Akarvia Tablet

Introduction

Akarvia Tablet 200 mg is an antiviral medication initially developed to treat influenza. It has also been studied for use against other RNA viruses, including SARS-CoV-2, the virus responsible for COVID-19. Akarvia Tablet 200 mg works by inhibiting viral replication, helping to reduce the severity and duration of viral infections. It has been used in various countries as an emergency treatment for COVID-19 under certain regulatory approvals.

Uses

Akarvia Tablet 200 mg is primarily used for:

• Treatment of influenza, particularly strains resistant to other antiviral drugs.
• Emergency use in treating COVID-19 in certain countries, where it is prescribed to reduce viral load and alleviate symptoms in mild to moderate cases.

Mechanism of Action

Akarvia Tablet 200 mg acts by inhibiting RNA-dependent RNA polymerase, an enzyme crucial for viral replication. It mimics a nucleotide and is incorporated into the viral RNA during replication, leading to premature termination of RNA synthesis. This disrupts the replication process, limiting the spread of the virus within the host.

How Long Does It Take to Work?

Akarvia Tablet 200 mg typically begins to reduce viral replication within a few hours of administration. Clinical improvement in symptoms for viral infections such as influenza or COVID-19 can be observed within a few days, depending on the patient's immune response and the severity of the infection.

Absorption

Akarvia Tablet 200 mg is rapidly absorbed after oral administration, reaching peak plasma concentrations within 2-4 hours. The drug exhibits good bioavailability but may be slightly reduced when taken with a high-fat meal.

Route of Elimination

Akarvia Tablet 200 mg is metabolized primarily in the liver by aldehyde oxidase and xanthine oxidase. Its metabolites are excreted mainly through the urine, with a small amount eliminated through feces. Less than 1% of the drug is excreted unchanged.

Dosage

For influenza, the typical dosage of Akarvia Tablet 200 mg is:

• Initial dose: 1,600 mg orally twice on the first day.
• Maintenance dose: 600 mg orally twice daily for the following 4 days.

• Initial dose: 1,800 mg orally twice on the first day.
• Maintenance dose: 800 mg orally twice daily for 7-10 days.

Administration

Akarvia Tablet 200 mg is administered orally in tablet form. It should be taken with water, with or without food. Patients should adhere to the prescribed dosing schedule and complete the full course of treatment, even if symptoms improve early, to prevent the risk of viral resistance.

Side Effects

Common side effects of Akarvia Tablet 200 mg include:

• Nausea
• Diarrhea
• Dizziness
• Elevated liver enzymes (ALT, AST)

Toxicity

Akarvia Tablet 200 mg has a relatively wide safety margin but may cause liver toxicity, particularly in patients with preexisting liver conditions. Overdose symptoms may include gastrointestinal distress and hepatotoxicity. Teratogenicity is a known risk, and it is contraindicated in pregnant women. In animal studies, it has shown potential for embryonic death and birth defects.

Precautions

Akarvia Tablet 200 mg should be used cautiously in patients with hepatic or renal impairment, and regular monitoring of liver function is recommended during treatment. It is contraindicated in pregnant women due to its teratogenic effects. Women of childbearing potential should use effective contraception during and after treatment. It is also important to monitor for signs of liver injury, such as jaundice or dark urine.

Interaction

Akarvia Tablet 200 mg may interact with:

• Pyrazinamide: Increased risk of hyperuricemia due to inhibition of xanthine oxidase.
• Drugs metabolized by aldehyde oxidase: Possible altered metabolism of drugs such as theophylline and acyclovir.
• Antiviral drugs: Caution should be taken when co-administered with other antivirals as the combined effects on viral replication and resistance have not been fully studied.

Disease Interaction

Akarvia Tablet 200 mg should be used with caution in patients with liver or kidney impairment due to its metabolism and excretion pathways. It may exacerbate liver damage in patients with preexisting liver conditions and should be avoided or used with close monitoring in such individuals.

Drug Interaction

Akarvia Tablet 200 mg can interact with other medications metabolized by aldehyde oxidase or xanthine oxidase, potentially altering their effectiveness or increasing the risk of side effects. Drugs such as theophylline and acyclovir may require dose adjustments when co-administered with Akarvia Tablet 200 mg. There are no known interactions with commonly used antibiotics, but caution should be exercised with drugs that impact liver function.

Food Interactions

Food does not significantly affect the absorption of Akarvia Tablet 200 mg, though a high-fat meal may slightly delay the time to peak concentration. It can be taken with or without food according to the patient’s preference and tolerance.

Pregnancy Use

Akarvia Tablet 200 mg is contraindicated in pregnancy due to its potential teratogenic effects. Animal studies have shown an increased risk of fetal death and malformations. Women of childbearing potential should use effective contraception during and for a period after treatment, and pregnancy should be ruled out before starting therapy.

Lactation Use

It is not known whether Akarvia Tablet 200 mg is excreted in human breast milk. Due to the potential risks to a nursing infant, breastfeeding should be discontinued during treatment with Akarvia Tablet 200 mg, or an alternative antiviral therapy should be considered if breastfeeding is to be continued.

Acute Overdose

In cases of acute overdose, symptoms may include gastrointestinal distress, liver enzyme elevation, and potentially hepatotoxicity. There is no specific antidote for Akarvia Tablet 200 mg overdose, and treatment should be supportive, with monitoring of liver function and symptomatic management.

Contraindication

Akarvia Tablet 200 mg is contraindicated in patients with a known hypersensitivity to the drug or any of its components. It is also contraindicated in pregnant women due to its teratogenic potential and in patients with severe hepatic impairment. Additionally, it should not be used in patients with a history of gout or hyperuricemia without close monitoring, as it may exacerbate these conditions.

Use Direction

Akarvia Tablet 200 mg should be taken as prescribed by a healthcare professional, typically at a dosage schedule tailored to the specific viral infection being treated. Patients should adhere to the recommended dosing schedule, avoid missing doses, and complete the full course of therapy. Women of childbearing potential should use effective contraception during treatment, and liver function should be monitored regularly.

Storage Conditions

Akarvia Tablet 200 mg tablets should be stored at room temperature, between 15°C and 30°C (59°F and 86°F), away from moisture and heat. They should be kept out of reach of children and not used after the expiration date.

Volume of Distribution

Akarvia Tablet 200 mg has a moderate volume of distribution, indicating that it is distributed widely throughout the body tissues. The exact volume of distribution has been reported to be around 15-20 L after oral administration.

Half-Life

The elimination half-life of Akarvia Tablet 200 mg is approximately 2-5 hours, depending on the patient's liver function. In patients with hepatic impairment, the half-life may be prolonged, necessitating dose adjustments.

Clearance

Akarvia Tablet 200 mg is primarily cleared through hepatic metabolism by aldehyde oxidase and xanthine oxidase, with its metabolites excreted mainly through the urine. The clearance rate may be reduced in patients with hepatic impairment, requiring careful monitoring and possible dosage adjustments.

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