Brivudine

ATC CodeJ05AB15
CAS number69304-47-8
PUB number446727
Drugbank IDDB03312
Empirical formulaC11H13BrN2O5
Molar mass (g·mol−1)333,135
Physical statesolid
Density (g·cm−3)1,9
Melting point (°C)165
Boiling point (°C)582,81
PKS value9,74
Solubility0.4059 mg/mL

Basics

Brivudine is an active ingredient that is used to treat viral diseases. It is an antiviral agent and is used specifically for shingles, which is caused by the herpes zoster virus . Brivudine inhibits the multiplication of viruses, thereby reducing the viral load. The active ingredient is also a prodrug and is only converted into the active form in infected cells. A prodrug is an inactive substance that is only converted into its active form in the body, where it is supposed to work.

Graphic structural formula of the active substance brivudine

Effect

Brivudine works by inhibiting the DNA polymerase of the viruses. DNA polymerase is an enzyme that is essential for the replication of viruses. By inhibiting DNA polymerase, replication (i.e. multiplication) is stopped. This works by incorporating brivudine as a DNA building block. However, because our body recognizes the active substance as non-self, the replication process is stopped.

Dosage

Always take Brivudine exactly as described in the package leaflet or as advised by your doctor.

Adults:

The usual recommended dose is 125 mg daily .

Treatment should be started no later than 72 hours after the onset of the first symptoms and should NOT last longer than 7 days.

Side effects

The following side effects may occur:

Frequent:

  • Nausea

Occasional:

Rarely:

  • Reduction in the number of blood platelets
  • hallucinations
  • State of confusion
  • Taste disturbances
  • Trembling
  • earache
  • low blood pressure
  • liver inflammation
  • increased bilirubin concentrations
  • bone pain

Frequency unknown:

  • Balance disorders
  • vasculitis
  • acute liver failure
  • fixed exanthema
  • exfoliative dermatitis
  • erythema multiforme
  • Stevens-Johnson syndrome

Interactions

Interactions may occur if the following medicines are taken at the same time:

Contraindications

Brivudine must NOT be taken in the following cases:

  • With existing, past or future use of certain chemotherapies(capecitabine, 5-fluorouracil, tegafur, etc.): Fatal interactions are possible.
  • with existing, past or future treatment of fungal infections with flucytosine: fatal interactions are possible.
  • in case of allergy to brivudine

Age restriction

Brivudine should NOT be taken under the age of 18, as safety and efficacy have not been studied at this age.

Pregnancy & breastfeeding

Brivudine should NOT be used during pregnancy. There is evidence from animal experiments of toxic effects after high doses.

Brivudine should NOT be used during breast feeding. The main degradation product of brivudine passes into breast milk.

History of the active ingredient

The active ingredient brivudine has been produced in England since the 1970s. It was approved for the treatment of herpes simplex infections until 2000. Since 2001, it has only been used for herpes zoster.

Thomas Hofko

Thomas Hofko



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