and optimizing outcomes across effusive, non-effusive, neurological, and ocular forms of FIP. Recent clinical trials have demonstrated encouraging efficacy for both compounds while also highlighting important differences in adverse-effect profiles and clinical response.

Learning Objectives

By the end of this lecture, participants will be able to:

Describe the pharmacology and mechanisms of action of molnupiravir (EIDD-2801) and EIDD-1931 in the treatment of feline infectious peritonitis.
Apply evidence-based dosing protocols and monitoring strategies for cats with effusive, non-effusive, neurological, and ocular FIP.
Recognize expected treatment responses, laboratory changes, adverse effects, and indications for dose adjustments or retreatment.
Develop practical treatment plans based on published evidence and real-world clinical experience to maximize treatment success and manage challenging or relapsing cases.