|Main uses||Smallpox, monkeypox, cowpox, complications of smallpox vaccination|
|Side effects||Nausea, headache, abdominal pain|
|Typical dose||600 mg BID|
|Chemical and physical data|
|Molar mass||376.335 g·mol−1|
|3D model (JSmol)|
Tecovirimat, sold under the brand name Tpoxx, is an antiviral medication with activity against smallpox. Other uses may include monkeypox, cowpox, and complications of smallpox vaccination. It is taken by mouth.
Common side effects include nausea, headache, and abdominal pain. No serious side effects have been seen. It works by blocking orthopoxvirus VP37 protein, which prevents the virus from leave a cell.
Tecovirimat became the first drug approved for use in smallpox in the United States in 2018. Two million doses are in the US Strategic National Stockpile in the event that smallpox reoccurs. As of 2021 it is not approved in Europe.
The results of trials support its use against smallpox and other related orthopoxviruses. It has shown potential for a variety of uses including preventive healthcare, as a post-exposure therapeutic, as a therapeutic and an adjunct to vaccination.
Tecovirimat can be taken orally and has recently been permitted for Phase II trials by the U.S. Food and Drug Administration (FDA). In Phase I trials, tecovirimat was generally well tolerated with no serious adverse events.
In those over 40 kg it is taken at a dose of 600 mg twice per day for two weeks.
Mechanism of action
Tecovirimat inhibits the function of a major envelope protein required for the production of extracellular virus. The drug prevents the virus from leaving an infected cell, hindering the spread of the virus within the body.
Based on research on monkeypox-challenged prairie dogs and safety studies in humans, Tecovirimat became the first drug approved for use in smallpox in the United States in 2018. The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.
Due to its importance for biodefense, the FDA has designated tecovirimat for 'fast-track' status, creating a path for expedited FDA review and eventual regulatory approval. On 13 July 2018, the FDA announced approval of tecovirimat.
Society and culture
Originally researched by the National Institute of Allergy and Infectious Diseases, the drug was previously owned by Viropharma and discovered in collaboration with scientists at USAMRIID. It is owned and manufactured by Siga Technologies, a pharmaceutical company in the biodefense arena that won a government contract to develop the drug.
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