II. Indications

  1. Influenza
    1. Alternative to Oseltamivir (Tamiflu)

III. Mechanism

  1. Cap-dependent endonuclease inhibitor
  2. Some RNA Viruses (including Influenza) replicate via cap snatching
    1. Virus extracts first 15-20 of host RNA residues which is used as 5' cap on virus RNA
    2. Virus RNA polymerase has endonuclease functionality used in cap snatching

IV. Dosing

  1. One single oral dose

V. Efficacy

  1. May shorten Influenza symptoms by up to 1 day if started within 48 hours
  2. No evidence for benefit in high risk patients (under age 2, over age 65, pregnancy)

VI. Adverse Effects (in 1-3% of patients)

VII. Drug Interactions

  1. Agents that decrease absorption (e.g. calcium, aluminum or iron salts)

VIII. References

  1. (2018) Presc Lett 25(12): 67

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