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10 points to know Azvudine
Author | Shi Chunhuan
Now that the new crown epidemic continues to spread, in the case of the superposition of viruses and underlying diseases, diabetics have borne more pressure, "domestic new crown oral drug" azvudine, is diabetic suitable for taking? What should I pay attention to? Let's take a look
together.
01
Is azvudine a new crown drug?
First of all, it should be clear that there is currently no specific drug
for the new crown virus.
Clinically, azvudine can shorten the time of patients to carry the virus, reduce the viral load, or shorten the symptoms of 1~2 days, etc.
, which does not mean that the drug can kill the virus
.
If the onset is too long, the disease has progressed to severe and critical disease, and the role of antiviral drugs is limited
.
Patients should still carry out symptomatic treatment in accordance with relevant treatment principles, such as the use of antipyretic analgesics according to body temperature, cough and sputum symptomatic, cough and phlegm, etc
.
02
What kind of medicine is Azvudine?
Azvudine is a novel nucleoside reverse transcriptase and helper protein dual-target inhibitor approved in 2021 for the treatment of HIV-1 infected adults with high viral
loads.
In 2022, the State Food and Drug Administration approved the indication for the treatment of novel coronavirus pneumonia with conditions, and the drug was included in the "Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (9th Edition)" [1].
03
Mechanism of action [2].
Azvudine is a broad-spectrum RNA virus inhibitor that can specifically act on the new coronavirus polymerase (RdRp) and embed viral RNA in the process of new coronavirus RNA synthesis, thereby inhibiting the replication of the new coronavirus and achieving the effect
of treating new coronavirus infection.
04
Can diabetic patients take the drug in advance to prevent the new crown?
Can't
.
Azvudine is only used to reduce the risk of developing severe disease in high-risk groups, cannot prevent new crown infection, and cannot relieve clinical symptoms
such as fever and fatigue after new crown infection.
The indications of the drug in the ninth edition of the diagnosis and treatment protocol are: for the treatment of adult patients
with common novel coronavirus pneumonia (COVID-19).
05
Can diabetic patients use the drug after being infected with the new crown?
Whether it can be taken needs to be taken needs to be considered by three factors: the patient's condition, the time of taking and the contraindications
to compatibility.
First of all, pay attention to the patient's condition, diabetes is not a contraindication to the drug, but for serious metabolic diseases (such as long-term poor blood sugar control) should be used with caution to avoid aggravation
.
If diabetic patients with the following diseases should use this product with caution: abnormal liver function, abnormal renal function, pancreatitis, viral hepatitis
.
In addition, the "Azvudine Application for Marketing Technical Review Report" shows that the drug has genotoxicity and reproductive toxicity, and it is not recommended for
pregnant women.
Secondly, pay attention to the time
of use.
It is generally considered to be meaningful to take it early in the infection, and if the onset is too long, the disease has progressed to severe and critical disease, and the role of antiviral drugs is limited
.
The "Recommendations and Appropriate Technologies for Primary Diagnosis and Treatment of Novel Coronavirus Infection in Peking Union Medical College Hospital" [3] mentions that high-risk groups with poorly controlled primary diseases such as diabetes and diabetes complications may require antiviral therapy, and from the perspective of clinical benefit, it is taken in the early stage of infection (within 3-5 days) and the rapid replication of the virus.
Finally, it depends on whether there are contraindications
to compatibility with existing drugs.
Azvudine is a P-glycoprotein (P-gp) substrate and a weak P-gp inducer
.
The hypoglycemic drugs vildagliptin and lintagliptin are the substrates of P-gp, and caution is required when combined, and many patients with endocrine diseases such as diabetes are often complicated by cardiovascular diseases
.
Commonly used drugs for cardiovascular disease, digoxin and dabigatran etexilate, are P-gp substrates, while dronedarone, amiodarone, verapamil, etc.
are P-gp inhibitors
.
The above drugs and azvudine should be used with caution, if it is really necessary to use in combination, blood concentration monitoring should be carried out if necessary, especially in patients with
obvious impairment of liver and kidney function.
In addition, the market time of this product is short, the drug interaction research is not perfect, and the risk of self-medication is greater, and it must be taken
under the guidance of a doctor.
06
How safe is Azvudine tablets? Are there potential security risks?
From the previous clinical observation studies carried out in China, Brazil, Russia and other countries, it is generally relatively safe, and there are no serious adverse events
.
Common adverse reactions are dizziness, abnormal liver function, nausea, vomiting, diarrhea and other gastrointestinal reactions [2].
If diabetic patients with the following diseases should use this product with caution: abnormal liver function, abnormal renal function, pancreatitis, viral hepatitis
.
In addition, the "Azvudine Application for Marketing Technical Review Report" shows that the drug has genotoxicity and reproductive toxicity, and it is not recommended for
pregnant women.
07
Are azvudine tablets effective against variants?
Clinical trials have proved that Azvudine tablets have a good therapeutic effect
on the current major circulating new coronavirus variants, such as alpha, beta, delta, Omicron, etc.
This may be related
to the nucleotide substrate that targets viral replication.
Therefore, the drug is effective
against the currently circulating variants of the new coronavirus.
08
How to take it correctly?
The main dosage form of azvudine is tablets, with specifications of 1 mg and 3 mg, and adult patients with common COVID-19 are suitable for 1 mg size
.
Oral 5mg each time, once a day, swallow whole, do not crush, the course of treatment is not more than 14 days
.
Postprandial administration increases exposure in the body, so fasting
is recommended.
If the missed dose is short, you can make up the dose as soon as possible, but if it is close to the next dose time (more than half of the interval between normal doses), you can skip the missed dose and take the drug directly at the next dose, not twice the dose
at once.
09
After taking azvudine, can the original hypoglycemic drugs continue to be taken? Antidiabetic drugs
cannot be discontinued.
For diabetics, poor blood sugar control can easily induce the occurrence
of severe or even critical new crowns.
While taking azvudine, hypoglycemic drugs must be continued as directed by your doctor
.
Common adverse reactions of azvudine include nausea, vomiting, diarrhea and other gastrointestinal reactions, and many hypoglycemic drugs themselves may cause gastrointestinal discomfort, which needs to be identified
.
It is recommended to take it at intervals with hypoglycemic drugs
.
After diabetic patients are infected with the new crown, it may affect their appetite, and in the case of reduced or no eating, it is recommended to adjust the amount of hypoglycemic drugs as appropriate under the guidance of a doctor to avoid hypoglycemia
.
10
What other things should diabetics pay attention to while taking medication? Diabetic patients still need to closely observe the progress of the disease during the period of taking azvudine, and the key indicators for observation are:
First, blood sugar status
.
After diabetic infection, due to loss of appetite, fever and other reasons, blood sugar fluctuations may be large, and hypoglycemic shock or ketoacidosis
will occur in severe cases.
Second, the fever situation
.
If the fever is more than 5 days after infection with the new crown, the fever does not subside, which indicates that the inflammatory response persists, and the virus replication may also persist, so you need to seek medical attention in time;
Third, the patient has chest tightness, gasping, especially after a little activity there is panic, chest tightness, and even including rapid heartbeat, shortness of breath, etc.
, if possible, you can then measure the blood oxygen saturation of the finger, if it is less than 90%, these are dangerous signs, need to seek medical attention
in time.
References:[1].
Diagnosis and treatment protocol of novel coronavirus pneumonia (trial 9th edition)[J].
Journal of Cardiopulmonary and Vascular Diseases.
2022,41(05)
[2].
Expert consensus of azvudine in Henan pharmacy for the treatment of novel coronavirus pneumonia[3].
Recommendations and appropriate technologies for primary diagnosis and treatment of novel coronavirus infection in Peking Union Medical College Hospital (First Edition [2023.
1.
3]).
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