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Generic drug could 'double' Tamiflu supply
Doctors think they have hit on a way to double supplies of the scarce
antiviral drug Tamiflu, reports a news exclusive in Nature this week.
Administering it alongside a second drug that stops Tamiflu being excreted
in urine means that only half doses would be needed.
The helper drug, called probenecid, stops many drugs, including antibiotics,
being removed from the blood by the kidneys. The technique was invented
during the Second World War to conserve precious penicillin supplies, but
probenecid is still widely used alongside antibiotics in emergency rooms,
and in treating gonorrhoea and syphilis.
The prospect of using the drug to stretch supplies of Tamiflu (oseltamivir
phosphate) was raised last week by an emergency-medicine specialist who was
browsing safety data published by Tamiflu's Swiss manufacturer, Roche. He
noticed that giving the flu drug with probenecid doubles the number of hours
its active ingredient stays in the blood, and doubles its maximum blood
concentration.
In other words, half a dose of Tamiflu with probenecid has the same effect
as a dose without. "It dawned on me that the data potentially represented a
tremendous therapeutic benefit," he says.
Doctors have welcomed the idea, telling Nature that the combination therapy
raises few safety considerations because probenecid is already so widely
used. But some caution that, although using probenecid will make Tamiflu go
further in emergency situations, coping with a large-scale pandemic still
requires a huge increase in the production of flu drugs themselves.
The World Health Organization and the US Food and Drug Administration
declined to comment on the idea, an apparent lack of interest that
scientists have described as "stupefying".
The possibility of effectively doubling Tamiflu stocks comes just as
President George W. Bush is scheduled to announce the US pandemic plan, at
the National Institutes of Health.
Contact for background information:
Declan Butler (Journalist, Nature)
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Ruth Francis, Nature London
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