Favipiravir or by his generic name Avigan is an important drug coping with the Covid-19 pandemic. The drug was originally developed by Fujifilm Japan as a potential treatment for SARS and swine flu. The drug got emergency approval in Japan back in 2014 for the treatment of severe influenza and later was one of the most promising treatments for the Ebola pandemic back in the same year. SARS and Covid-19 have a crone like a virus structure and hold a high contingency rate compare to regular flu.

The high contingency rate and virus replication are what make the Covid-19 so deadly and impactable. The rate of mortality as known to this date is between 2-3% compare to 0.2% in regular or H1N1 flu. The number of reported cases as of today is 65M people and the expected cases in the worst-case scenario might be a third of the deadly Spanish flu, where almost 500M people were infected and 50M have died. Hence, it is of vital importance to tackle this pandemic in the necessary seriosity.

Favipiravir is an antiviral drug that was explored and still under clinical trials in mild and moderate Covid-19 cases. The drug holds impressive clinical evidence, wherein some developing countries it faster the “clinical cure” (i.e., physician’s assessment of normalization of clinical signs – temperature, oxygen saturation, respiratory rate, and cough) in 40% as of Glenmark India study. The Chines study indicates on median Covid-19 negative results in just 4 days, the Russian study showed similar patterns with 65% of the Covid-19 patients treated with Favipiravir achieved viral clearance after day 4. The Japanese trial held by the innovator Fujifilm had shown a PCR negative result on average on day 11 compared to day 14 in the control group. It is well known today as was proven in numerous clinical trials including a 678 trial in NY (Weiss et al, 2020) that viral load is associate with high mortality and intubation. The study indicates a high pick of virus load on day 4 in mild patients and day 8 in moderate to severe patients.

There is a clear strategy that needs to take place mitigating the virus load in patients with co-morbidities and communities at risk. There is clear evidence to embrace this important treatment as part of the arsenal fighting Covid-19. Another major advantage of the drug is, that compares to the other drugs in this category, Favipiravir is the only drug that could be furnished as tablets, a fact that improve the drug accessibility as an early treatment option. The drug can be given to patients at risk diagnose with Covid-19 to be treated at their house monitored by their community doctor. This fact will lower the hospital overburden, save money, time, and efforts for patients, caregivers, and the medical community. 

Does Favipiravir is a miracle drug against Covid-19, I guess the simple answer is no, but for sure it is at least comparable to Remdesivir in a more comfortable and cost-effective setup. The drug holds some warning labels not to be given to pregnant women and not to perform sexual activity 12 days after the last administration because of teratogenic features. Nevertheless, every effective drug comes with some tolerable side effects and warnings, once you follow the guidance you should be safe. While the drug is already widely embraced by developing countries, all the eyes are zooming on the Japanese authorities that evaluating the drug for Covid-19 indication those days. The assumption is we might see the expended label approval for Covid-19 mild and moderate patients treatment before the end of the year. 

This approval will have an impactable effect on all the developed world countries in their endeavor to find a viable solution or at least increase their arsenal coping with the pandemic. I truly believe that the vaccination won’t happen at a glance because of many known challenges, hence it is of vital importance to enlarge the treatment options and to apply innovatively and out of the box thinking where needed. Time is of the essence and I believe the most crucial point of the pandemic (third wave) is just ahead of us, where the winter associated with higher morbidities club with Covid-19, might lead to a devastating outcome. I strongly believe Favipiravir will be a game-changer if position properly in the treatment formulary for moderate to mild patients, by inhibiting the disease deterioration.