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Fracture healing is a process in which many factors interact. In addition to many treatments, physical and biological therapy methods that affect different steps of this process, there are many biological and chemical agents that cause fracture union delay. Although the number of studies on fracture healing is increasing day by day, the mechanism of fracture healing, which is not fully understood, still attracts the attention of all researchers. In this study, we aimed to investigate the effects of favipiravir and hydroxychloroquine used in the treatment of COVID-19. In this study, 48 male Wistar rats weighing 300 ± 50 g were used. Each group was divided into eight subgroups of six rats each to be sacrificed at the 2nd and 4th weeks and evaluated radiologically and histologically. Favipiravir (group 1), hydroxychloroquine (group 2), favipiravir + hydroxychloroquine (group 3), and random control (group 4) were used. A statistically significant difference was observed between the 15th day histological scoring averages of the groups (p < 0.05). Although there was no statistically significant difference between the 15th day radiological score distributions of the groups (p > 0.05), we obtained different results in terms of complete bone union distributions and radiological images of the fracture line. Although favipiravir has a negative effect on fracture union in the early period, favipiravir may have a positive effect on fracture union in the late period. We did not find any effect of hydroxychloroquine on fracture union. [ABSTRACT FROM AUTHOR]

In this study, the ionization constant (pKa) of favipiravir was determined using both green and the traditional RPLC methods. To determine these values, acetonitrile‐water and methanol‐water mixtures were used in the traditional RPLC methods, while ethanol‐water and micellar solvent‐free mixtures were used in the green RPLC methods. The pKa value of favipiravir was calculated by evaluating the chromatographic data obtained in the investigated hydro‐organic and micellar solvent‐free mixtures using two different calculation methods. In the determination of their pKa values in water wwpKa ${\left({}_{w}{}^{w}{pK}_{a}\right)}$ from the pKa values sspKa ${\left({}_{s}{}^{s}{pK}_{a}\right)}$ of the investigated compounds determined in hydro‐organic mixtures, the relationship between some macroscopic values of acetonitrile, methanol, ethanol and the sspKa ${{}_{s}{}^{s}{pK}_{a}}$ values was used, while the wwpKa ${{}_{w}{}^{w}{pK}_{a}}$ values of the compounds could be determined directly in micellar solvent‐free mobile phases. It was found that the directly and indirectly calculated wwpKa ${{}_{w}{}^{w}{pK}_{a}}$ values were quite compatible with each other. Using the wwpKa ${{}_{w}{}^{w}{pK}_{a}}$ value calculated for favipiravir, the ionization percentages at different pH values (1–12) were calculated by the Henderson‐Hasselbalch equation. The environmental impact of the RPLC methods used in this study was assessed using the Green Metrics tools GAPI and AGREE. [ABSTRACT FROM AUTHOR]

Introduction: Favipiravir (FVP) is an antiviral, targeting RNA-dependent RNA polymerase. We aimed to evaluate the efficacy of FVP as a treatment for COVID-19. Methods: We conducted a retrospective study in two centers (San Martino University Hospital in Genova, Italy, and Marmara University Pendik Training and Research Hospital, Turkey). Adult patients (inpatients) diagnosed with COVID-19 between March and June 2020 were included. All patients in the Italian center received the standard of care (SoC) treatment, while in the Turkish center patients received FVP in addition to SoC. Results: Six hundred-nineteen patients were analyzed (225 from Turkey, all treated with FVP, and 394 from Italy, none treated with FVP). Propensity score-matching was done in 142 patients (71 from the SoC group vs. 71 from the SoC + FVP group). A Higher requirement of NIV/CPAP (n = 38; 53.5%) was registered in the SoC group compared to the SoC + FVP group (n = 9; 12.7%). A higher frequency of intubation was registered in the SoC + FVP group (n = 25; 35.2% vs n = 13, 18.3%). There was a trend towards better survival in SoC + FVP treated patients with HR = 0.64 (95% CI 0.30-1.34). At 28 days the OS was, respectively, 70.3% (95% CI: 53.2-82.1) vs 80.3% (95% CI: 69.0-87.8). Conclusions: The addition of FVP to SoC did not show a significant difference in survival and invasive and noninvasive (CPAP/NIMV) mechanical ventilation compared to standard of care in moderate and severe COVID-19-infected patients. [ABSTRACT FROM AUTHOR]

Favipiravir is a nucleoside analogue antiviral drug and inhibits the replication of many RNA viruses, especially influenza viruses. Favipiravir has also been used to treat patients with mild to moderate COVID-19 disease. However, various side effects, including neurological side effects, have been reported related to the use of favipiravir. Therefore, in this study, we aimed to investigate the possible effects of favipiravir alone or in combination with vitamin C on aged rats' brain tissue and the possible mechanisms of these effects. A total of 30 rats used in the study were randomly divided into 5 equal groups and the first group was kept as the control group. High-dose (100 mg/kg) or low-dose (20 mg/kg) favipiravir was administered alone or in combination with vitamin C (150 mg/kg) to other groups. Administration of both high and low doses of favipiravir significantly increased TBARS levels in brain tissue of aged rats. Similarly, both high and low doses of favipiravir led to significant increases in Bcl-2 and caspase-3 relative mRNA expression. However, only low dose favipiravir caused a significant increase in iNOS and IL-1β relative mRNA expression levels. Similar results were also observed in histopathological examinations. However, co-administration of vitamin C with favipiravir attenuated some of the adverse effects of favipiravir. In conclusion, in this study, it was shown that the use of favipiravir caused some adverse effects through oxidative, inflammatory and apoptotic processes in the brain tissue of aged rats, and the potential of vitamin C to alleviate these effects. [ABSTRACT FROM AUTHOR]

This work wants to investigate the potential of Cu-Si52, Cu-C52, Cu-Al26N26, Cu-doped nanotubes (6, 0) to adsorb and deliver the Favipiravir as COVID-19 drug by DSD-PBEPBE-D3/aug-cc-pVDZ method. This work aims to propose the suitable materials for drug delivery of Favipiravir as COVID-19 drug. Results indicated that the Cu adoption can be increased the stability of Si52, C52, Al26N26, SiNT (6, 0), CNT (6, 0) and AlNNT (6, 0), significantly. The ΔGadsorption of complexes of Favipiravir with Cu-Si52, Cu-C52, Cu-Al26N26, Cu-doped nanotubes (6, 0) are -3.14, -3.25, -3.40, -3.89, -4.03 and -4.13 eV, respectively. The recovery time (τ) values of complexes of Favipiravir with Cu-Si52, Cu-C52, Cu-Al26N26, Cu-doped nanotubes (6, 0) in gas phase are 50.0, 51.8, 55.0, 56.3, 58.3 and 63.0 s. The Cu-AlNNT (6, 0) and Cu-Al26N26 have higher recovery time (τ) than Cu-Si52, Cu-C52, Cu-doped nanotubes (6, 0). Results shown that the Cu-Si52, Cu-C52, Cu-Al26N26, Cu-doped nanotubes (6, 0) have higher capacitates and abilities to deliver and transfer of the Favipiravir than other nanostructures in previous works. Finally, the Cu-AlNNT (6, 0) and Cu-CNT (6, 0) are proposed as acceptable structures to deliver and transfer of Favipiravir as drug of Coronavirus disease. [ABSTRACT FROM AUTHOR]

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INTRODUCTION. The risk of liver damage correlates with the severity of COVID-19. However, a growing number of studies have shown an association between liver function impairment and combinations of medicinal products used to treat COVID-19.AIM. The study aimed to analyse the annual consumption of medicinal products associated with a high risk of drug-induced liver injury (DILI) used as part of combination therapy in COVID-19 patients and to review a number of medication administration records in order to develop measures to prevent DILI.MATERIALS AND METHODS. The study used the ATC/DDD methodology to study consumption data for 2020, 2021, and 2022 and analysed a sample of 1250 inpatient medical records and medication administration records of COVID-19 patients treated in a Volgograd region hospital converted into a COVID-19 care centre. For genetically engineered biologicals and cyclophosphamide, which were lacking DDDs, the authors calculated the volume of consumption using the average dose per treatment course. The authors identified medicines capable of causing clinically apparent liver damage (according to the LiverTox database and Russian clinical practice guidelines) and/or elevated liver enzymes in ≥1% of patients (according to safety reports).RESULTS. The study found that 28% of the medicinal products used in combination for inpatient treatment of COVID-19 were associated with a high risk of DILI. In 2020, 2021, and 2022, the total consumption of medicinal products associated with a high risk of DILI was 342.3, 425.3, and 402.3 DDDs per 100 bed days, and the total consumption of genetically engineered biologicals (administered as a single dose) and cyclophosphamide was 3.5, 16.9, and 29.7 average course doses per 100 patients, respectively. According to the selective analysis of medical records, 19.8% (247/1250) reported concomitant use of 5 or more medicinal products associated with a high risk of DILI, which increased the risk of adverse drug interactions leading to DILI. In 2022, the most prescribed medicinal products with a high risk of DILI were omeprazole (188.7 DDDs per 100 bed days), non-steroidal anti-inflammatory drugs and paracetamol (54.4 DDDs per 100 bed days), atorvastatin (46.2 DDDs per 100 bed days), levofloxacin (26.4 DDDs per 100 bed days), ceftriaxone (20.5 DDDs per 100 bed days), favipiravir (17.3 DDDs per 100 bed days), and genetically engineered biologicals (24.0 DDDs per 100 bed days).CONCLUSIONS. To reduce the risk of DILI in COVID-19 patients admitted to infectious disease units, including the risk of DILI due to drug interactions, it is necessary to limit the use of hepatotoxic antibacterial agents, proton-pump inhibitors, and non-steroidal anti-inflammatory drugs, or consider alternative medicinal products with a lower risk of hepatotoxicity.

Abstract In this study, Density-functional theory/Time-dependent density-functional theory (DFT/TDDFT) and Molecular docking method was used to investigate the effect of methyl acetate, tetrahydrofuran and cyanobenzylidene substituents on the electronic structure and antiviral activity of favipiravir for treating COVID-19. The DFT and TDDFT computations were employed using the Gaussian 09 software package. The values were calculated using the 6-311++G(d, p) basis set and the hybrid B3LYP functional method. Autodock vina software was used for simulations to better predictions and to validate the modified compounds' binding affinities and poses. Results of the study indicate that compounds 1 to 6 all displayed a planar structure, where the pyrazine ring, carboxamide, hydroxyl groups, and other substituents are all situated within the same plane. In addition, the energy gaps (Egap) of these six compounds (Cpd 1, 2, 3, 4, 5, and 6) were compared. The significant dipole moment and binding affinity achieved implies a particular orientation for binding within the target protein, signaling the anticipated strength of the binding interaction. In all six compounds, the electrophilic domain is situated in the vicinity of the amine functional group within the carboxamide compound, whereas the nucleophilic domain encompasses both the carbonyl and hydroxyl groups. The most negatively charged sites are susceptible to electrophilic interactions. In conclusion, compounds 5 and 6 exhibit a high binding affinity of the target protein, while compound 6 has a high energy gap, which could enhance its antiviral activity against the COVID-19 virus.

Background. The COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, originated in Wuhan, China, has claimed millions of lives around the world. In this regard, the search for effective drugs, including the repurposing of existing ones, has become an urgent task. A promising treatment strategy appears to be drug disruption of viral reproduction. RNA-dependent RNA polymerase (RdRp) is the central subunit of the RNA synthesis process for all positive-strand RNA viruses and is therefore an attractive target for antiviral inhibitors.The aim of this work is an experimental study of the antiviral activity of various drugs based on 6-fluoro-3-hydroxy-2-pyrazinecarboxamide (Favipiravir) in vitro and in vivo against the SARS-CoV-2 coronavirus (COVID-19).Material and methods. The experiments were carried out on a permanent culture of African green monkey kidney cells — Vero Cl008. The effectiveness of the drugs was assessed by suppressing the reproduction of the virus in vitro. Biological activity was assessed by titration of the virus-containing suspension in Vero Cl008 cell culture by the formation of negative colonies. Syrian golden hamsters orally infected with the SARS-CoV-2 virus, variant B, were used in the study. The effectiveness of the drug was assessed by the coefficient of therapeutic action.Results. The results of the study revealed that the compounds FP-1 and Avifavir in the concentration range of 100–400 µg/ml almost completely suppress the reproduction of the SARS-CoV-2 virus; the CTI index for the drug FP-1 was 4, for Avifavir it was 2. The ED₅₀ value for FP-1 was 26 µg/ml, for Avifavir it was 36 µg/ml. Preparations T-705 and Coronavir revealed antiviral activity only at extremely high concentrations. The CTI was 1. During the study on Syrian golden hamsters orally infected with the SARS-CoV-2 virus, variant B, at a dose of 5×105 PFU, it was shown that the use of Avifavir and FP-1 has a high protective efficacy, while Coronavir and T-705 cause a moderate suppression of virus reproduction in the target organ. According to the complex of clinical-virological, biochemical, and hematological indicators, the disease severity index (DSI) and the therapeutic index (TI) were calculated. For the drug Avifavir, the DSI was 0.269; the TI was 71.3% with a probability of 99.9%.Conclusion. Of the studied compounds, Avifavir and FP-1 showed the highest antiviral activity.

Background The pharmacokinetics of oral favipiravir and the relationships of plasma concentrations to antiviral effects are incompletely studied in influenza. Methods Serial plasma samples were collected from adults with uncomplicated influenza who were randomized to favipiravir (1800 mg twice a day on day 1, 800 mg twice a day on days 2 to 5; n = 827) or placebo (n = 419) in 2 phase 3 trials. Post hoc analyses assessed the frequency of reaching an average minimum concentration (Cmin) ≥20 µg/mL, its association with antiviral efficacy, and factors associated with reduced favipiravir exposure. Results Wide interindividual variability existed in favipiravir concentrations, and this regimen failed to reach an average Cmin > 20 µg/mL in 41%–43% of participants. Those attaining this threshold showed greater reductions in nasopharyngeal infectious virus titers on treatment days 2 and 3 and lower viral titer area under the curve compared to those who did not. Those with average Cmin <20 µg/mL had over 2-fold higher mean ratios of the metabolite T-705M1 to favipiravir, consistent with greater metabolism, and were more likely to weigh > 80 kg (61.5%–64%). Conclusions Higher favipiravir levels with average Cmin > 20 µg/mL were associated with larger antiviral effects and more rapid illness alleviation compared to placebo and to favipiravir recipients with lower average Cmin values in uncomplicated influenza. Clinical Trials Registration. NCT1068912 and NCT01728753. [ABSTRACT FROM AUTHOR]

Background and Aims: Favipiravir (FAV) is one of the active pharmaceutical ingredients used in the treatment of patients suffering from Covid-19. The epidemic started in 2019 and is still continuing all over the world. In this study, an analysis method was developed and validated for the simultaneous analysis of FAV and its degradation impurities. Methods: The stationary phase of the developed method was determined using Kinetex® EVO C18 column and the mobile phase was pH 3.0 phosphate buffer:acetonitrile (90:10; v/v). Chromatographic separations were carried out at 30°C column temperature and samples were monitored by a UV-Visible detector with a wavelength of 222 nm at 0.5 mL/min flow rate. Results: Total analysis time was 25 minutes; FAV retention time was approximately 9 minutes. The retention times of major impurities formed under alkaline, acidic, oxidative conditions were observed at about 4, 5, 7 and,12 minutes (RRT 0.51, 0.54, 0.76, 1.31), respectively. According to the validation data, the linearity range was obtained as 0.030 – 0.750 μg/mL, the limit of quantitation and the limit of detection were 0.030 μg/mL and 0.010 μg/mL, respectively. Percentage relative standard deviation values obtained in intra-day and between day repeatability studies were determined as 0.17% and 0.28%, respectively, and the average recovery value was found to be 99.46%. Conclusion: This validated method has been successfully applied to the determination of all possible degradation impurities of FAV that increase under stress conditions such as high temperature, humidity and photodegradation from tablet form. The developed HPLC method is extremely suitable for the routine analysis of this drug used in the treatment of the Covid-19 disease, especially in terms of speed and convenience. [ABSTRACT FROM AUTHOR]

The antiviral agents, Favipiravir (FAV) and Remdesivir (REM), were introduced in the last few years alone or as combination regimen for successful management of the rapidly spreading CORONA virus pandemic. A newly developed rapid and sensitive high performance liquid chromatographic method (HPLC) has been developed for the simultaneous determination of their mixture. Firstly, one factor at a time optimization (OFAT) has been applied. Afterwards, quality by design approach (QbD) has been utilized using Box Behnken experimental design (BBD) for the development of an experimental design of four independent and nine dependent variables for much better refining of the optimized parameters. The established model has given an optimum resolution at; acetonitrile percentage of 52.66, mobile phase of pH 2.91, percentage of triethylamine of 0.15 and 1.30 mL/min flow rate. The proposed method has been validated according to the USP 31 NF 26 guidelines. Good linearity ranges have been obtained from 5.00 up to 50.00 μg/mL for FAV and from 2.00 up to 60.00 μg/mL for FAV and REM, respectively. Excellent relative standard deviation values (not more than 1.40) were obtained upon investigation of accuracy, precision and robustness. The developed method has succeeded in analysis of investigated drugs in their pharmaceutical formulations and spiked plasma samples with good recoveries of 99.00 and up to 106.00%. The proposed method is considered eligible for the quality control laboratories as well as in‐vivo determinations of both analytes. A rapid and sensitive HPLC method was developed to determine Favipiravir (FAV) and Remdesivir (REM) simultaneously. The method was optimized using one factor at a time optimization (OFAT) and quality by design approach (QbD) with Box Behnken experimental design (BBD). The optimized conditions resulted in an optimum resolution. The method was validated using USP guidelines, showing good linearity ranges and excellent accuracy, precision, and robustness. The method was successfully applied to analyze the drugs in pharmaceuticals and spiked plasma samples. [ABSTRACT FROM AUTHOR]

In this study, Density-functional theory/Time-dependent density-functional theory (DFT/TDDFT) and Molecular docking method was used to investigate the effect of methyl acetate, tetrahydrofuran and cyanobenzylidene substituents on the electronic structure and antiviral activity of favipiravir for treating COVID-19. The DFT and TDDFT computations were employed using the Gaussian 09 software package. The values were calculated using the 6-311++G(d, p) basis set and the hybrid B3LYP functional method. Autodock vina software was used for simulations to better predictions and to validate the modified compounds' binding affinities and poses. Results of the study indicate that compounds 1 to 6 all displayed a planar structure, where the pyrazine ring, carboxamide, hydroxyl groups, and other substituents are all situated within the same plane. In addition, the energy gaps (Egap) of these six compounds (Cpd 1, 2, 3, 4, 5, and 6) were compared. The significant dipole moment and binding affinity achieved implies a particular orientation for binding within the target protein, signaling the anticipated strength of the binding interaction. In all six compounds, the electrophilic domain is situated in the vicinity of the amine functional group within the carboxamide compound, whereas the nucleophilic domain encompasses both the carbonyl and hydroxyl groups. The most negatively charged sites are susceptible to electrophilic interactions. In conclusion, compounds 5 and 6 exhibit a high binding affinity of the target protein, while compound 6 has a high energy gap, which could enhance its antiviral activity against the COVID-19 virus. [ABSTRACT FROM AUTHOR]

This study aims to develop of a novel electrochemical method for the detection of the antiviral drug favipiravir (FAV). For this purpose, a sensitive electrochemical sensor with niobium (Nb) nanoparticles supported on zirconium oxide‐carbon nanotubes (ZrO2‐(CNT)MW) was constructed on a glassy carbon electrode (GCE). The proposed electrochemical sensor (Nb@ZrO2‐(CNT)MW/GCE) exhibited excellent repeatability, high stability and high sensitivity for FAV owing to the impact of Nb on ZrO2‐(CNT)MW composite. The oxidation potential (Ep) of FAV was occurred at 1.2 V, 1.12 V, 1.03 V and 1 V at GCE, (CNT)MW/GCE, ZrO2‐(CNT)MW/GCE and Nb@ZrO2‐(CNT)MW/GCE, respectively. Interestlingly, the gradual shift clearly indicates that Nb@ZrO2‐(CNT)MW/GCE can exhibit high catalytic activity towards FAV. The proposed electrode has also good selectivity towards FAV. The Nb@ZrO2‐(CNT)MW/GCE system exhibited a linear working range of 5 nM–300 nM with a limit of detection (LOD) of 1.8 nM (based on 3sb/m) for FAV. The Nb@ZrO2‐(CNT)MW/GCE system was successfully applied for the detection of FAV in pharmaceuticals and biological fluids. The experimental results demonstrated that Nb@ZrO2‐(CNT)MW/GCE can be an ideal sensing platform for the sensitive detection of FAV. [ABSTRACT FROM AUTHOR]

Favipiravir is a ribonucleoside analogue that has been explored as a therapeutic for the treatment of Ebola Virus Disease (EVD). Promising data from rodent models has informed nonhuman primate trials, as well as evaluation in patients during the 2013–2016 West African EVD outbreak of favipiravir treatment. However, mixed results from these studies hindered regulatory approval of favipiravir for the indication of EVD. This study examined the influence of route of administration, duration of treatment, and treatment schedule of favipiravir in immune competent mouse and guinea pig models using rodent-adapted Zaire ebolavirus (EBOV). A dose of 300 mg/kg/day of favipiravir with an 8-day treatment was found to be fully effective at preventing lethal EVD-like disease in BALB/c mice regardless of route of administration (oral, intraperitoneal, or subcutaneous) or whether it was provided as a once-daily dose or a twice-daily split dose. Preclinical data generated in guinea pigs demonstrates that an 8-day treatment of 300 mg/kg/day of favipiravir reduces mortality following EBOV challenge regardless of route of treatment or duration of treatments for 8, 11, or 15 days. This work supports the future translational development of favipiravir as an EVD therapeutic. [ABSTRACT FROM AUTHOR]

Key Clinical Message: The purpose of this case report is to reveal one of the cardiovascular side effects of favipiravir, sinus bradycardia. Favipiravir has emerged as a potential treatment for COVID‐19, with its antiviral properties showing promise in inhibiting viral replication. However, concerns regarding its safety profile, particularly its cardiac adverse effects, remain a subject of debate. We present the case of a 58‐year‐old man with a history of diabetes mellitus and chronic obstructive pulmonary disease who developed bradycardia following treatment with favipiravir for COVID‐19 pneumonia. Despite being asymptomatic, the patient exhibited sinus bradycardia, which resolved upon discontinuation of favipiravir. Favipiravir has been associated with QT prolongation and sinus bradycardia, though the exact mechanisms remain unclear. Our case adds to the growing body of evidence highlighting the potential cardiac complications of favipiravir therapy in COVID‐19 patients. Further research is warranted to clarify the underlying mechanisms and optimize patient management strategies. Clinicians should be cautious for cardiac adverse events when prescribing favipiravir for COVID‐19 treatment, especially in patients with preexisting cardiac conditions. Continued research is essential to ensure the safe and effective use of favipiravir in the management of COVID‐19. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, caused by SARS-CoV-2, has posed significant health challenges worldwide. While children generally experience less severe illness compared to adults, pneumonia remains a substantial risk, particularly for those under five years old. This study examines the clinical characteristics and treatment outcomes of pediatric COVID-19 pneumonia patients treated with favipiravir in Thailand, aiming to identify associated factors for pneumonia. A retrospective review was performed on pediatric patients aged 1 month to 18 years hospitalized with COVID-19 at Srinagarind Hospital, Khon Kaen University, from 13 January 2020 to 15 November 2021. Data on demographics, clinical symptoms, treatment, and outcomes were collected, and logistic regression analysis was used to identify factors associated with pneumonia. Among 349 hospitalized children, the median age was 8 years, with 51.9% being male. Symptoms included a fever (100%), a cough (74.2%), and a rash (24.9%). COVID-19 pneumonia was diagnosed in 54.7% of the children. Favipiravir was administered as the standard treatment, showing mild adverse effects, including a rash (4.3%) and nausea (2.8%). Monocytosis was significantly associated with COVID-19 pneumonia (aOR 30.85, 95% CI: 9.03–105.41, p < 0.001), with an ROC curve area of 0.77 (95% CI: 0.71–0.83). Pediatric COVID-19 patients typically exhibit mild-to-moderate symptoms, with pneumonia being common in the early pandemic phase. Monocytosis is a significant factor associated with COVID-19 pneumonia. Favipiravir demonstrated mild adverse effects. Further studies are needed to validate these findings across different settings and phases of the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Initiating favipiravir in COVID-19 patients with long-term warfarin use can lead to increased INR. However, data on the onset and duration of the increasing INR are limited. Method: We reviewed patient charts to include COVID-19 adult patients who received favipiravir for at least 5 days and used warfarin at the same dose for at least 12 weeks. Data on demographics, comorbidities, other medical characteristics, international normalized ratio (INR), and signs of bleeding were collected. Result: Eight patients, with a mean age of 70.88 ± 8.49 years old, received the standard dose of favipiravir. The mean maximum INR (4.30 ± 1.26) was statistically different from the baseline INR (P =.00029) and the change was observed within 4.38 ± 1.99 days after initiating favipiravir. Warfarin was then discontinued without favipiravir discontinuation in most patients, allowing the INR to gradually decrease within 2 to 3 days. Conclusion: Concurrent use of favipiravir and warfarin led to INR prolongation within approximately 4 days. The effect of such interaction can be acute as the prolongation occurred within 1 day in 1 of the patients. [ABSTRACT FROM AUTHOR]

Purpose: Coronavirus disease 2019 (COVID-19) has affected millions of people worldwide and caused mortality. Many factors have been reported to affect the prognosis of COVID-19. In this study, we aimed to investigate the effects of drug therapy and vaccination on prognosis in patients hospitalized with a COVID-19 diagnosis. Methods: In this single-center, cross-sectional study, data were retrospectively collected from patients receiving inpatient treatment at a university hospital with a diagnosis of COVID-19 between January 1, 2020, and April 30, 2022. The patients' demographic and clinical characteristics were recorded. The Chi-square, Cox and logistic regression was performed, P < 0.05 was considered statistically significant. Results: Total 1723 patients (50.1% were men, mean age: 60.6 ± 16.90) who had not been vaccinated rate was 27.0% (> 3 doses: 45.7%). Mortality rate was 17.0%. Increasing age, male, a high Charlson Comorbidity Index (CCI), and no vaccination significantly increased mortality (P < 0.05). The mortality rate was significantly lower in the chloroquine treatment group than in the other treatment groups. Increasing age, male, and a high CCI were determined to be factors that significantly increased the length of hospital stay (LOHS). LOHS found to be significantly lower in the favipiravir or chloroquine groups compared to the remaining treatment groups (P < 0.001). Both mortality and the LOHS significantly differed according to AST, d-dimer, ferritin, and GFR. Conclusion: This study primarily investigated the effect of treatment and vaccination on the prognosis of COVID-19. This was determined to be prepared for another potential pandemic that may arise due to COVID-19. [ABSTRACT FROM AUTHOR]

To determine favipiravir in bulk and marketed formulation, a stability-indicating reversedphase high performance liquid chromatographic approach has been established that was proved to be sensitive and accurate. SPOLAR C18 column with 250 mm x 4.6 mm, 5 µ dimensions, 0.1% ortho-phosphoric acid buffer: acetonitrile in 50:50 as a mobile phase at 30 °C were used to achieve the chromatographic separation. The retention time of 2.613 min was recorded, when favipiravir measured at 323 nm using 1 mL/min flow rate. The suitable chromatographic conditions were identified through optimization studies. The method showed appreciable linearity (R² = 0.999) over 10-60 µg/mL concentration range. The calculated values for detection and quantification of favipiravir were 0.12 and 0.37 µg/mL, respectively. The methodology was verified, and the validation parameters results fell within the acceptable range outlined by ICH protocols. Satisfactory result was obtained on adopting optimized protocol in marketed formulation. Hence, this chromatographic methodology is suitable for the regular analysis of favipiravir in various marketed formulations. [ABSTRACT FROM AUTHOR]

Purpose: Favipiravir (FAV) used against COVID-19 is an antiviral drug that causes adverse reactions, such as hyperuricaemia, liver damage, and hematopoetic toxicity. The aim of the study was to investigate the systemic and ocular side-effects of FAV in rats, for the first time.Materials and methods: A total of 18 albino male Wistar rats were used in the study. The rats were divided into 3 groups as the healthy group (HG), the group given 50 mg/kg/day favipiravir (FAV50), and the group given 200 mg/kg/d favipiravir (FAV200). These doses were given to the experimental groups for one week. At the end of the experiment histopathological examinations were performed on the conjunctiva and sclera of the eye. In addition, malondialdehyde (MDA), total glutathione (tGSH), superoxide dismutase (SOD), interleukin-1β (IL-1β), and tumor necrosis factor alpha (TNF-α) levels were measured in blood samples taken from rats. Results: Compared to HG, the MDA (1.37 ± 0.61 vs. 4.82 ± 1.40 µmol/mL), IL-1β (2.52 ± 1.14 vs. 6.67 ± 1.99 pg/mL), and TNF-α levels (3.28 ± 1.42 vs. 8.53 ± 3.06 pg/mL) of the FAV200 group were higher. The levels of tGSH (7.58 ± 1.98 vs. 2.50 ± 0.98 nmol/mL) and SOD (13.63 ± 3.43 vs. 3.81 ± 1.43 U/mL) the FAV200 group were lower than the HG (p < 0.05, for all). The degree of damage to the cornea and sclera of the FAV200 group was quite high according to HG (p < 0.001). Conclusions: FAV can cause damage to rat conjunctiva and sclera by increasing oxidant stress and inflammation at high dose. [ABSTRACT FROM AUTHOR]

Favipiravir (FVP) is an oral antiviral drug approved in 2021 for the treatment of COVID‐19. It is a pyrazine derivative that can be integrated into anti‐viral RNA products to inhibit viral replication. While, adenine is a purine nucleobase that is found in deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) to generate genetic information. For the first time, the binding mechanism between FVP and adenine was determined using different techniques, including UV–visible spectrophotometry, spectrofluorimetry, synchronous fluorescence (SF) spectroscopy, Fourier transform infrared (FTIR), fluorescence resonance energy transfer (FRET), and metal ion complexation. The fluorescence spectra indicated that FVP is bound to adenine via Van der Waals forces and hydrogen bonding through a spontaneous binding process (ΔGο < 0). The quenching mechanism was found to be static. Various temperature settings were used to investigate thermodynamic characteristics, such as binding forces, binding constants, and the number of binding sites. The reaction parameters, including the enthalpy change (ΔHο) and entropy change (ΔSο), were calculated using Van't Hoff's equation. The findings demonstrated that the adenine‐FVP binding was endothermic. Furthermore, the results of the experiments revealed that some metal ions (K+, Ca+2, Co+2, Cu+2, and Al+3) might facilitate the binding interaction between FVP and adenine. Slight changes are observed in the FTIR spectra of adenine, indicating the binding interaction between adenine and FVP. This study may be useful in understanding the pharmacokinetic characteristics of FVP and how the drug binds to adenine to prevent any side effects. [ABSTRACT FROM AUTHOR]

COVID-19 is an acute respiratory disease resulting from the infection of SARS-COV-2 viruses and causes high morbidity, which requires appropriate treatment targets. Favipiravir is an antiviral that selectively inhibits RNA-dependent RNA polymerase (RdRp) of virus. This review aimed to identify several studies that prove the effectiveness and safety of using Favipiravir for COVID-19 patients. The search method used the electronic media PubMed and ScienceDirect with the keywords "Efficacy", "Favipiravir", "Treatment", "Safety", SARS-COV-2", and "Favipiravir induced", accompanied by the addition of the affixes "AND" and "OR" and selection by the publication date starting December 2019. The literature search resulted in eight (8) published articles that met the exclusion and inclusion criteria. The results of the review showed that concurrent administration of Favipiravir and Lopinavir/Ritonavir or Chloroquine, with a dosage of Favipiravir of 3200 mg/day followed by 1200 mg/day each in 2 divided doses, was considered adequate for improving the clinical symptoms of COVID-19 patients with mild-moderate symptoms in early administration. Meanwhile, administering Favipiravir with anti-IL-6 Tocilizumab for patients with severe symptoms showed a fairly good effect. The most frequently reported ADE (adverse drug events) in the use of Favipiravir were hyperuricemia and elevated alanine aminotransferase (ALT) levels. This review concluded that the best clinical response to Favipiravir is shown in COVID-19 patients with mild-to-moderate early symptoms.

Karuna Chavalertsakul,1 Yuda Sutherasan,1 Tananchai Petnak,1 Kanin Thammavaranucupt,2 Suppachok Kirdlarp,2 Viboon Boonsarngsuk,1 Somnuek Sungkanuparph2 1Division of Pulmonary and Pulmonary Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, ThailandCorrespondence: Yuda Sutherasan, Division of Pulmonary and Pulmonary Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand, Tel +6622011619, Fax +6622011629 Ext 2, Email Sutherasan_yuda@yahoo.comBackground: Remdesivir treatment was associated with a reduced 28-day mortality and recovery time among patients hospitalized with severe COVID-19. Favipiravir is broadly used to treat COVID-19. However, various studies have had conflicting results on the efficacy of favipiravir for COVID-19. We hypothesized that remdesivir is more effective in clinical outcomes regarding the 29-day mortality rates, length of stay, and recovery rate than favipiravir in patients with moderate to severe COVID-19 pneumonia.Methods: We performed a retrospective cohort study that included adult hospitalized COVID-19 pneumonia patients with hypoxemia. Patients were classified into two groups according to the antiviral drugs. Age, oxygen saturation, fraction of inspired oxygen, and Charlson comorbidity index were used for propensity score matching. The primary objective was to determine whether the type of antiviral agent is associated with 29-day mortality. Other outcomes were the 15-day recovery rate and the length of intensive care unit or hospital stay.Results: A total of 249 patients with moderate to severe COVID-19 pneumonia were included. With an adjustment for propensity score-matched, there were 204 patients for further analysis (102 patients in each antiviral drug group). Remdesivir patients had higher Radiographic Assessment of Lung Edema (RALE) scores on Chest X-ray (14.32± 9.08 vs 11.34± 8.46; standardized mean difference =33.9%). The Charlson Comorbidity Index Scores were comparable. The prevalences of diabetes, obesity, hypertension, and non-HIV immunocompromised state were higher in the remdesivir group. Regarding the primary outcomes, after adjusting by diabetes, obesity, and RALE score, there was no difference in the 29-day mortality rate between both groups [26 patients (25.5%) in the remdesivir group vs 28 patients (27.5%) in the favipiravir group]. The Kaplan-Meier curve analysis at 29 days indicated no significant difference in cumulative survival rate. The two groups’ adjusted hazard ratio was 0.72; 95% CI, 0.41 to 1.25, p=0.24. A Kaplan-Meier analysis on the 15-day cumulative survival rate observed a trend towards a higher survival rate in the remdesivir group (adjusted hazard ratio 0.41; 95% CI, 0.20 to 0.84; p= 0.02) The proportion of patients who recovered on day 15, the length of intensive care unit(ICU) stays, and the hospital stay were not different between remdesivir and favipiravir groups (62 patients (60.8%) vs 56 patients (54.9%), p=0.39; 11.48 ± 11.88 days vs 10.87 ± 9.31 days, p=0.69; and 16.64± 14.28 days vs 16.59 ± 11.31 days, p=0.98, respectively).Conclusion: In patients with moderate to severe COVID-19 pneumonia, Remdesivir did not demonstrate superior benefits over Favipiravir regarding 29-day mortality, 15-day recovery rates, or hospital and ICU stay lengths. However, further investigation into the 15-day cumulative survival rate revealed a trend towards improved survival in the Remdesivir group.Keywords: remdesivir, favipiravir, moderate to severe COVID-19 pneumonia

Background: The efficacy of the viral clearance and clinical outcomes of favipiravir (FPV) in outpatients being treated for coronavirus disease 2019 (COVID-19) is unclear. Ivermectin (IVM), niclosamide (NCL), and FPV demonstrated synergistic effects in vitro for exceed 78% inhibiting severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) replication. Methods: A phase 2, open-label, 1:1, randomized, controlled trial was conducted on Thai patients with mild-to-moderate COVID-19 who received either combination FPV/IVM/NCL therapy or FPV alone to assess the rate of viral clearance among individuals with mild-to-moderate COVID-19. Results: Sixty non-high-risk comorbid patients with mild-to-moderate COVID-19 were randomized; 30 received FPV/IVM/NCL, and 30 received FPV alone. Mixed-effects multiple linear regression analysis of the cycle threshold value from SARS-CoV-2 PCR demonstrated no statistically significant differences in viral clearance rates between the combined FPV/IVM/NCL therapy group and the FPV-alone group. World Health Organization Clinical Progression scores and symptomatic improvement did not differ between arms on days 3, 6, and 10, and no adverse events were reported. No patients required hospitalization, intensive care unit admission, or supplemental oxygen or died within 28 days. C-reactive protein on day 3 was lower in the FPV/IVM/NCL group. Conclusion: Viral clearance rates did not differ significantly between the FPV/IVM/NCL combination therapy and FPV-alone groups of individuals with mild-to-moderate COVID-19, although the combined regimen demonstrated a synergistic effect in vitro. No discernible clinical benefit was observed. Further research is required to explore the potential benefits of FVP beyond its antiviral effects.Trial registration: TCTR20230403007, Registered 3 April 2023 - Retrospectively registered, https://trialsearch.who.int/Trial2.aspx?TrialID=TCTR20230403007

Introduction. Favipiravir is an antiviral compound that inhibits the RNA-dependent polymerase and possesses antiviral properties against RNA viruses, including SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2). The new drug Areplivir® Zinc as a combination of favipiravir (200 mg) and zinc gluconate (70 mg) in the form of film-coated tablets has been developed by LLC "PROMOMED RUS", Russia. This combination of favipiravir and zinc gluconate could provide more effective treatment of COVID-19.Aim. The aim of the pharmacokinetics study is comparison between Areplivir® Zinc (INN: favipiravir + zinc gluconate), film-coated tablets (the manufacturer is JSC "Biokhimic", LLC "PROMOMED RUS" as registration certificate holder) and Areplivir® (INN: favipiravir), film-coated tablets (the manufacturer is JSC "Biokhimic", LLC "PROMOMED RUS" as registration certificate holder) to evaluate the effect of zinc on the favipiravir pharmacokinetics.Materials and methods. The clinical and analytical phases as well as pharmacokinetic analyses have been performed as a part of a phase I clinical trial. Chromatographic separation and detection of favipiravir were performed by high-performance liquid chromatography – tandem mass spectrometry (HPLC-MS/MS) method using Nexera XR high-performance liquid chromatograph with triple quadrupole tandem mass spectrometer LCMS-8040 (Shimadzu Corporation, Japan). The validated analytical range of the method was 50.00–15 000.00 ng/mL in human plasma. The plasma zinc concentrations were measured by a biochemical method with the use of the kit «Zinc-Novo (50)» (JSC "Vector-Best", Russia). The descriptive statistics were calculated using Microsoft Excel (Microsoft Corporation, USA). The pharmacokinetic parameters, analysis of variance (ANOVA), 90 % confidence intervals (90 % CIs) and the intra-subject variability (CVintra) were calculated by R Project 3.5.1 software (package «bear», version 2.8.3-2), originally created by Hsin-ya Lee and Yung-jin Lee, Taiwan.Results and discussion. The 90 % confidence intervals of the ratios for Сmax and AUC(0–t) were 86.48–100.38 % and 103.77–119.47 %, respectively. The 90 % confidence intervals were all within the acceptance range of 80.00–125.00 % which means there is no effect of zinc on the favipiravir pharmacokinetics. The intra-subject variability (CVintra) of favipiravir for the pharmacokinetic parameters Cmax and AUC(0–t) were 15.06 % and 14.23 %.Conclusion. The results justified the subsequent phases of clinical trials of Areplivir® Zinc (INN: favipiravir + zinc gluconate), film-coated tablets (LLC "PROMOMED RUS", Russia). This combination of favipiravir and zinc could expand the existing armamentarium of antiviral drugs for the treatment of COVID-19.

Introduction. COVID-19 (Coronavirus disease 2019) almost 4 years after he start of the pandemic is still a significant public health problem. SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) that causes COVID-19 continues to mutate and spread throughout the world. Molnupiravir and favipiravir have been shown to be efficacious against variety of RNA viruses including the SARS-CoV-2. The Ministry of Health of the Russian Federation approved the use of these drugs as a treatment of COVID-19. The developed drug contains the combination of two antiviral agents with different mechanisms of suppressing viral RNA replication, which suggests efficacy against the vast majority of ARVI pathogens found in the human population including SARS-CoV-2 and influenza.Aim. The aim of the pharmacokinetics study is comparison between JTBC00301 (INN: molnupiravir + favipiravir), film-coated tablets (LLC "PROMOMED RUS", Russia), Esperavir® (INN: molnupiravir), capsules (LLC "PROMOMED RUS", Russia) and Areplivir® (INN: favipiravir), film-coated tablets (LLC "PROMOMED RUS", Russia) to evaluate the impact of monocomponents on each other's pharmacokinetics.Materials and methods. The clinical and analytical phases as well as pharmacokinetic analyses have been performed as a part of a phase I, randomized, open-label, 3-period crossover study of drug JTBC00301 (INN: molnupiravir + favipiravir), film-coated tablets, 400 + 400 mg (LLC "PROMOMED RUS", Russia). The plasma concentration of β-D-N4-hydroxycytidine (NHC), the active metabolite of molnupiravir and favipiravir were determined in 42 healthy volunteers after taking the test drug JTBC00301 (1 tablet of 400 + 400 mg), the reference drug Esperavir® (2 capsules of 200 mg) and the reference drug Areplivir® (2 tablets of 200 mg). The descriptive statistics were calculated using Microsoft Excel (Microsoft Corporation, USA). The pharmacokinetic parameters, analysis of variance (ANOVA), the intra-subject coefficient of variation (CVintra) and 90 % confidence intervals (90 % CI) were calculated by R Project 3.5.1 software (package «bear», version 2.8.3-2), originally created by Hsin-ya Lee and Yung-jin Lee, Taiwan.Results and discussion. Pharmacokinetic parameters of NHC and favipiravir were determined, averaged pharmacokinetic profiles in linear and log-linear scales were plotted, analysis of variance was carried out. The 90% CIs for geometric mean ratios of Сmax and AUC(0–t) for NHC and favipiravir were all within the acceptance range of 80–125 % which means there is no effect of monocomponents on each other’s pharmacokinetics.Conclusion. The development of the fixed-dose drug combination of molnupiravir and favipiravir has great potential as it may allow to increase the safety profile and improve the tolerability of therapy as well as increase the effectiveness of antiviral therapy. The results justified the study of the subsequent phases of clinical trials of JTBC00301 (INN: molnupiravir + favipiravir), film-coated tablets, 400 + 400 mg (LLC "PROMOMED RUS", Russia).

Background Coronavirus disease 2019 (COVID-19) has created the need to evaluate drugs such as favipiravir (FPV), an antiviral inhibitor of RNA-dependent RNA-polymerase (RdRp), and Maraviroc (MVC), an antiretroviral that antagonizes the chemokine receptor CCR5, which could affect the modulation of inflammation and viral replication in the treatment of COVID-19. We sought to evaluate the effect of MVC and/or FPV plus systemic steroid (SS) vs. SS alone on the viral load and progression to critical disease. Methods Sixteen patients with severe COVID-19 were evaluated in three treatment arms: 1) SS only (n=6), 2) SS plus one test drug MVC or FPV (n=5), and 3) SS plus both test drugs (MVC and FPV, n=5). The viral load was determined for N, E, and RdRp viral genes. Results A significant decrease in viral load was observed in the three treatment groups, with a larger effect size in the group that combined SS with both test drugs. The E, N, and RdRp genes with Cohen’s d were 120%, 123%, and 50%, respectively. Conclusions The largest effect on viral load reduction, as measured by effect size, was observed in the combination treatment group; however, no statistical significance was found, and it did not prevent progression to critical illness.

Favipiravir is a nucleobase analogue that exhibits antiviral activities against a variety of RNA viruses. Due to the lack of antivirals to combat SFTS, an emerging tickborne epidemic caused by a RNA virus belonging to the Phenuividae family within Bunyavirales, Favipiravir has been put brand new attention as optimal SFTS clinical candidate. We here disclose chemical synthesis of novel derivatives of Favipiravir. All derivatives showed favorable inhibitory effect on SFTSV replication in vitro. The 50 % effective concentration (EC50) of the most active compound H3 was 12.06 μM, better than that of Favipiravir (15.51 μM). Most importantly, compared with the clinical candidate Favipiravir, pharmacokinetic studies conducted on rats demonstrated enhanced pharmacokinetic properties for H2 and H3 including parameters of T1/2, Cmax and AUC. These combined attributes identified novel promising drug candidates for the treatment of SFTSV infection.

Designing new validated analytical procedures with a focus on many objectives, such as simplicity, environmental friendliness, analytical effectiveness, and sustainability, has grown to be a top priority in quality control departments. Applying green and white analytical chemistry concepts is no longer a luxury. In this report, two new approaches, Capillary Zone Electrophoresis (CZE) with Photo Diode Array (PDA) detection and derivative ratio spectrophotometric methods, are established and validated for the simultaneous analysis of molnupiravir (MLP) and favipiravir (FAV) in bulk, single dosage forms, and their expected combined dosage forms. For the two drugs, linearity ranges of 5–50 μg/mL and 1–30 μg/mL were achieved using the CZE and spectrophotometric methods, respectively. Both techniques have been validated and used for the estimation of the two medications in lab‐made capsules in accordance with the International Council for Harmonization's (ICH) recommendations. Seven assessment models were used to evaluate the greenness and sustainability of the introduced approaches compared to three previously published HPLC, chemometric, and HPTLC techniques. ChlorTox and BAGI tools are applied for the first time for the evaluation of an analytical procedure. Higher green and sustainable qualities were declared by suggested approaches than by earlier ones. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 or commonly called COVID-19 is an infectious disease caused by SARS-CoV-2. Favipiravir is a broad-spectrum antiviral drug so it has potential antiviral action against SARS-CoV-2 which is an RNA virus. This research aims to find out the relationship between Covid-19 symptoms when receiving favipiravir and the length of treatment of patients hospitalized at RSUD Dr. Iskak Tulungagung. Observational research with descriptive retrospective methods in COVID-19 patients' moderate symptoms with Favipiravir therapy at RSUD dr. Iskak Tungagung period July - September 2021. Data collection using the calculation of the Slovin formula to determine the number of patient samples. Analysis analysis using SPSS by carrying out the Chi-square test. The results of the study were obtained from 146 patients, the pattern of using Favipiravir was given at a dose (2x1600mg) on the first day followed by (2x600mg) on the second day and so on with the most giving range of 1-7 days. [ABSTRACT FROM AUTHOR]

The efficacy of the viral clearance and clinical outcomes of favipiravir (FPV) in outpatients being treated for coronavirus disease 2019 (COVID-19) is unclear. Ivermectin (IVM), niclosamide (NCL), and FPV demonstrated synergistic effects in vitro for exceed 78% inhibiting severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) replication. A phase 2, open-label, 1:1, randomized, controlled trial was conducted on Thai patients with mild-to-moderate COVID-19 who received either combination FPV/IVM/NCL therapy or FPV alone to assess the rate of viral clearance among individuals with mild-to-moderate COVID-19. Sixty non-high-risk comorbid patients with mild-to-moderate COVID-19 were randomized; 30 received FPV/IVM/NCL, and 30 received FPV alone. Mixed-effects multiple linear regression analysis of the cycle threshold value from SARS-CoV-2 PCR demonstrated no statistically significant differences in viral clearance rates between the combined FPV/IVM/NCL therapy group and the FPV-alone group. World Health Organization Clinical Progression scores and symptomatic improvement did not differ between arms on days 3, 6, and 10, and no adverse events were reported. No patients required hospitalization, intensive care unit admission, or supplemental oxygen or died within 28 days. C-reactive protein on day 3 was lower in the FPV/IVM/NCL group. Viral clearance rates did not differ significantly between the FPV/IVM/NCL combination therapy and FPV-alone groups of individuals with mild-to-moderate COVID-19, although the combined regimen demonstrated a synergistic effect in vitro. No discernible clinical benefit was observed. Further research is required to explore the potential benefits of FVP beyond its antiviral effects. Trial registration: TCTR20230403007 , Registered 3 April 2023 - Retrospectively registered, https://trialsearch.who.int/Trial2.aspx?TrialID=TCTR20230403007 [ABSTRACT FROM AUTHOR]

In the current work, favipiravir (an antiviral drug) loaded pH-responsive polymeric hydrogels were developed by the free redical polymerization technique. Box-Behnken design method via Design Expert version 11 was employed to furnish the composition of all hydrogel formulations. Here, polyethylene glycol (PEG) has been utilized as a polymer, acrylic acid (AA) as a monomer, and potassium persulfate (KPS) and methylene-bisacrylamide (MBA) as initiator and cross-linker, respectively. All networks were evaluated for in-vitro drug release (%), sol-gel fraction (%), swelling studies (%), porosity (%), percentage entrapment efficiency, and chemical compatibilities. According to findings, the swelling was pH sensitive and was shown to be greatest at a pH of 6.8 (2500%). The optimum gel fraction offered was 97.8%. A sufficient porosity allows the hydrogel to load a substantial amount of favipiravir despite its hydrophobic behavior. Hydrogels exhibited maximum entrapment efficiency of favipiravir upto 98%. The in-vitro release studies of drug-formulated hydrogel revealed that the drug release from hydrogel was between 85 to 110% within 24 h. Drug-release kinetic results showed that the Korsmeyer Peppas model was followed by most of the developed formulations based on the R2 value. In conclusion, the hydrogel-based technology proved to be an excellent option for creating the sustained-release dosage form of the antiviral drug favipiravir. [ABSTRACT FROM AUTHOR]

Antiviral therapies are integral in the fight against SARS‐CoV‐2 (i.e. severe acute respiratory syndrome coronavirus 2), the causative agent of COVID‐19. Antiviral therapeutics can be divided into categories based on how they combat the virus, including viral entry into the host cell, viral replication, protein trafficking, post‐translational processing, and immune response regulation. Drugs that target how the virus enters the cell include: Evusheld, REGEN‐COV, bamlanivimab and etesevimab, bebtelovimab, sotrovimab, Arbidol, nitazoxanide, and chloroquine. Drugs that prevent the virus from replicating include: Paxlovid, remdesivir, molnupiravir, favipiravir, ribavirin, and Kaletra. Drugs that interfere with protein trafficking and post‐translational processing include nitazoxanide and ivermectin. Lastly, drugs that target immune response regulation include interferons and the use of anti‐inflammatory drugs such as dexamethasone. Antiviral therapies offer an alternative solution for those unable or unwilling to be vaccinated and are a vital weapon in the battle against the global pandemic. Learning more about these therapies helps raise awareness in the general population about the options available to them with respect to aiding in the reduction of the severity of COVID‐19 infection. In this 'A Guide To' article, we provide an in‐depth insight into the development of antiviral therapeutics against SARS‐CoV‐2 and their ability to help fight COVID‐19. [ABSTRACT FROM AUTHOR]

Orthobunyavirus is the largest and most diverse genus in the family Peribunyaviridae. Orthobunyaviruses are widely distributed globally and pose threats to human and animal health. Ebinur Lake virus (EBIV) is a newly classified Orthobunyavirus detected in China, Russia, and Kenya. This study explored the antiviral effects of two broad-spectrum antiviral drugs, favipiravir and ribavirin, in a BALB/c mouse model. Favipiravir significantly improved the clinical symptoms of infected mice, reduced viral titer and RNA copies in serum, and extended overall survival. The median survival times of mice in the vehicle- and favipiravir-treated groups were 5 and 7 days, respectively. Favipiravir significantly reduced virus titers 10- to 100-fold in sera at all three time points compared to vehicle-treated mice. And favipiravir treatment effectively reduced the virus copies by approximately 10-fold across the three time points, relative to vehicle-treated mice. The findings expand the antiviral spectrum of favipiravir for orthobunyaviruses in vivo. [ABSTRACT FROM AUTHOR]

In this work, we conducted a study of the interaction between DNA and favipiravir (FAV). This chemotherapeutic compound is an antiviral drug for the treatment of COVID-19 and other infections caused by RNA viruses. This paper examines the electroanalytical characteristics of FAV. The determined concentrations correspond to therapeutically significant ones in the range of 50–500 µM (R2 = 0.943). We have shown that FAV can be electro-oxidized around the potential of +0.96 V ÷ +0.98 V (vs. Ag/AgCl). A mechanism for electrochemical oxidation of FAV was proposed. The effect of the drug on DNA was recorded as changes in the intensity of electrochemical oxidation of heterocyclic nucleobases (guanine, adenine and thymine) using screen-printed graphite electrodes modified with single-walled carbon nanotubes and titanium oxide nanoparticles. In this work, the binding constants (Kb) of FAV/dsDNA complexes for guanine, adenine and thymine were calculated. The values of the DNA-mediated electrochemical decline coefficient were calculated as the ratio of the intensity of signals for the electrochemical oxidation of guanine, adenine and thymine in the presence of FAV to the intensity of signals for the electro-oxidation of these bases without drug (S, %). Based on the analysis of electrochemical parameters, values of binding constants and spectral data, intercalation was proposed as the principal mechanism of the antiviral drug FAV interaction with DNA. The interaction with calf thymus DNA also confirmed the intercalation mechanism. However, an additional mode of interaction, such as a damage effect together with electrostatic interactions, was revealed in a prolonged exposure of DNA to FAV. [ABSTRACT FROM AUTHOR]