Description

Simple

A medication used to treat the flu.

Clinical

An antiviral used to manage influenza, and that has the potential to target other viral infections.

Overview

Discovered by Toyama Chemical Co., Ltd. in Japan, favipiravir is a modified pyrazine analog that was initially approved for therapeutic use in resistant cases of influenza.[7,9] The antiviral targets RNA-dependent RNA polymerase (RdRp) enzymes, which are necessary for the transcription and replication of viral genomes.[7,12,Read more

Pharmacology

Indication

In 2014, favipiravir was approved in Japan to treat cases of influenza that were unresponsive to conventional treatment.[ Read more

Pharmacodynamic

Favipiravir functions as a prodrug and undergoes ribosylation and phosphorylation intracellularly to become the active favipiravir-RTP.[ Read more

Mechanism of action

The mechanism of action of favipiravir is novel compared to existing influenza antivirals that primarily prevent entry and exit of the virus from cells.[ Read more

Absorption

The bioavailability of favipiravir is almost complete at 97.6%.[18] The mean Cmax for the recommended dosing schedule of favipiravir is 51.5 ug/mL.[ Read more

Protein binding

Favipiravir is 54% plasma protein-bound.[9] Of this fraction, 65% is bou... Read more

Volume of distribution

The apparent volume of distribution of favipiravir is 15 - 20 L.[ Read more

Clearance

The recommended oral dosing regimen for favipiravir is as follows: Day 1: 1600 mg twice daily; Days 2-5: 600 mg twice daily.[18]The reported CL/F for favipirav... Read more

Half life

The elimination half-life of favipiravir is estimated to range from 2 to 5.5 hours.[ Read more

Route of elimination

Favipiravir's metabolites are primarily renally cleared.[9]

Toxicity

Based on single-dose toxicity studies, the lethal dose for oral and intravenous favipiravir in mice is estimated to be >2000 mg/kg.[18] In rats, the lethal dos... Read more

Adverse Effects

Contraindications

  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Regions: US
  • Patient Conditions:
      • Name: Pregnancy
      • Drugbank Id: DBCOND0018394
  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Regions: US
  • Patient Conditions:
      • Name: Possible Pregnancy
      • Drugbank Id: DBCOND0127087

Food Interactions

    Information currently not available.

Interactions

Type in a drug name to check for interaction with Favipiravir
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(R)-warfarin
The metabolism of (R)-warfarin can be decreased when combined with Favipiravir.
(S)-Warfarin
The metabolism of (S)-Warfarin can be decreased when combined with Favipiravir.
Acetyldigoxin
Favipiravir may decrease the excretion rate of Acetyldigoxin which could result in a higher serum level.
Acyclovir
The excretion of Acyclovir can be decreased when combined with Favipiravir.
Adefovir dipivoxil
The excretion of Adefovir dipivoxil can be decreased when combined with Favipiravir.
Afatinib
The serum concentration of Afatinib can be increased when it is combined with Favipiravir.
Allopurinol
The excretion of Allopurinol can be decreased when combined with Favipiravir.
Almotriptan
The metabolism of Almotriptan can be decreased when combined with Favipiravir.
Alprostadil
The excretion of Alprostadil can be decreased when combined with Favipiravir.
Ambrisentan
The serum concentration of Ambrisentan can be increased when it is combined with Favipiravir.
Aminohippuric acid
The excretion of Aminohippuric acid can be decreased when combined with Favipiravir.
Aminophenazone
The metabolism of Aminophenazone can be decreased when combined with Favipiravir.
Amiodarone
The metabolism of Amiodarone can be decreased when combined with Favipiravir.
Amitriptyline
The metabolism of Amitriptyline can be decreased when combined with Favipiravir.
Amodiaquine
The metabolism of Amodiaquine can be decreased when combined with Favipiravir.
Anastrozole
The metabolism of Anastrozole can be decreased when combined with Favipiravir.
Antipyrine
The metabolism of Antipyrine can be decreased when combined with Favipiravir.
Apalutamide
The metabolism of Apalutamide can be decreased when combined with Favipiravir.
Apixaban
The serum concentration of Apixaban can be increased when it is combined with Favipiravir.
Atorvastatin
The metabolism of Atorvastatin can be decreased when combined with Favipiravir.
19 References
  1. 1 . Beigel J, Bray M: Current and future antiviral therapy of severe seasonal and avian influenza. Antiviral Res. 2008 Apr;78(1):91-102. doi: 10.1016/j.antiviral.2008.01.003. Epub 2008 Feb 4.PubMed: 18328578
  2. 2 . Hsieh HP, Hsu JT: Strategies of development of antiviral agents directed against influenza virus replication. Curr Pharm Des. 2007;13(34):3531-42.PubMed: 18220789
  3. 3 . Gowen BB, Wong MH, Jung KH, Sanders AB, Mendenhall M, Bailey KW, Furuta Y, Sidwell RW: In vitro and in vivo activities of T-705 against arenavirus and bunyavirus infections. Antimicrob Agents Chemother. 2007 Sep;51(9):3168-76. Epub 2007 Jul 2.PubMed: 17606691
  4. 4 . Sidwell RW, Barnard DL, Day CW, Smee DF, Bailey KW, Wong MH, Morrey JD, Furuta Y: Efficacy of orally administered T-705 on lethal avian influenza A (H5N1) virus infections in mice. Antimicrob Agents Chemother. 2007 Mar;51(3):845-51. Epub 2006 Dec 28.PubMed: 17194832
  5. 5 . Furuta Y, Takahashi K, Kuno-Maekawa M, Sangawa H, Uehara S, Kozaki K, Nomura N, Egawa H, Shiraki K: Mechanism of action of T-705 against influenza virus. Antimicrob Agents Chemother. 2005 Mar;49(3):981-6.PubMed: 15728892
  6. 6 . Furuta Y, Takahashi K, Fukuda Y, Kuno M, Kamiyama T, Kozaki K, Nomura N, Egawa H, Minami S, Watanabe Y, Narita H, Shiraki K: In vitro and in vivo activities of anti-influenza virus compound T-705. Antimicrob Agents Chemother. 2002 Apr;46(4):977-81.PubMed: 11897578
  7. 7 . Furuta Y, Komeno T, Nakamura T: Favipiravir (T-705), a broad spectrum inhibitor of viral RNA polymerase. Proc Jpn Acad Ser B Phys Biol Sci. 2017;93(7):449-463. doi: 10.2183/pjab.93.027.PubMed: 28769016
  8. 8 . Venkataraman S, Prasad BVLS, Selvarajan R: RNA Dependent RNA Polymerases: Insights from Structure, Function and Evolution. Viruses. 2018 Feb 10;10(2). pii: v10020076. doi: 10.3390/v10020076.PubMed: 29439438
  9. 9 . Hayden FG, Shindo N: Influenza virus polymerase inhibitors in clinical development. Curr Opin Infect Dis. 2019 Apr;32(2):176-186. doi: 10.1097/QCO.0000000000000532.PubMed: 30724789
  10. 10 . Madelain V, Nguyen TH, Olivo A, de Lamballerie X, Guedj J, Taburet AM, Mentre F: Ebola Virus Infection: Review of the Pharmacokinetic and Pharmacodynamic Properties of Drugs Considered for Testing in Human Efficacy Trials. Clin Pharmacokinet. 2016 Aug;55(8):907-23. doi: 10.1007/s40262-015-0364-1.PubMed: 26798032
  11. 11 . Nguyen TH, Guedj J, Anglaret X, Laouenan C, Madelain V, Taburet AM, Baize S, Sissoko D, Pastorino B, Rodallec A, Piorkowski G, Carazo S, Conde MN, Gala JL, Bore JA, Carbonnelle C, Jacquot F, Raoul H, Malvy D, de Lamballerie X, Mentre F: Favipiravir pharmacokinetics in Ebola-Infected patients of the JIKI trial reveals concentrations lower than targeted. PLoS Negl Trop Dis. 2017 Feb 23;11(2):e0005389. doi: 10.1371/journal.pntd.0005389. eCollection 2017 Feb.PubMed: 28231247
  12. 12 . de Farias ST, Dos Santos Junior AP, Rego TG, Jose MV: Origin and Evolution of RNA-Dependent RNA Polymerase. Front Genet. 2017 Sep 20;8:125. doi: 10.3389/fgene.2017.00125. eCollection 2017.PubMed: 28979293
  13. 13 . Shu B, Gong P: Structural basis of viral RNA-dependent RNA polymerase catalysis and translocation. Proc Natl Acad Sci U S A. 2016 Jul 12;113(28):E4005-14. doi: 10.1073/pnas.1602591113. Epub 2016 Jun 23.PubMed: 27339134
  14. 14 . Nagata T, Lefor AK, Hasegawa M, Ishii M: Favipiravir: a new medication for the Ebola virus disease pandemic. Disaster Med Public Health Prep. 2015 Feb;9(1):79-81. doi: 10.1017/dmp.2014.151. Epub 2014 Dec 29.PubMed: 25544306
  15. 15 . Rosenke K, Feldmann H, Westover JB, Hanley PW, Martellaro C, Feldmann F, Saturday G, Lovaglio J, Scott DP, Furuta Y, Komeno T, Gowen BB, Safronetz D: Use of Favipiravir to Treat Lassa Virus Infection in Macaques. Emerg Infect Dis. 2018 Sep;24(9):1696-1699. doi: 10.3201/eid2409.180233. Epub 2018 Sep 17.PubMed: 29882740
  16. 16 . Delang L, Abdelnabi R, Neyts J: Favipiravir as a potential countermeasure against neglected and emerging RNA viruses. Antiviral Res. 2018 May;153:85-94. doi: 10.1016/j.antiviral.2018.03.003. Epub 2018 Mar 7.PubMed: 29524445
  17. 17 . Nature Biotechnology: Coronavirus puts drug repurposing on the fast track Link
  18. 18 . Pharmaceuticals and Medical Devices Agency: Avigan (favipiravir) Review Report Link
  19. 19 . World Health Organization: Influenza (Avian and other zoonotic) Link