Favipiravir: Brands, Price & Uses in Bangladesh

Favipiravir is an antiviral medicine that inhibits viral RNA-dependent RNA polymerase (RdRp). Its approved and emergency-use indications differ by country, and its role is best understood by the strength of evidence behind each use.

• Novel/re-emerging influenza virus infections (established, approved use in country of origin): Favipiravir is approved in Japan for infections caused by novel or re-emerging influenza viruses for which other antivirals are ineffective or insufficiently effective. It is not approved or intended for routine seasonal influenza and is normally reserved by national stockpile/public-health authorities for outbreak situations.
• COVID-19 (emergency/conditional-use indication): Favipiravir received emergency or conditional-use authorisation in several countries, including Bangladesh, India, Russia, and others, for mild-to-moderate COVID-19 in adults. This is not an FDA- or EMA-approved indication. Evidence of meaningful clinical benefit is limited; a 2024 Cochrane systematic review found no clear benefit of Favipiravir on mortality, need for mechanical ventilation, or hospitalization in COVID-19. Favipiravir should be used for COVID-19 only under a physician's supervision and in line with current local treatment guidance, not as a substitute for vaccination or other established supportive care.
• Investigational/off-label use: Favipiravir has been studied against other RNA viruses (e.g., certain other viral haemorrhagic fever pathogens) in research settings, but such uses remain investigational and are not established indications.

Favipiravir is not approved by the US FDA or the European Medicines Agency for any indication.

Dosing of Favipiravir is indication-specific and should always follow the prescribing physician's instructions and current local treatment protocols. Representative regimens reported in approved labeling and emergency-use protocols are summarized below.

Tablets should be swallowed whole with water and may be taken with or without food. Doses should be spaced approximately 12 hours apart. The full course must be completed exactly as prescribed even if symptoms improve early; do not stop, extend, skip doses, or share this medicine with others without medical advice.

Adverse effects reported with Favipiravir include:

• Common: hyperuricemia (raised blood uric acid), diarrhea, nausea, vomiting, decreased appetite, elevated liver transaminases (ALT/AST).
• Less common but clinically important: neutropenia, QT interval prolongation, psychiatric/behavioral disturbances (confusion, abnormal behavior), and skin rash.
• Rare: severe hepatic dysfunction, serious cardiac arrhythmia associated with QT prolongation.

Patients should seek prompt medical attention for irregular heartbeat, palpitations, yellowing of the skin/eyes, severe abdominal pain, or unusual behavioral changes while taking Favipiravir.