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They say that if a cold is treated, it will pass in seven days, and if not treated, in a week. This statement is justified only in the case of a mild viral infection – when there is a slight cough and runny nose, but the patient’s general condition hardly suffers. A different approach requires influenza, which is accompanied by high fever and often leads to the development of complications. Not only tea with raspberries and mustard plasters come into the fight against the disease, but also more modern methods – antiviral drugs.
The focus of our article today will be two remedies against a viral infection – Arbidol and Ingavirin. According to manufacturers, these drugs reduce the duration of the flu, alleviate the patient’s condition and reduce the risk of complications. According to the latest data, they are even being used against the new coronavirus infection COVID-19. Whether these drugs really cope with the disease and how effective they are, we will tell in the article.
Characteristics of the preparation | Arbidol | Ingavirin |
Active substance | Umifenovir | Pentandioic acid imidazolylethanamide |
Release form and dosage | Film-coated tablets 50 mg Capsules 100 mg Powder for suspension for oral administration 25 mg / 5 ml | Capsules 60 and 90 mg |
Manufacturer | OTCPharm, Russia | Valenta Pharm, Russia |
Cost | 100-1000 rub. depending on the form of release and quantity | 350-700 руб. |
Composition
Arbidol and Ingavirin belong to the same pharmacological group – antiviral drugs. Ingavirin is also declared by the manufacturer as an anti-inflammatory agent, however, it is not used in isolation for this indication. The anti-inflammatory effect here is auxiliary and is added to the main action – the fight against a viral infection.
Arbidol and Ingavirin are produced in Russia and are included in Register of Medicinal Products. In Europe and the USA, both funds are not registered, because have not received FDA (Food and Drug Administration) approval.
In the fight against the virus: how they work
Let’s turn to the instructions for the use of drugs and find out how they cope with a viral infection.
Arbidol
Umifenovir specifically affects influenza A and B viruses (including H1N1), as well as other viruses (coronavirus associated with severe acute respiratory syndrome, adenovirus, respiratory syncytial virus, rhinovirus). The umifenovir molecule binds to the hemagglutinin of the virus and prevents it from incorporating into the cells of the human body. Outside the cell, the virus cannot live and multiply; in fact, it is a parasite. Only by penetrating through the cell membrane does it acquire the ability to reproduce its own kind and, like an enemy army, march victoriously through the healthy cells of the body.
Umifenovir has not only antiviral, but also a non-specific immunostimulating effect: it increases the body’s resistance to infections, enhances the production of interferon. According to the manufacturer, Arbidol reduces the duration and severity of the disease, reduces the incidence of complications and exacerbations of chronic processes.
Ingavirin
The drug with an unpronounceable name is effective against influenza A and B viruses, parainfluenza virus, adenovirus, RS virus – and this is only what has been proven in clinical trials, that is, on sick people. In preclinical studies (in the laboratory), it was found that the drug can cope with other types of viruses, including coronavirus and Coxsackie.
Unlike Arbidol, Ingavirin does not act directly on viruses. It works indirectly through the immune system: it stimulates innate immunity factors in response to the introduction of a foreign agent. Experiments have shown that Ingavirin increases the expression of interferon and stimulates the synthesis of the antiviral protein MxA. As a result, the reproduction of the virus slows down, and the disease subsides.
Ingavirin also has an anti-inflammatory effect. The drug suppresses the production of key cytokines involved in the development of the inflammatory response. In experimental studies, it was also possible to find out that Ingavirin enhances the effect of antibiotics in a bacterial infection.
Evaluation of the effectiveness of drugs
According to manufacturers, both antiviral drugs effectively cope with their task: they reduce the duration and severity of the disease, and reduce the risk of developing serious complications. But how does it work in practice?
Arbidol
In order for a drug to be recognized internationally, it must prove its effectiveness in clinical trials – and not just any, but with a fairly good sample of patients. There are certain criteria to reduce the likelihood of error and get really reliable data. The study must be randomized, double-blind, placebo-controlled. This means that one group of subjects receives the drug, the other – a dummy (placebo). No one – neither the doctor nor the patient – knows what exactly: both the drug and the pacifier have the same shape, color, smell, taste. The sample of patients is random. This is the only way to prove that the results are not rigged, the drug really works, and its action is not based on self-hypnosis.
All studies conducted on the drug are entered into the medical knowledge base, and the most famous among them is PubMed. Search for Arbidol is more than 160 articles, however, not all of them are of interest to us. Most of the studies were carried out in the laboratory (in vitro), sometimes on animals. This is an important part of drug evaluation, but not the final one. To recognize the drug as effective, you need to test it on people – real patients who have the flu or SARS.
Of greatest interest to us is the study ARBITRATORthat meets all the stated criteria. It was carried out at 15 research centers in Russia, lasted about five years and ended in 2016. The study involved 359 adult patients aged 18-65 with influenza or SARS lasting no more than 36 hours. The results of this study indicate the efficacy and safety of Arbidol. Scientists concluded that the drug works best in the first days of the disease, and its main effect is to reduce the duration of the disease. It was not said whether the use of Arbidol reduces the risk of complications.
The post-registration clinical trial “ARBITR” on the drug Arbidol became the first Russian trial included in the international database ClinicalTrials. The placement of articles in this database is carried out after an independent examination – and only if the study complies with international standards of evidence-based medicine.
In 2020, a lot of publications appeared on the network that Arbidol is used against a new coronavirus infection. But the effectiveness of the drug against COVID-19 is still not proven: insufficient data to draw conclusions.
Ingavirin
The drug Ingavirin is spoken about mainly in the Russian-language medical literature. Review, published in the journal Effective Pharmacotherapy, covers the results of various studies on the drug in children of different ages. The authors of the review concluded that the appointment of Ingavirin in the first 36 hours of illness shortens the period of fever and reduces the severity of symptoms, as well as the incidence of complications.
Similar findings were obtained when evaluating the effect of the drug in influenza and SARS in adults. However, in the scientific world, not everyone agrees with the results of the reviews. Some of the presented studies do not follow the principles of evidence-based medicine, others include too small a sample of patients.
Arbidol vs Ingavirin
Direct studies comparing Arbidol and Ingavirin have not yet been conducted. But both of these drugs are periodically compared in various trials related to the action of other antiviral agents. In particular, in one of the Research no statistically significant differences were found between Arbidol and Ingavirin. In another laboratory experiment there was no clear advantage of one drug or another. Perhaps in the future more serious studies will be carried out on this topic, but for now we can be content with what we have.
Application Scheme
Antiviral drugs should be taken strictly according to the instructions. Deviation from the recommended schedule reduces the effectiveness of therapy.
Arbidol
For prevention during the ARVI epidemic, Arbidol is prescribed for adults 200 mg 2 times a week for three weeks. In direct contact with a sick person, the drug should be taken daily.
For treatment, the drug must be taken every 6 hours for 5 days.
Arbidol is prescribed for children from the age of 6. The dosage is calculated individually.
Ingavirin
For prevention and treatment, Ingavirin is prescribed to adults at 90 mg per day for 5-7 days.
Ingavirin is allowed for children from the age of 13 at a lower dosage (60 mg).
Both drugs are available without a prescription, but their use must be agreed with the doctor. Arbidol and Ingavirin are prescribed only for influenza and acute viral infections. With signs of bacterial infection, the ordinary use of these drugs is not indicated.
Adverse Reactions
Side effects with both antiviral drugs are rare. Against the background of the use of Arbidol and Ingavirin, there may be allergic reactions: skin rash, itching. If symptoms worsen, stop taking the drug and consult a doctor.
Противопоказания
Arbidol is not used in pregnant women in the first trimester and in children under 6 years of age.
Ingavirin is not used in children under 13 years of age and at any stage of pregnancy.
Both drugs are prohibited in case of individual intolerance.
Conclusions
To sum up:
Arbidol and Ingavirin are antiviral drugs. They are active against influenza A and B viruses, as well as some other ARVI pathogens. The action of Arbidol against COVID-19 is being studied.
The effectiveness of Arbidol has been confirmed in the ARBITR clinical trial. In relation to Ingavirin, large-scale studies have not been conducted.
Both antivirals are well tolerated, rarely cause adverse reactions and have almost no contraindications.
Attention! This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.