Favipiravir is a nucleoside analogue developed and licensed in Japan for the treatment of influenza in emerging pandemics.
Prior to receiving an international non-proprietary name, favipiravir was designated by the developer index T-705. The first publications about the drug appeared in 2002.
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Favipiravir for the treatment of influenza is registered only in Japan, in other countries its applicability against influenza and other diseases is being investigated.
Favipiravir has been investigated as a possible treatment for SARS-CoV-2 and has been included in the treatment guidelines of some countries. In 2020, it is registered in the USA, Great Britain, Norway, Denmark, Germany, France, Russia, South Korea, Canada, Singapore and Thailand and is included in the list of vital and essential medicines of the Ministry of Health.
Mechanism of action
There are different opinions about the mechanism of action of favipiravir. Some researchers believe that favipiravir selectively inhibits viral RNA-dependent RNA polymerase. Other studies show that favipiravir induces lethal RNA transversion mutations, producing a nonviable viral phenotype by terminating the extension of the nascent RNA strand.
It is also believed that favipiravir in both oral and intravenous forms is a prodrug that is metabolized to its active form, favipiravir-ribofuranosyl-5'-triphosphate (favipiravir-RTP). The human hypoxanthine-guanine phosphoribosyltransferase (HGPRT) is believed to play a key role in its activation process.
Application in medicine
Favipiravir has been approved for the treatment of influenza in Japan. However, it is indicated only for new influenza (strains that cause more severe illness), and not for seasonal influenza. As of 2020, the likelihood of developing resistance appears to be low.
In the UK, USA, India, Philippines, South Africa and Australia, favipiravir is included in the recommendations for the treatment of COVID-19.