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Favipiravir is an antiviral drug used in the treatment of mild to moderate cases of COVID-19. It functions by inhibiting the replication of the SARS-CoV-2 virus, which helps lower the viral load, curbs the progression of the disease, and promotes quicker recovery. It received approval from the USFDA on October 22, 2020.
BRAND NAME:
Favivir – It is available as film coated tablet contains Favipiravir 200mg as the main active ingredient.
MECHANISM OF ACTION:
Favipiravir is metabolized into ribosyl triphosphate, which is then converted into its active form, Favipiravir-RTP. This active form inhibits the enzyme essential for viral replication, thereby preventing the virus responsible for the infection from multiplying in the body.
PHARMACOKINETICS:
Absorption: The bioavailability of favipiravir is almost complete at 97.6%. The mean Cmax for the recommended dosing schedule of favipiravir is 51.5µg/ml.
Distribution: Favipiravir has an apparent volume of distribution ranging from 15 to 20 liters and exhibits approximately 54% binding to plasma proteins.
Metabolism: Favipiravir is metabolized in the liver by aldehyde oxidase and xanthine oxidase converts to its inactive hydroxylated metabolite.
Excretion: Favipiravir takes 2 -5 hours for elimination. It is mainly excreted through urine as inactive metabolites and renal excretion of unchanged drug is minimal.
PHARMACODYNAMICS:
Favipiravir functions as a prodrug and undergoes ribosylation and phosphorylation intracellularly to become the active favipiravir-RTP. Fvaipiravir –RTP binds to and inhibits RNA-dependent RNA polymerase, which ultimately prevents viral transcription and replication.
DOSAGE ANDADMINISTRATION:
Favipiravir is available in the form of oral suspension and tablets. Depending on the patient's condition and the severity of the infection the dose will be recommended.
For Covid-19, the recommended dose is,
- Day 1: 1600mg or 1800mg twice daily.
- Day 2 – 10: 600mg or 800mg twice daily.
- Duration: 7 -14 days depending on severity and clinical response.
For influenza, the recommended dose is
- Day 1: 1600mg twice daily
- Day 2 – 5: 600mg twice daily
- Duration: 5 days.
DRUG INTERACTIONS:
Some medicines should be avoided while taking favipiravir as these drugs can interact and cause severe adverse effects. Below are the few drugs that should be avoided while taking favipiravir.
- Anti-TB: Pyrazinamide
- Hyperglycaemic agent: Repaglinide
- Methylxanthines: Theophylline
- Anti-viral: Famciclovir, Acyclovir
- NSAID: Sulindac
CONTRAINDICATIONS:
Contraindicated in patients with known allergy to favipiravir or any of its components.
ADVERSE EFFECTS:
- Diarrhea
- Hyperuricemia
- Reduced neutrophil count
- Nausea
- Vomiting
- Abdominal pain
TOXICITY:
Taking overdose can cause toxic effects that lead to
- Seizures
- Death
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