Molnupiravir should be avoided in which population due to mutagenic concerns?

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Molnupiravir is a ribonucleoside analog that induces mutations in viral RNA to stop replication, but this same mutagenic mechanism raises concerns about effects on developing fetal cells. Because a fetus is especially vulnerable to DNA/RNA alterations, avoiding this drug during pregnancy is essential unless a clearly proven benefit outweighs the potential risk. Animal studies have shown fetal harm with mutagenic exposure, and human data are limited, so labeling recommends against use in pregnancy and cautions use around conception and during pregnancy. The other groups (renal impairment, children under 12, breastfeeding) lack this specific fetal mutagenicity concern as the primary risk driver, making pregnancy the best answer.