Oseltamivir.
Oseltamivir is available in the form of Oseltamivir Phosphate which is a prodrug. Prodrug means the initial form has no anti-viral effect and requires the enzyme esterase in the digestive tract to be replaced with Oseltamivir carboxylate which is the active form.
- Oseltamivir is used for the treatment of influenza type A and type B, H1N1 and H5N1 virus infections.
- The mechanism of action of Oseltamivir is as a neuraminidase inhibitor that can inhibit the release of influenza viruses that replicate from host cells and from cells that have been infected.
- In-vitro research shows neuraminidase inhibitors do not have antiviral activity in corona virus.
- Most of the literature does not use Oseltamivir, but in Indonesia Oseltamivir is given to Covid-19 patients and produces a fairly good response.
- The use of Oseltamivir for Covid-19 still needs to be studied.
- Oseltamivir is available in oral form.
Oseltamivir dose for influenza types A and B : 2 × 75 mg, for 5 days.
Oseltamivir side effects :
- Indigestion (nausea, discomfort in the abdomen, vomiting) that can be prevented by feeding. Food does not affect Oseltamivir levels in the blood.
- In patients with impaired kidney function, especially if creatinine clearance < 30 ml/min, Oseltamivir dosage adjustments are needed.
At present there are 3 studies that are still being processed about Oseltamivir for Covid-19 patients. Two in the form of clinical trial phase 3, one clinical trial phase 4.
Favipiravir.
Favipiravir is an anti-virus with the trademark Avigan. Favipiravir was first developed by Toyama Chemicals Japan. In 2014, Avigan obtained a marketing authorization as an anti-influenza virus in Japan.
- Favipiravir is also effective against the Ebola virus.
- Favipiravir/Avigan effectively and potentially inhibits the RNA-dependent RNA-polymerase (RdRp) virus, which in turn inhibits the polymerase from the virus.
- The use of Favipiravir is relatively safe, a preliminary study of Favipiravir / Avigan on 320 Covid-19 patients in China proves the efficacy and safety of the drug.
- Patients receiving Favipiravir therapy have a better pulmonary CT scan.
Favipiravir/Avigan is given for 14 days :
The first dose of 1600 mg tablets, 2 × daily ➡ followed by 600 mg tablets 2 × daily, on the 2nd day until the 14th day.
Favipiravir side effects :
- There were no serious side effects in patients given Favipiravir.
- Diarrhea.
- Decreased liver function.
Research on Favipiravir is still ongoing today in China. Studies of Favipiravir in Covid-19 patients to date have not been published.
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