The best antiviral remedies for the flu

*Overview of the best according to the editors of Healthy Food Near Me. About selection criteria. 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.

We will consider how viral infections differ from bacterial ones, what principles underlie the treatment of influenza and SARS. Then we will consider the main differences between influenza and a banal adenovirus infection, and proceed to a review of drugs that exhibit truly proven antiviral activity.

The author sincerely hopes that his efforts will not be in vain, and the reader will form a solid image: what to do and what is better not to do when symptoms of ARVI or flu appear. But we will start by explaining how viruses differ from other organisms, and what are the features of the interaction between the human body and viruses. This will be important for understanding the mechanism of action of drugs in influenza and acute respiratory viral infections.

Features of the viral process

Strictly speaking, it is still unclear to scientists whether viruses are living organisms or not. Living organisms can reproduce on their own, reproduce their copies in the external environment (or the internal environment of a person). But even strict, obligate parasites that cannot live without a host, they need it as a habitat. Any microorganism, any causative agent of an infectious disease has all the necessary means and tools to reproduce independently in the human body, once in the necessary environment.

Reproduction (copying cells) occurs through the work of intracellular organelles. Ribosomes of bacteria synthesize protein, double all the necessary structures, and the cell divides in half. A virus is a non-cellular form of “life”, it cannot create anything on its own, and has no tools for protein synthesis. It can reproduce only by using our genes, embedding its hereditary code into them. Viruses use our cells for their own purposes, in much the same way as a tractor factory captured by the enemy will produce tanks for his army at its own facilities, but according to its drawings.

By the way, at the forefront of medical science, an amazing breakthrough has indeed been realized, without quotes, a real breakthrough. Scientists have learned with a single injection to treat severe spinal muscular atrophy, which in 100% led babies to death, starting at the age of two, and in mild cases they could live up to 20 years. This is a hereditary disease in which there is a defect in the gene encoding the synthesis of a special protein that allows large motor neurons to function normally.

Special, non-pathogenic varieties of adenoviruses were created, and a special, previously non-existing nucleic acid site was introduced into their hereditary material, which was supposed to replace the defective gene. Since the viral genome is built into the hereditary material of a person, this was the whole calculation, and it was justified. In essence, the virus was simply used as a tool to repair the human genome, and then just one shot of a drug containing these viruses was enough. After they reproduced in the body, and after they left the body, a correction of the defective section of the gene occurred. The child was healed of a severe hereditary disease, from which he was bound to die due to progressive muscle atrophy.

This medicine, Zolgensma (“Zolgensma”), was approved by the FDA in May 2019. It was invented in the USA. But back to the “simple” flu.

Differences between cold and flu

In fact, we are talking about a substitution of concepts, about two or more different infections, all of which are of a viral nature. It’s just that the flu is a more severe ARVI infection, and other ARVIs that are caused by other viruses, such as adenoviruses, do not have such epidemic significance, the severity of the process, and such a number of deaths.

Let’s compare the important symptoms and signs that are characteristic of the flu and other infections that are similar in flow, but not related to the flu:

1. with influenza in its typical form, the onset is always acute, and the patient can sometimes even indicate the hour when he became worse. ARVI does not have such an abrupt onset;

2. fever syndrome with influenza is pronounced, the temperature rises quickly, to numbers usually significantly exceeding 38,5 ° C, sometimes above 40 ° C. Respiratory infection occurs with fever at the level of subfebrile condition, and usually not higher than 38 ° C;

3. The flu loves to start dry. Rhinorrhea, a runny nose, appears later, and with respiratory viral infections, a runny nose may first debut, and only then a general malaise will appear;

4. with influenza there is very often a painful and dry cough, without any expectoration of sputum, and during and after coughing there is an unpleasant sensation, or even severe pain in the retrosternal region;

5. in the case of adenovirus infection, other diseases, but not influenza etiology, cough does not appear immediately, and sometimes later, on the second or third day, or does not appear at all.

Cough should be mentioned separately. In the event that the patient improves after the flu or a respiratory infection, the symptoms of intoxication disappear, the condition returns to normal, and then it becomes worse again, a runny nose and a wet cough with a large sputum discharge appear, then here, most likely, there is already an attachment secondary bacterial infection. Here you need to connect antibacterial therapy, or antibiotics. In viral infections, the prescription of antibiotics is a great harm and stupidity, since all antibiotics and other antibacterial drugs destroy microbial cells, or disrupt the functioning of cellular structures. Viruses, on the other hand, do not have any cells, they are a non-cellular form of life, and the use of antibiotics in the early days of influenza will only facilitate the emergence of resistant bacterial strains;

1. pronounced signs of intoxication – general malaise, chills, muscle pain, aching joints, pain when moving the eyes, a sharp rejection of bright light, that is, photophobia, increased skin sensitivity, for example, discomfort and pain when combing hair, are characteristic of influenza. In the case of ARVI, there are no such pronounced signs of intoxication;

2. a very important factor is the seasonality of the epidemic situation. Influenza usually occurs in winter, passes in a wave through settlements and disappears, and acute respiratory viral infection can be infected all year round, regardless of the situation with influenza;

3. even if the patient has normal immunity, SARS can occur up to several times a year, and proceed without any complications. As for the flu, it is a rather serious disease that can be complicated by pneumonia, respiratory failure, viral meningitis, and in cases of weakened immunity, lead to death.

4. It must be remembered that the flu pandemic called “Spanish flu” in 1918 claimed the lives of more than 50 million people around the world. Of course, antibiotics were not known then, and if they had been discovered 30 years earlier, then many complications associated with bacterial pneumonia would have been curable, and there would have been fewer victims. But there are also fulminant forms of influenza, in which hemorrhagic syndrome immediately develops, DIC associated with severe intoxication and coagulopathy of consumption, multiple organ failure and death occurs literally within 1-2 days.

Therefore, since the flu can proceed at lightning speed, then antiviral agents for influenza should be taken as quickly as possible, and in any case, no later than two days after the onset of the first symptoms, and even better – during the first day.

I have the flu…

In a normal state of health, influenza is diagnosed using modern laboratory methods. And the instruction of the Ministry of Health says that in order to accurately identify the influenza virus, the clinical picture we have described above is not enough. Required:

1. real-time PCR analysis, so that the analysis shows the presence of virus RNA, and precisely the influenza virus;

2. it is necessary to see an increase in the titer of antibodies to the virus in the blood serum within 1-2 days to 3 weeks of the disease.

And the staging of a viral infection influenza only according to complaints and according to the clinical picture is possible in two cases:

1. when there is an epidemic of flu all around, and there is no doubt that the virus is ubiquitous;

2. unavailability of laboratory methods.

From this a practical conclusion is drawn. If you were “lucky enough” to get sick at the very beginning of the epidemic, before the epidemic threshold was exceeded, when doctors were still forbidden to diagnose the flu, then you can be diagnosed with ARVI, although you have a real flu, and you need to be treated more seriously.

How flu and colds are treated

So, what are the approaches to the treatment of SARS (not the flu!) in different countries?

So, in Belgium, no antiviral drugs, immunomodulators, and even more so interferons or their inducers are used. The Ministry of Health has nothing to do with it, it is not a repressive apparatus, but a doctor prescribes everything. It acts in accordance with modern scientific data, and scientific data suggest that it is possible to use immunity modulators, interferon inducers if and only if an immunity deficiency has been established using modern laboratory methods, that is, an immunological examination has been carried out, and appropriate conclusions have been drawn.

The immune system is a complex, multilayered and duplicated structure, and poking into it with an unknown over-the-counter immunomodulator is like trying to fix a fragile piece of jewelry with a hammer.

In Germany, there is an integrated approach: the right diet, fluid load, such as cranberry or lingonberry juice. Approximately the same approach to the treatment of colds in Finland. The country is northern, and in every home first aid kit there is an antipyretic, for example, Theraflu, ibuprofen, and no suspicious drugs are used there.

In general, one should extrapolate the principles of prescribing medicines for colds and flu to how vitamins are used abroad. Vitamins should only be used if there is a proven deficiency of a specific vitamin, and there are appropriate symptoms, and the deficiency of the vitamin has been confirmed in the laboratory.

Then the doctor will not have any questions whether to prescribe the vitamin or not. So, a sailor of the Columbus expedition, who ate corned beef and tortillas for several months, whose gums began to bleed and teeth to fall out, will be diagnosed with scurvy – an acute vitamin C vitamin deficiency, and then urgent treatment will be needed – intramuscular injections of vitamin C. Similarly, in case of other avitaminosis.

And the use of vitamins, vitamin-mineral complexes in the form of tens and hundreds of varieties “for prevention”, for example, due to increased physical activity at work, is not an indication, but the desire of pharmaceutical companies to cash in.

Overview of Medications

We realized that the creation of truly effective antiviral drugs is a long, complicated, and very expensive business. But even an already established drug that has any activity in the lab, in cellular media, or in mice cannot be advertised as being great for humans at all. On the contrary, only from this moment begins, perhaps, the most expensive phase of clinical trials, and the longest. We need a large number of healthy volunteers in the control group, really patients with diagnosed (laboratory!) influenza, we need a control group of patients with influenza who will not be prescribed a new remedy.

It is necessary to insure all people, to standardize all methods of measurement, all methods of taking tests, to create a placebo, that is, a pacifier, to compare the effect of a medicinal substance with a pacifier blindly. Blindly – this means that neither the doctor knows what he is giving to the patient, nor the patient does not assume that he is receiving. Only researchers know this. Only as a result of such a maximally objective study, which is called a double-blind, randomized, placebo-controlled study, can truly proven results of the effectiveness of a drug be obtained.

But even this is not enough. A wonderful drug that works great, and promises big profits for manufacturers, can do “meanness”, and have a serious side effect that was not at all expected. An example is the infamous thalidomide, an excellent sleeping pill that was discontinued because it caused severe fetal deformities in pregnant women that were incompatible with life. The drug may accumulate in the body, it may have a small therapeutic latitude, that is, a very small distance between the minimum dose and the symptoms of severe overdose. Therefore, reliable and effective drugs are always few.

The following is a list of medicines that are really effective against influenza. As we agreed, we treat SARS without antiviral drugs. All of them are in the WHO recommendations, and are approved for use throughout the world. First, the international non-proprietary name of the drug will be given, then the original name, that is, the remedy that was first created and most researched. Then, if available, some generics, or commercial copies of that drug, will be listed.

Then some prices relevant for February 2020 on the territory of the Russian Federation will be indicated. The list of drugs is not intended to advertise to anyone, and as for anti-advertising, all non-recommended drugs really have not passed full-fledged tests. And now let’s move on to the really necessary and useful remedies that are required on the very first day after the onset of flu symptoms.

Proven Effective Flu Remedies

It should be warned right away that in this case we are talking only about the flu, the drugs listed below are not intended for the treatment of acute respiratory viral infections, or a common cold, using them is a big mistake, they will not give any effect. This is about the same as trying to use another key to open the door, which simply does not fit the lock. And this short review begins with the most famous drug for the treatment of influenza, which is sold in Russia under the brand name Tamiflu.

Oseltamivir (Tamiflu)

Rating: 4.9

Attention! Do not confuse Tamiflu with Theraflu! Theraflu has nothing to do with antiviral action!

The mechanism of action of this drug is the inhibition of neuraminidase. Tamiflu inhibits one of two very important factors in the spread of viruses in the respiratory tract, namely, the viral enzyme neuraminidase. To interact with neuraminidase, oseltamivir does not need to enter the cells, in addition, the agent inhibits the growth of the virus and reduces its pathogenicity, and also reduces its excretion from the body. It is important that it does not affect the introduction of the influenza vaccine, and is highly effective, and the resistance of viruses to Tamiflu does not exceed 2%.

The drugs are indicated for viral influenza of two types, A and B. It must be used orally, and no later than 2 days after the onset of the disease. The duration of admission is 5 days, the average dosage is 75 mg 2 times a day. During an epidemic, you can take a medicine for prevention, one capsule for 6 weeks.

The drug is produced by the well-known pharmaceutical company Hoffmann-la Roche (Switzerland-Germany), and a package of 10 capsules, just designed for a course of treatment in a standard dose, will cost from 980 to 1200 rubles. In case of severe course, you can increase the dose, and then the course will require two packs. There is a domestic analogue, Akrikhin’s oseltamivir, and its cost is, on average, 550 rubles.

Advantages and disadvantages

The most important advantage that covers all the shortcomings is really the elimination of flu symptoms, or a significant reduction in them, the prevention of complications, and the risk of shortening the period of disability. But the drug also has limitations. These are severe renal failure, liver failure, caution in children, pregnant and lactating women, and the possibility of nausea and vomiting, insomnia on the first day of treatment.

Zanamivir (Relenza, Relenza)

Rating: 4.8

Relenza is a highly effective antiviral drug, which also belongs to the neuraminidase inhibitors. Neuraminidase, together with hemagglutinin, are influenza virus aggression enzymes that are located outside the virion. Hemagglutinin “manages” the successful penetration of the virus into the cell, and neuraminidase ensures the exit of multiplied particles from the cells. This drug does not penetrate the cell, as well as Tamiflu, and significantly reduces the reproduction of viruses, and prevents them from leaving the cells.

The medicine is used for influenza types A and B, in adults and in children over 5 years old. Interestingly, these are not capsules, but they are used in the form of inhalations through the mouth, that is, the drug enters directly into the lungs, and to use it, you need to use the diskhaler that is attached.

The usual dosage is two inhalations of 5 mg 2 times a day for 5 days. The sooner treatment is started, the better. The drug can be prescribed for prevention, and then Relenza is used at the same dose, but only once a day for 10 days, that is, the daily dose is half as much. The instructions describe in detail how to carry out inhalations, but children should use them under adult supervision. Zanamivir is produced by Glaxosmithkline from the UK, and 4 doses of 5 mg each cost from 950 to 1900 rubles in pharmacies. Generics, that is, commercial copies, this drug does not exist. This is the only original drug.

Advantages and disadvantages

Perhaps the disadvantage is the fact that there are only four inhalation doses in the package, that is, one package is enough for 2 days, and you will still need to buy at least one package so that you can be treated for at least 4 days. In this sense, Tamiflu is much more economical.

Like any powerful tool, the drug has contraindications, but they are few standard. This is the first trimester of pregnancy, breastfeeding and children under 5 years of age. With caution, Relenza is used when there are phenomena of bronchospasm, that is, in chronic obstructive pulmonary diseases, when inhalation of the drug can cause an increase in bronchospasm. In general, the drug is well tolerated, and sometimes, very rarely, side effects such as allergic reactions, feeling hot, or rash and urticaria occur.

Promising agent: baloxavir marboxil (Xofluza)

Rating: 4.7

It is a brand new influenza antiviral developed in Japan, licensed by Roche and approved for use in Japan and the United States, and was marketed in late 2018 under the commercial name Xofluza.

Its mechanism of action is that it does not affect the neuraminidase enzyme, but suppresses replication, that is, the multiplication of the influenza virus by disrupting the synthesis of its nucleic acids, therefore it has an affinity for the mechanism of action with antiherpetic antiviral drugs, such as acyclovir. Indications for use – adults and children over 12 years of age, the first two days after the onset of flu symptoms.

Advantages and disadvantages

Information about this drug is extremely scarce in the Russian literature. However, it is known that the drug eliminates the fever syndrome very well, due to the fact that there is no virus replication, it does not multiply in the body, and the viral load decreases much faster than with the appointment of neuraminidase inhibitors.

Finally, the most important plus is that the medicine should be taken only once. Compared to oseltamivir, which has to be taken twice a day for 5 days, this is indeed a very important advantage. In the Russian Federation, this drug is not registered and is unknown.

However, on commercial sites I can buy Xofluza on order, in the amount of 2 tablets, 40 mg each in a package. It will currently set you back around $370 for two tablets, or in the region of RUB 24000. You can also buy one tablet, which will cost 14000 rubles. Conclusions to draw, as they say, only you.

Conclusion

Now we know how to deal with influenza viruses, and it remains to tell a little about what awaits us in 2020 and 2021. First of all, the danger of an epidemic of swine flu, which was first detected in Mexico in 2009, remains. From Mexico, it has spread all over the world, and it is quite possible that this strain will continue to evolve and mutate further, this is H1N1 A-flu.

Also, we should not forget about the possible epidemics of the Hong Kong flu, this is also influenza A, the H3N2 strain. It is known that influenza epidemics return in the same structure of hemagglutinin and neuraminidase, when generations that have received immunity to this particular strain, or who have recovered from it, leave.

Some 50 years have passed since the Hong Kong flu spread widely around the world, and therefore it is quite possible to expect its arrival, again with severe, and even fatal cases. We should not forget about the Australian flu, which was first registered in Australia in 2008, and is still rather poorly studied.

Now a new threat of coronavirus infection hangs over the world. When the hysteria on this topic subsides a little, then it turns out that he is not as scary as he is painted. Treatment regimens for coronavirus infection transmitted to humans from bats are already being successfully used, using a combination of oseltamivir and ritonavir, that is, drugs for the treatment of influenza and drugs for the treatment of HIV infection.

But medicine today is not what it was 50 years ago. All the world’s leading scientific institutions and laboratories have already received information about what constitutes the genome, or the nucleotide sequence of the coronavirus. His genome has been successfully sequenced, and everyone has the key to creating a new drug.

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.