Arbidol capsules 100 mg: instructions for use

Pharmacology

The instructions say that Arbidol belongs to the category of antiviral drugs. Once in the human body, it destroys influenza and coronavirus viruses.

The medication reduces the incidence of complications that can be caused by viruses, and also reduces the incidence of exacerbation of bacterial diseases that occur in a chronic form.

The use of the drug can reduce the duration of the disease. Intended for internal use and has virtually no toxic effects. If you adhere to the specified dosage, then no negative reactions will occur.

Once the active component enters the body, it is quickly absorbed from the digestive system. The maximum content is reached after 1.5 hours. Actively disperses throughout organs and tissues.

Metabolism occurs in the liver. The half-life is approximately 18-20 hours. About 45% of the constituent substances are excreted in their original form, most of them with bile, a small amount through the kidneys. In the first 24 hours, about 85% of the received dose of medication leaves the body.

Arbidol in the treatment of ARVI

Parainfluenza is characterized by moderate to severe general intoxication, damage to the upper respiratory tract, mainly the larynx. Rhinovirus disease, or contagious runny nose, is caused by rhinoviruses and is characterized by predominant damage to the nasal mucosa and mild symptoms of general intoxication. In adenoviral respiratory infections, the pathological process, in addition to the mucous membranes of the respiratory organs, involves the conjunctiva and lymphoid tissue, and in rare cases, even parenchymal organs and the intestines [22]. The pathogenesis of MS infection is characterized by the fact that after primary damage to the epithelium of the upper respiratory tract and short-term viremia, the pathogen penetrates into the lower respiratory tract. In this case, inflammatory damage to the mucous membranes of small bronchi and bronchioles leads to diffuse obstruction of the bronchi and impaired gas exchange in the lungs. It was noted that the severity of broncho-obstructive syndrome in acute respiratory infection of RS viral etiology is inversely proportional to the age of the patients. At the same time, MS infection is most severe in young children [17]. Coxsackie viruses often cause acute diseases of the nasopharynx in the form of pharyngitis and herpetic sore throat. Identification of clinical syndromes characteristic of ARVI of a certain etiology makes it possible to promptly prescribe etiotropic therapy to the patient and thereby significantly increase the effectiveness of treatment [18]. Influenza is an acute respiratory disease of viral etiology, occurring with symptoms of general intoxication and damage to the respiratory tract. Influenza virus type A was isolated in 1933, type B was isolated in 1940, type C was isolated in 1947. Influenza viruses of types B and C practically do not change their antigenic structure, while the influenza virus type A quickly changes, forming new subtypes and antigenic variations. Influenza viruses belong to the RNA-containing orthomyxoviruses. Influenza viruses contain various antigens; the S antigen includes ribonucleic acid and viral protein. The outer shell of the virion contains the surface V antigen. It contains hemagglutinin and neuraminidase. Changes in hemagglutinin and neuraminidase cause the emergence of new subtypes of the virus within type A. In the pathogenesis of influenza, there are five main phases of the pathological process: – virus reproduction in the cells of the respiratory tract; – viremia, toxic and toxic-allergic reactions; – damage to the respiratory tract with a predominant localization of the process in any part of the respiratory tract; – possible bacterial complications from the respiratory tract and other body systems; – reverse development of the pathological process. The leading role in the damage to various organs and systems during influenza is played by circulatory disorders, which are caused by disturbances in the tone, elasticity and permeability of the vascular wall, primarily capillaries [22]. Despite the diversity of etiological factors, the pathogenesis of most acute respiratory viral infections is generally characterized by common mechanisms. The duration of the incubation period is from 2 to 5 days. (on average 2–3 days). Infection with respiratory viruses is accompanied by the interaction of pathogens with receptors of epithelial cells of the mucous membrane of the upper respiratory tract. Viruses penetrate epithelial cells, release their genome and reconfigure the functioning of the infected cell. As a result, cellular enzymes are involved in the synthesis of viral proteins, which leads to the formation of new daughter virions. At the same time, physiological mechanisms of vital activity in the infected cell are disrupted, and metabolic changes increase. The process of primary viral replication ends with the release of daughter virions from the infected cell. The resulting virions penetrate into still intact epithelial cells of the mucous membrane of the respiratory tract, and also enter the vascular bed. The viremia that develops is clinically manifested by symptoms of the prodromal period of the disease (malaise, chills, headache, etc.). Viremia, as a rule, is short-term and does not lead to generalization, but under certain conditions it can contribute to the further spread of infection [17]. The reverse development of the pathological process is characterized by the elimination of the virus and complete recovery, or the formation of a latent or chronic form of the disease in adenoviral and respiratory syncytial viral infections, which play an important role in the formation of chronic diseases of the ENT organs and bronchopulmonary system [21]. ARVI is clinically characterized by relatively mild symptoms of general intoxication, predominant damage to the upper parts of the respiratory tract and a generally benign course [22]. The characteristic clinical manifestations of ARVI, depending on the etiology of the disease, are presented in Table 1. The classic clinical picture of influenza is still different from other ARVIs. Its main symptoms are a sudden onset, general intoxication, manifested by an increase in body temperature to 39°C or more, headache, muscle pain, aches throughout the body, and depression. Catarrhal phenomena (slight rhinitis or dry cough) often occur only on the 2-3rd day of the disease and bother the patient relatively little. Influenza is a dangerous disease that often causes complications, the occurrence of which is associated with secondary immunodeficiency developing under the influence of the virus, leading to a decrease in the overall resistance of the body and the protective properties of the mucous membranes of the respiratory tract. Often, as post-influenza complications, inflammation of the bronchi, paranasal sinuses, ears, and lungs occurs - pneumonia, especially in young children and the elderly, patients with chronic cardiovascular, bronchopulmonary diseases. In such patients, their chronic diseases often worsen: rheumatism, tuberculosis, cardiopulmonary diseases [23]. After suffering from the flu, a person acquires strong immunity, which is highly specific and can only be overcome by a virus with new antigenic properties. The duration of influenza immunity to a particular antigenic variant is about 20 years. Immunity to other respiratory viruses is imperfect and fragile. In most cases, intense immunity does not develop after an illness. For immunity against respiratory viral infections, the formation of local antibodies (class A immunoglobulins) by the mucous membrane of the respiratory tract is important [27]. Currently, there are no vaccine preparations against current pathogens of ARVI (with the exception of influenza vaccines), which helps maintain the incidence at a high level. Nonspecific prophylaxis is indicated for people with clinical signs of reduced body resistance: frequent respiratory diseases with a protracted or complicated course; the presence of chronic foci of infections; severe chronic somatic diseases [2]. The most important factor in nonspecific resistance is the interferon system, which, as a rule, is significantly ahead of specific methods of protection [21]. Among immunomodulators, the domestic drug Arbidol has proven itself in recent years [3]. Arbidol is a synthetic chemotherapy drug of the hydroquinone class, used for the treatment of influenza type A and type B, which, in addition to its antiviral effect, has pronounced interferon-inducing and immunomodulatory activity, which is confirmed by the phenomenon of cellular immunity and macrophage indicators [16]. The drug was created at the Center for the Chemistry of Medicines - the All-Russian Scientific Research Chemical and Pharmaceutical Institute (VNIHFI) and was approved by the Pharmaceutical Committee of the Ministry of Health of the Russian Federation for clinical use in adults [4]. It has a wide spectrum of activity against DNA and RNA viruses [5]. Arbidol has an immunomodulatory effect, leading to an increase in the total number of T-lymphocytes and T-helper cells [6]. At the same time, the use of Arbidol did not lead to significant changes in the absolute number of T-suppressor cells in the groups as a whole, which confirms the opinion of a number of researchers that the stimulating activity of Arbidol is not associated with inhibition of the function of suppressor cells [7]. Determining the immunoregulatory index (the ratio of T-helpers and T-suppressors) also provides important information about the state of a person’s immunity, since its decrease may indicate the development or presence of an immunodeficiency state. The data obtained indicate that Arbidol has no effect on the immunoregulatory index, which is within normal limits, and its normalization with initially reduced indicators [6]. An important property of Arbidol is its stimulating effect on phagocytosis. The drug not only increases the total number of macrophages with ingested bacteria, but also increases the phagocytic number [8]. An increase in phagocytosis was also noted in patients suffering from chronic bronchitis, which was accompanied by an improvement in the clinical condition of the patients and in some cases made it possible to stop taking antibiotics [9–10]. This data is important because... It is phagocytosis that is the condition for the implementation of intracellular cytolysis, which is most effective in protecting against infectious agents [8]. Arbidol significantly reduces the duration and severity of infection. The drug is the optimal remedy for patients with ARVI complicated by bronchitis, pneumonia and sinusitis [11]. Clinical trials of Arbidol were carried out in leading institutions of Russia: Influenza Research Institute of the Russian Academy of Medical Sciences, Virology Research Institute named after. DI. Ivanovsky RAMS and NIIEM named after. Pasteur. They showed the high effectiveness of the drug when used during an epidemic for the prevention and treatment of influenza caused by influenza viruses type A, subtypes H3N2 and H3N1, and type B or their combinations. About 9 thousand adults and more than 500 children from 6 months took part in the studies, which took place over several years. and older (Tables 2–5) [24–26]. For the treatment of influenza and other acute respiratory viral infections, Arbidol must be prescribed to the patient in the first 48 hours from the onset of the disease. Prevention of ARVI can be carried out in three main areas: 1. Vaccination. 2. Use of immunomodulators and interferon inducers. 3. Use of interferon drugs. Immunomodulation agents are most widely represented on the pharmacological market of the Russian Federation; existing drugs can be divided into three main groups: • vitamins and microelements; • interferon inducers; • others [20]. There is a number of data on the preventive effectiveness of Arbidol against influenza and ARVI among both adults and children [12–14]. During the epidemic season, this should be done twice a week for three weeks. And if there are already patients with influenza or ARVI in the family, then Arbidol for prevention is taken once a day, 0.2 g for 10–14 days [11]. A particularly important task is the prevention of influenza in the elderly. This contingent is the most vulnerable to infection with the influenza virus. Elderly people have an increased risk of severe disease and the development of concomitant bacterial complications. Unlike other drugs for the treatment and prevention of influenza and other acute respiratory viral infections, Arbidol is a low-toxic drug and has no contraindications for use in adults and children. Compatible with drugs used to treat respiratory infections, with other antiviral drugs and antibiotics. Approved for sale from pharmacies without a prescription [1]. When administered orally in recommended doses, it does not have any negative effects on the child’s body. It is noted that Arbidol does not have mutagenic, carcinogenic, teratogenic or embryotoxic effects [19]. Recognition of the merits of Arbidol was the inclusion of this medicine in several important lists by the Ministry of Health. It was included in the new “List of medicines dispensed on prescription from a doctor (paramedic) when providing additional free medical care to certain categories of citizens entitled to receive state social assistance.” This is the official name of the new list of preferential medications, and this means that doctors can prescribe Arbidol to “beneficiaries” for the treatment and prevention of influenza and ARVI. The drug is included in the mandatory assortment list for pharmacies, that is, it must be sold in every pharmacy. After all, like all antiviral drugs, Arbidol should always be on hand so as not to run to pharmacies when the first symptoms of influenza and ARVI appear - it is at this time that they should be taken in order to stop the development of the infection at the very beginning [11]. The use of Arbidol for therapeutic and prophylactic purposes allows to reduce the incidence, increase the effectiveness of treatment measures and optimize the costs associated with the prevention and treatment of ARVI.

Literature 1. Magazine Pharmacist 2003 issue No. 3 2. Sat. works of St. Petersburg NIIEM named after. Pasteur “Infectious morbidity in the North-Western Federal District of Russia. Improving surveillance and prevention technology.” St. Petersburg, 2001. 3. Erofeeva M.K. Prevention of influenza and other acute respiratory viral infections in risk groups / Abstract. doc. diss. 2001. 46 p. 4. Belyaev A.L., Burtseva E.I., Slepushkin A.N. and others. Arbidol is a new drug for the prevention of influenza and acute respiratory viral infections in children // Bulletin of the Russian Academy of Medical Sciences, 1996; 8:34–7. 5. Strachunsky L.S. Kozlov S.N. Antiviral drugs used for respiratory infections // RMZh. 2001. T. 3. No. 1–2. 6. RMJ, Volume 9 No. 16–17, 2001 Study of the immunomodulatory activity of arbidol 7. Surinov B.P., Karpova N.A., Kulish Yu.S. Immunomodulatory properties of arbidol. // Chem-pharm. magazine, 1995; 3:14–5. 8. Stebaeva L., Guskova T., Nikolaeva I.//Intemational Congress of infectious Diseases. Prague, 1994: Abstr. 1274. 9. Karaulov A.V., Sidorenko I.V., Bulycheva N.A. and others // Man and Medicine: Abstracts of the 2nd Russian National Congress. M., 1995, p. 188. 10. Borisova A.M., Artemova O.P., Zabolotnikova O.D. Clinical and immunological assessment of the effectiveness of arbidol in patients with secondary immunodeficiencies.// Immunology, 1996; 2:58–61. 11. Journal “Policlinic” No. 3, 2005, p. 21 12. Gagarinova V.M., Ignatieva G.S., Sinitskaya L.V. and others. New chemotherapy drug Arbidol: preventive effectiveness during influenza epidemics // Journal of Microbiology. 1993. No. 5. P. 40–43. 13. Shumilov V.I., Shuster A.M., Lobastov S.P. and others. The effectiveness of arbidol in the prevention and treatment of acute respiratory infections in military personnel // Military Medical Journal. 2001. T. 323. No. 3. P. 51–53. 14. Uchaikin V.F., Shuster A.M., Kladova O.V. and others. Arbidol in the prevention and treatment of influenza and other acute respiratory viral infections in children // Pediatrics. 2002. No. 6. P. 1–4. 15. RMJ 2001 Vol.9 No. 19 16. Consilium medicum volume 06 No. 1 2004 17. Consilium medicum Pediatrics volume 08 No. 1 2006 Vol. 2, ST. 42 (pp.212–214) // October, 2001 18. RMJ, Volume 10 No. 3, 2002 Acute respiratory infections in children: modern possibilities of etiotropic therapy Ph.D. A.L. Zaplatnikov, professor N.A. Korovin 19. State register of medicines: Ministry of Health of the Russian Federation, 2000. (Internet version of the updated database dated January 17, 2002 on the website www.remedium.ru) 20. Krylov Yu.F. Radar. Encyclopedia of drugs. M.: RLS-2001, 2001. – 1503 p. 21. RMJ, Volume 8 No. 13–14, 2000 22. Handbook of infectious diseases 1997 pp. 305–331 St. Petersburg “Comet” Rostov-on-Don “Phoenix” 23. Journal Doctor.Ru 2003–06 A. N Slepushkin, A. L. Belyaev, State Research Institute of Virology named after. D.I. Ivanovsky RAMS, Moscow 24. Guskova T.A., Glushkov R.G. Arbidol (immunomodulator, interferon inducer, antioxidant) / UKHLS-VNIHFI. M., 2001. 28 pp. 25. New chemotherapy drug Arbidol: preventive effectiveness during influenza epidemics / V.M. Gagarinova, G.S. Ignatieva, L.V. Sinitskaya and others // Journal. microbiology, epidemiology and immunobiology. 1993. No. 5. P. 40–43. 26. Arbidol is a new drug for the prevention of influenza and acute respiratory viral infections in children / A.A. Belyaev, E.I. Burtseva, A.N. Slepushkin et al. // Vestn. RAMS. 1996. No. 8. pp. 34–37. 27. https://www.03.ru/therapy/index.shtml?

Why take Arbidol

The main indication for use of the product is the treatment of viral diseases. Also used for preventive purposes.

The product is effective for the following diseases:

• ARVI;
• flu;
• bronchitis and pneumonia (as part of complex therapy);
• respiratory syndrome in severe acute form.

The product can also be used to prevent possible complications associated with the appearance and spread of infection after surgery, to stabilize the patient’s immunity.

Instructions for use of arpetol and dose

Before using this medicine, consult your doctor.

Arpetol is taken orally, before meals. Single dose: children from 3 to 6 years old - 50 mg, from 6 to 12 years old - 100 mg, over 12 years old and adults - 200 mg (2 tablets of 100 mg or 4 tablets of 50 mg).

For nonspecific prophylaxis

• In direct contact with patients with influenza and other acute respiratory viral infections: - from 3 to 6 years of age - 50 mg, from 6 to 12 years - 100 mg, over 12 years and adults - 200 mg once a day for for 10-14 days.
• To prevent exacerbations of chronic bronchitis, relapse of herpes infection during an influenza epidemic and other acute respiratory viral infections: - from 3 to 6 years - 50 mg, from 6 to 12 years - 100 mg, over 12 years and adults - 200 mg. twice a week for 3 weeks.
• For the prevention of severe acute respiratory syndrome (in contact with patients): - children from 6 to 12 years old, 100 mg, over 12 years old, 200 mg once a day (before meals), up to 12-14 days.
• Prevention of postoperative complications: - from 3 to 6 years - 50 mg, from 6 to 12 years - 100 mg, from 12 years old and adults - 200 mg 2 days before surgery, then on days 2 and 5 after surgery.

For treatment

• Influenza, other acute respiratory viral infections without complications: - from 3 to 6 years - 50 mg, from 6 to 12 years - 100 mg, from 12 years - 200 mg 4 times a day (every 6 hours) for 5 days.
• Influenza, other acute respiratory viral infections with the development of complications (bronchitis, pneumonia, etc.): - from 3 to 6 years - 50 mg, from 6 to 12 years - 100 mg, from 12 years and adults - 200 mg 4 once a day (every 6 hours) for 5 days, then a single dose once a week for 4 weeks.
• Severe acute respiratory syndrome: - from 12 years of age and adults - 200 mg 2 times a day for 8-10 days.
• In the complex treatment of chronic bronchitis, herpetic infection: - from 3 to 6 years - 50 mg, from 6 to 12 years - 100 mg, from 12 years and adults - 200 mg 4 times a day (every 6 hours) for 5-7 days, then a single dose 2 times a week for 4 weeks.
• Complex therapy of acute intestinal infections of rotavirus etiology in children over 3 years of age: - children from 3 to 6 years old - 50 mg, from 6 to 12 years old - 100 mg, from 12 years old - 200 mg 4 times a day (every 6 hours ) up to 5 days.

If you have any doubts or questions, contact your healthcare provider.