Modern drugs for the treatment of ARVI and influenza

The rise in the incidence of SARS-CoV-2 has caused a surge in demand for drugs. And some of the most popular products are those that boost immunity and help the body resist the virus. Our article will tell you which drugs in this group a pharmacist can confidently offer if requested, and how to justify the recommendation.

It should be said right away that there is no specific prevention of COVID-19 [1]. There are no drugs that have been proven in studies to prevent infection by SARS-CoV-2, at least as of early April 2021. But this does not mean that today we are completely unarmed against infection. The virus is still very young. While scientists around the world are working to create new drugs for the treatment and prevention of COVID-19, doctors are using long-known drugs, selected empirically, and gaining their own experience of successful or not so successful therapy.

The most popular and effective antiviral drugs.

May 17, 2021
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Content

• How to distinguish ARVI from influenza?
• Umifenovir
• Viferon
• Kagocel
• The best flu medications
• Zanamivir
• Oseltamivir

Antiviral drugs are a large group of drugs, which includes drugs for the treatment of HIV and hepatitis, and those prescribed for influenza and other acute respiratory viral infections, and even homeopathic drugs, which are so widely advertised, but in fact are “dummies”.

Our rating of antiviral drugs is drugs aimed at treating acute respiratory viral infections, including influenza. Some drugs on our list are sold exclusively by prescription and should be taken exclusively under the supervision of a physician.

How to distinguish ARVI from influenza?

ARVI (or, as people say, a cold) is, one might say, a common occurrence. Doctors say that children with normal immunity can get ARVI up to 6 times a year, adults - up to 4. But influenza is a more serious disease, which is fraught with various complications (usually respiratory failure and viral pneumonia). Therefore, if you suspect you have the flu, consult a doctor immediately.

IMPORTANT!

The antiviral drugs presented below are effective if taken within the first 48 hours of the onset of ARVI or flu symptoms.

How to distinguish influenza from ARVI
Photos from open sources

Sources

1. Virology. Methodological materials: Textbook. method. aid for students biol. fak. / Authors-comp. E. V. Glinskaya, E. S. Tuchina, S. V. Petrov. — Saratov. — 2013.
2. Mechanisms of transmission of pathogens and ecological and epidemiological classification of infectious and parasitic human diseases. / V. I. Sergevnin. — Epidemiology and vaccine prevention. — No. 2(63). — 2012.
3. Approximate list of essential medicines. 21st list, 2021—Copenhagen: WHO Regional Office for Europe, 2020.
4. Samoshchenkova I.F., Garankina R.Yu., Bobkova E.A., Omelchenko A.A. Study of the range of antiviral drugs with in-depth product analysis of the drug Normomed // Bulletin of the North-Eastern Federal University named after. M.K. Amosova. Series "Medical Sciences". — 2021. — No. 1 (22). — P. 41-51.
5. Telnova E.A., Shchepin V.O., Zagoruichenko A.A. Antiviral drugs: from creation to the present time // Bulletin of the National Research Institute of Public Health named after. ON THE. Semashko. - 2021. - No. 4. - P. 108-119.
6. Shestakova I.V. Antiviral drugs // Infectious diseases: news, opinions, training. - 2015. - No. 1. - P. 77-86.

Umifenovir

Trade names: “Arbidol”, “Arpeflu”, “Orvitol”, “Afludol”. Arbidol has a controversial reputation, because once it appeared, the evidence base for this antiviral drug was insignificant. But recently, the number of studies on the effectiveness of Arbidol has increased. There is a lot of evidence that umifenovir fights influenza viruses, enteroviruses, and seasonal colds. Studies have shown that umifenovir reduces the duration of the disease by 1.7-2.65 days, while reducing the risk of complications from ARVI and influenza by 4 times.

"Arbidol" is indicated for children from 2 years of age (the drug is sold in powder for preparing a suspension). There is also Arbidol in capsules and tablets.

Contraindications include: pregnancy and intolerance to the drug. Known side effects: allergic reactions.

Umifenovir

OZON, Russia

Umifenovir is used for the prevention and treatment of influenza A and B and other acute respiratory viral infections in adults and children from 3 years of age (for the dosage form of a capsule of 50 mg), from 6 years of age (for the dosage form of a capsule of 100 mg).
As a complex therapy for acute intestinal infections of rotavirus etiology in children over 3 years of age (for the dosage form of a capsule 50 mg), from 6 years of age (for the dosage form of a capsule 100 mg). Complex therapy of recurrent herpes infection. Prevention of postoperative infectious complications. from 98

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Antiviral drugs in general practice

Antiviral drugs are compounds of natural or synthetic origin used to treat and prevent viral infections. The action of many of them is selectively aimed at various stages of the development of viral infection and the life cycle of viruses.

Currently, more than 500 viruses are known to cause human diseases. Viruses contain single- or double-stranded ribonucleic acid (RNA) or deoxyribonucleic acid (DNA) enclosed in a protein shell called a capsid. Some of them also have an outer shell of lipoproteins. Many viruses contain enzymes or genes that enable reproduction in the host cell. Unlike bacteria, viruses do not have their own metabolism: they use the metabolic pathways of the host cell.

RNA viruses either synthesize messenger RNA (mRNA), or the RNA itself performs the function of mRNA. It synthesizes viral proteins, including RNA polymerase, with the participation of which viral mRNA is formed. Transcription of the genome of some RNA viruses occurs in the nucleus of the host cell. Under the influence of retroviral reverse transcriptase, complementary DNA (provirus) is synthesized based on viral RNA, which is integrated into the genome of the host cell. Subsequently, during transcription, both cellular RNA and viral mRNA are formed, on which viral proteins are synthesized for the assembly of new viruses. Viruses and the diseases they cause are shown in Table. 1.

Basic mechanisms of action of antiviral drugs

At the infection stage, the virus is adsorbed on the cell membrane and penetrates the cell. During this period, drugs are used that disrupt this process: soluble false receptors, antibodies to membrane receptors, inhibitors of the fusion of the virus with the cell membrane.

At the stage of virus penetration, when the virion is deproteinized and the nucleoprotein is “undressed,” ion channel blockers and capsid stabilizers are effective.

At the next stage, intracellular synthesis of viral components begins. At this stage, inhibitors of viral DNA polymerases, RNA polymerases, reverse transcriptase, helicase, primase, and integrase are effective. The translation of viral proteins is affected by interferons (IFN), antisense oligonucleotides, ribozymes and inhibitors of regulatory proteins. Proteolytic cleavage is affected by protase inhibitors.

IFN and inhibitors of structural proteins actively affect virus assembly.

The final stage of the replication cycle involves the release of daughter virions from the cell and the death of the infected host cell. At this stage, neuraminidase inhibitors, antiviral antibodies and cytotoxic lymphocytes are effective.

There are different classifications of antiviral agents. This article presents a classification based on the effect on a particular virus (Table 2).

Let's look at anti-influenza and anti-herpetic drugs.

Classification of antiviral drugs approved for use in Russia.

• group of anti-influenza drugs: – Amantadine; – Arbidol; – Oseltamivir; - Rimantadine.
• Drugs acting on herpes viruses: – Alpizarin; – Acyclovir; – Bonafton; – Valacyclovir; – Ganciclovir; – Glycyrrhizic acid; – Idoxuridine; – Penciclovir; – Riodoxol; – Tebrofen; – Tromantadine; – Famciclovir; - Florenal.
• Antiretroviral drugs: – Abacavir; – Amprenavir; – Atazanavir; – Didanosine; – Zalcitabine; – Zidovudine; – Indinavir sulfate; – Lamivudine; – Nelfinavir; – Ritonavir; – Saquinavir; – Stavudin; – Phosphazide; - Efavirenz.
• Other antiviral drugs: – Inosine pranobex; – Interferon alpha; – Interferon alpha-2; – Interferon alpha-2b; – Interferon beta-1a; – Interferon beta-1b; – Yodantipyrine; – Ribavirin; – Tetraoxo-tetrahydronaphthalene (Oxolin); – Tiloron; – Flacoside.

Anti-influenza drugs (Table 2)

Arbidol is a derivative of indole carboxylic acid. The mechanism of action of the drug consists of suppressing the reproduction of the influenza virus, influencing the synthesis of IFN, increasing the number of T-lymphocytes and the functional activity of macrophages, as well as an antioxidant effect.

The drug penetrates unchanged into both uninfected and infected cells and is detected in the nuclear and cytoplasmic fractions. Arbidol inhibits the process of fusion of the lipid viral envelope with endosome membranes (at pH 7.4), leading to the release of the viral genome and the beginning of transcription. Unlike amantadine and rimantadine, Arbidol inhibits the release of the nucleocapsid itself from external proteins, neuraminidase and the lipid membrane. Thus, Arbidol acts in the early stages of viral reproduction.

The drug has no strain specificity (in cell cultures it suppresses the reproduction of the influenza A virus by 80%, the influenza B virus by 60% and the influenza C virus by 20%, and also affects the avian influenza virus, but weaker than the reproduction human strains of influenza virus).

IFN synthesis increases, starting from taking 1 tablet to 3 tablets. However, there is no further increase in IFN levels when taking Arbidol. A rapid increase in IFN synthesis can have a preventive effect when taken before the onset of influenza.

Arbidol has an immunomodulatory effect, leading to an increase in the total number of T-lymphocytes and T-helper cells. Moreover, normalization of these indicators was observed in patients with an initially reduced number of CD3 and CD4 cells, and in individuals with normal functioning of the cellular component of immunity there were practically no changes in the number of T-lymphocytes and T-helper cells. At the same time, the use of Arbidol does not lead to a significant decrease in the absolute number of T-suppressor lymphocytes - thus, the stimulating activity of the drug is not associated with inhibition of the function of suppressor cells. Arbidol increases the total number of macrophages with engulfed bacteria and the phagocytic number. It is assumed that the activating stimuli for phagocytic cells were cytokines and, in particular, IFN, the production of which is enhanced under the influence of the drug. The content of natural killer cells, NK cells, also increases, which allows the drug to be characterized as an inducer of natural killer cell activity.

The drug is quickly absorbed from the gastrointestinal tract (GIT). T1/2 is 16–21 hours. It is excreted unchanged in feces (38.9%) and urine (0.12%). During the first day, 90% of the administered dose is eliminated.

Drug interactions of Arbidol with other drugs have not been described in the literature.

Almost the only side effects of the drug are allergic reactions. The drug is approved for use from 2 years of age.

Arbidol has a fairly wide spectrum of antiviral action and is used for the prevention and treatment of influenza types A and B, including those complicated by bronchitis and pneumonia; acute respiratory diseases (ARVI); chronic bronchitis, pneumonia, recurrent herpetic infection; in the postoperative period - to normalize the immune status and prevent complications.

Amantadine and rimantadine are adamantane derivatives. Both drugs suppress the reproduction of virus A, even in small doses. Their antiviral activity is due to two mechanisms.

Firstly, they act at the early stage of viral reproduction, suppressing the “undressing” of the virus. The primary target for these drugs is the M2 protein of the influenza A virus, which forms an ion channel in its envelope. Suppression of the function of this protein leads to the fact that protons from endosomes cannot enter the virus, the dissociation of the ribonucleide and the release of the virus into the cytoplasm are blocked.

Secondly, they can also act at the stage of virus assembly, apparently by changing the processing of hemagglutinin. This mechanism is possible in some strains of viruses.

Among wild strains, drug resistance rarely occurs, but resistant strains are obtained from patients taking them. The sensitivity and resistance of viruses to amantadine and rimantadine are cross-sensitivity.

Both drugs are well absorbed when taken orally and have a large volume of distribution. Most amantadine is excreted unchanged in the urine. The half-life (T1/2) in young people is 12–18 hours, in the elderly it almost doubles, and in renal failure it increases even more. Therefore, the dose of the drug must be reduced even if there is a slight change in renal function. Rimantadine is actively metabolized in the liver, T1/2 averages 24–36 hours, 60–90% of the drug is excreted in the urine in the form of metabolites.

When taking both drugs, minor dose-dependent disturbances in the gastrointestinal tract (nausea, loss of appetite) and central nervous system (CNS) (irritability, insomnia, impaired concentration) are most often noted. When taking high doses of amantadine, significant neurotoxic effects are possible: confusion, hallucinations, epileptic seizures, coma (these effects may be enhanced by concomitant use of H1-blockers, M-anticholinergics, psychotropic drugs and ethanol). Safety of use during pregnancy has not been established. Allowed for use from 7 years of age.

The drugs are used to prevent and treat influenza A. Taking them during influenza epidemics allows one to avoid infection in 70–90% of cases. In persons with uncomplicated influenza A, treatment with drugs for 5 days in age-specific dosages, started at an early stage of the disease, reduces the duration of fever and general symptoms by 1–2 days, accelerates recovery and sometimes shortens the period of virus shedding.

Oseltamivir is an inactive precursor that is converted in the body to an active metabolite, oseltamivir carboxylate. It is a transition analogue of sialic acid and a selective inhibitor of neuraminidase of influenza A and B viruses. In addition, it suppresses strains of influenza A virus that are resistant to drugs derived from adamantane.

Neuraminidase of the influenza virus cleaves off the terminal residues of sialic acids and, thus, destroys receptors located on the surface of cells and new viruses, i.e., it promotes the exit of the virus from the cell upon completion of reproduction. The active metabolite of oseltamivir causes changes in the active site of neuraminidase and suppresses its activity. Viruses aggregate on the cell surface and their spread slows down.

Resistant strains of influenza A virus are found in 1–2% of patients taking the drug. To date, no resistant strains of influenza B virus have been detected.

When taken orally, the drug is well absorbed. Eating does not affect its bioavailability, but reduces the risk of side effects on the gastrointestinal tract. The drug undergoes enzymatic hydrolysis in the gastrointestinal tract and liver with the formation of an active metabolite. The volume of distribution of the drug approaches the volume of fluid in the body. T1/2 of oseltamivir and its active metabolite is 1–3 and 6–10 hours, respectively. Both compounds are excreted primarily by the kidneys unchanged.

When taken orally, minor abdominal discomfort and nausea are possible, which decrease when taking the drug with food. Gastrointestinal disorders usually resolve within 1–2 days, even if the patient continues to take the drug. No clinically significant interactions of oseltamivir with other drugs have been identified. The drug is used in children over 1 year of age.

Oseltamivir is used to treat and prevent influenza. Prophylactic administration of oseltamivir during epidemics reduces the incidence both among those vaccinated with influenza vaccine and among unvaccinated people. When treating influenza with this drug, recovery occurs 1–2 days earlier, and the number of bacterial complications is reduced by 40–50%.

Antiherpetic drugs

Before moving on to a discussion of antiherpetic drugs, it is necessary to recall the various herpes viruses and the diseases caused by them (Table 4). Unfortunately, the arsenal of modern antiviral drugs does not contain drugs that act on all herpes viruses simultaneously (Table 5).

Herpes simplex virus type 1 causes damage to the skin, mouth, esophagus and brain; herpes simplex virus type 2 causes damage to the external genitalia, rectum, skin and meninges. The first antiherpetic drug approved for use was vidarabine (1977). However, due to its high toxicity, it was used to treat diseases caused by the herpes simplex virus and Varicella-zostervirus, only for health reasons. Since 1982, acyclovir has been used to treat patients with less severe disease.

Acyclovir is an acyclic analogue of guanosine, and valacyclovir is the L-valine ester of acyclovir. Acyclovir inhibits viral DNA synthesis after phosphorylation by viral thymidine kinase within infected cells. The acyclovir triphosphate formed in the cell is integrated into the DNA chain synthesized in the host cell, which leads to the cessation of growth of the viral DNA chain. The DNA molecule, which contains acyclovir, binds to DNA polymerase, irreversibly inactivating it.

Viral resistance may result from decreased viral thymidine kinase activity and changes in viral DNA polymerase. Changes in enzyme activity occur as a result of mutations.

The bioavailability of acyclovir when taken orally is only 10–30% and decreases with increasing dose. Unlike acyclovir, the bioavailability of valacyclovir when taken orally reaches 70%. The drug is quickly and almost completely converted to acyclovir. Acyclovir penetrates into many biological fluids, including the contents of chickenpox vesicles, cerebrospinal fluid, and accumulates in milk, amniotic fluid and the placenta. Its concentration in vaginal contents varies widely. Serum concentrations of the drug in mother and newborn are approximately the same. The drug is practically not absorbed through the skin. T1/2 of acyclovir averages 2.5 hours in adults, 4 hours in newborns, and can increase to 20 hours in patients with renal failure. The drug is almost completely excreted unchanged by the kidneys. During pregnancy, the pharmacokinetics of drugs does not change.

As a rule, acyclovir is well tolerated. When using an ointment based on polyethylene glycol, irritation of the genital mucosa and a burning sensation are possible. When taken orally, the drug occasionally causes headache, dizziness, rash and diarrhea. Renal failure and neurotoxic effects are even less common. Side effects of valacyclovir are similar to those of acyclovir - nausea, diarrhea, headache; high doses may cause confusion, hallucinations, kidney damage and, very rarely, thrombocytopenia. With intravenous administration of large doses of acyclovir, renal failure and central nervous system damage may develop.

Famciclovir itself is inactive, but upon its first passage through the liver it is quickly converted to penciclovir. Penciclovir is an acyclic analogue of guanosine. The mechanism of action of the drug is similar to the mechanism of action of acyclovir. Like acyclovir, penciclovir acts primarily against herpes simplex viruses and Varicella-zostervirus. Resistance to penciclavir is rare in the clinic.

Unlike penciclovir, whose bioavailability when taken orally is only 5%, famciclovir is well absorbed. When taking famciclovir, the bioavailability of penciclovir increases to 65–77%. Eating together with the drug slows down the absorption of the latter, but in general the bioavailability is not reduced. The volume of distribution of penciclovir is 2 times the volume of fluid in the body, T1/21/2 increases to 9.9 hours. The drug is easily removed by hemodialysis.

Acyclovir is well tolerated, but sometimes headache, nausea, diarrhea, urticaria may occur, and in older people - hallucinations and confusion. Topical preparations may cause contact dermatitis and ulceration.

The safety of the drug during pregnancy, as well as its interaction with other drugs, has not been established.

Ganciclovir is an acyclic analogue of guanosine. The mechanism of action of the drug is similar to the mechanism of action of acyclovir. Active against all herpes viruses, but most effective against cytomegalovirus.

The bioavailability of ganciclovir when taken orally with food is 6–9% and slightly less when taken on an empty stomach. Valganciclovir is well absorbed and quickly hydrolyzed to ganciclovir, the bioavailability of which increases to 61%. When taking valganciclovir with food, the bioavailability of ganciclovir increases by another 25%. With normal renal function, T1/2 is 2–4 hours. More than 90% of the drug is excreted unchanged by the kidneys. In case of renal failure, T1/2 increases to 28–40 hours.

The main dose-limiting side effect of ganciclovir is inhibition of hematopoiesis (neutropenia, thrombocytopenia). In 5–15% of patients, central nervous system lesions of varying severity are noted (from headache to seizures and coma). With intravenous administration, phlebitis, azotemia, anemia, rashes, fever, changes in liver biochemical parameters, nausea, vomiting, and eosinophilia are possible.

In laboratory animals, the drug had a teratogenic and embryotoxic effect and irreversibly impaired reproductive function. Cytotoxic drugs increase the side effects of ganciclovir on the bone marrow.

Idoxuridine is an iodine-containing analogue of thymidine. The mechanism of antiviral action is not fully understood. It is known that phosphorylated derivatives of the drug are incorporated into viral and cellular DNA, but only inhibit the replication of viral DNA. At the same time, DNA becomes more fragile, easily destroyed, and errors occur more often during its transcription. Resistant strains are isolated from patients with herpetic keratitis treated with idoxuridine. The drug is approved only for topical use. When using it, pain, itching, inflammation and swelling in the eye area, and allergic reactions are possible.

Advances in antimicrobial therapy in the 20th century led to almost complete control of bacterial infections. The task of infectious disease specialists and pharmacologists of the 21st century is to ensure control over viral infection. In addition to being highly effective, new antiviral drugs must be well tolerated. Currently, new agents with fundamentally new mechanisms of action are being developed. Means for suppressing pathological immune reactions and immunotherapy with monoclonal antibodies and vaccines may be promising.

N. M. Kiseleva, Candidate of Medical Sciences, Associate Professor L. G. Kuzmenko, Doctor of Medical Sciences, Professor of Russian State Medical University, Moscow

Viferon

This antiviral drug in suppositories contains human interferon, which has an antiviral effect and simultaneously stimulates the immune system. This drug can be purchased with a prescription. "Viferon" can be used in children from birth for flu or colds (one suppository every 12 hours). Children from birth to 7 years old are prescribed Viferon at a dosage of 150,000 IU. Over 7 years old and adults - suppositories of 500,000 IU.

"Viferon" can be used by pregnant and breastfeeding women. The only known side effect is allergic reactions. Contraindication – intolerance to the drug. The main disadvantage of Viferon is that it does not have a direct antiviral effect (since the influenza virus affects the respiratory tract, and suppositories act in the rectum). Therefore, the effectiveness of this antiviral drug depends on the individual response of the immune system.

Viferon

Feron, Russia

Viferon is a complex preparation containing recombinant human interferon alpha-2, ascorbic acid and alpha-tocopherol acetate.
The drug has antiviral, immunomodulatory and antiproliferative effects. from 136

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Types of antiviral agents

With all the diversity of viruses, the choice of drugs with proven effectiveness is relatively small. Some of them stimulate the patient’s own immunity. Others act on the principle of antibodies, preventing infection from entering the cell. Still others block the virus at a certain stage of its life cycle. Based on their purpose, the following medications are distinguished:

• anti-influenza;
• antiherpetic;
• anticytomegalovirus;
• antiretroviral (against HIV infection);
• drugs with an extended spectrum of action (interferons, lamivudine, ribavirin).

Based on the methods of influencing a viral infection, drugs are divided into large groups of local and systemic action⁶.

• Chemotherapy drugs are the most studied and widespread. They suppress the stages of virus reproduction without significantly affecting the cells themselves.
• Interferons are distinguished by their versatility, broad action and maximum safety for the body.
• Inducers of interferon synthesis - stimulate the formation of interferon in the body and have a wide spectrum of action.
• Immunomodulators - improve the insufficient functions of immunocytes (cells of the immune system).

The World Health Organization allocates only antiherpetic, antiretroviral, hepatitis and other drugs, which include ribavirin, valganciclovir³.

There are plenty of antiviral drugs in pharmacies, but not all of them are effective. Don't get carried away with self-medication! Photo: alfexe / Depositphotos

Kagocel

This antiviral drug does not have a direct effect against viruses, but it helps the body produce interferons, which stimulate the immune response. "Kagocel" is prescribed for influenza and other acute respiratory viral infections from the age of three. The drug is presented in tablets, and the course of treatment lasts 4 days (the treatment regimen is prescribed by the doctor, taking into account the patient’s age).

Possible side effects include allergic reactions. "Kagocel" is contraindicated for children under 3 years of age, pregnant and lactating women.

Kagocel

Nearmedic Pharma LLC, Russia

The greatest effectiveness in treatment with Kagocel® is achieved when it is prescribed no later than the 4th day from the onset of acute infection.
For preventive purposes, the drug can be used at any time, including immediately after contact with the infectious agent. from 199

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Zanamivir

Trade name: Relenza. Zanamivir, by blocking a special enzyme on the virus shell, inhibits the reproduction of the virus. Studies have shown that zanamivir reduces the duration of the disease by 1.5 days, and its use reduces the likelihood of influenza complications by 3 times. Zanamivir also reduces the release of the virus by a sick person, which means that the likelihood of infecting others with the flu is reduced.

This anti-flu medicine comes in the form of inhalation bottles. The set contains 5 rotadiscs and a special device for inhalation - a disc haller. Zanamivir for influenza is indicated for children from 5 years of age, both for children and adults - the doses and method of administration are the same: 2 inhalations twice a day for 5 days.

Side effects include intolerance to the drug. Use with caution in people prone to bronchospasms. Do not try to use the drug with a nebulizer, as this may damage the device. The drug is sold by prescription, is almost not absorbed into the blood, and is easy to use.

Relenza

GlaxoSmithKline, France

- treatment of infection caused by influenza virus types A and B in children over 5 years of age and adults;
- prevention of infection caused by influenza virus types A and B in children over 5 years of age and adults. from 1002

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Oseltamivir

The trade names of this flu medicine are Tamiflu, Nomides, Oseltamivir phosphate. Oseltamivir acts on the influenza virus in the same way as the previous drug. When using it, the illness lasts 2 days less. Oseltamivir can be prescribed to adults and children over 1 year of age. For children from one to 8 years old, it is better to use a suspension.

Possible side effects include dizziness, nausea, vomiting, and diarrhea. Contraindications to the use of oseltamivir: individual intolerance and renal failure. This flu medicine is available by prescription.

Oseltamivir

Types of viral diseases

A person comes into contact with thousands of viruses. To date, only a portion of them have been classified. They are mainly grouped according to the systems and organs they affect¹.

• Respiratory. These are diseases of the upper respiratory tract - from the nasopharynx to the lungs. These diseases are caused by influenza viruses, rhinoviruses, adenoviruses, coronaviruses and others. They are transmitted from person to person by airborne droplets and cause a runny nose and cough.
• Gastrointestinal. They are transmitted orally and cause vomiting and diarrhea. Rotaviruses, astroviruses, and adenoviruses are especially dangerous for children, and noroviruses for adults.
• Exanthematous. Infection most often occurs by airborne droplets. Viruses are also carried by insects. They cause skin lesions and diseases such as measles, rubella, scarlet fever, typhoid, and chickenpox.
• Neurological. A viral infection affects the nervous system. The most well-known disease is encephalitis. The most common carriers are mosquitoes and ticks.
• Liver infections. The most common are 5 types of hepatitis. Viruses are transmitted through blood, secretions, and orally and cause severe damage to liver tissue and disruption of its functions.
• Dermatotropic. Affects the skin and mucous membranes. The most common viruses are herpes and papilloma. They are dangerous because they can cause cancer.

Do antibiotics help against viruses?

No! These medications are designed specifically to fight bacteria, while special antiviral drugs are needed to treat viral infections. Bacteria are much larger and more complex than viruses; they are microorganisms of a completely different nature.