What is Tecovirimat: Uses, Dosage, Side Effects and More

Tecovirimat is an antiviral medication specifically designed to treat smallpox and monkeypox infections. While smallpox has been eradicated worldwide, this medication serves as an important backup treatment option and is currently used for monkeypox cases when other treatments aren't suitable.

You might be wondering about this medication if your doctor has mentioned it as a treatment option for a poxvirus infection. Let's walk through everything you need to know about tecovirimat in simple, clear terms.

What is Tecovirimat?

Tecovirimat is an antiviral drug that specifically targets poxviruses like smallpox and monkeypox. It works by blocking a protein that these viruses need to spread from one cell to another in your body.

The medication was originally developed as a countermeasure against smallpox, even though this disease was eliminated decades ago. Today, it's primarily used to treat monkeypox infections, especially in people who have severe symptoms or are at higher risk for complications.

This medication is relatively new compared to other antiviral drugs, having received approval from the FDA in 2018. It's considered a specialized treatment that's typically reserved for specific situations rather than routine use.

What is Tecovirimat Used For?

Tecovirimat is approved to treat smallpox disease in adults and children who weigh at least 3 kilograms (about 6.6 pounds). It's also used off-label to treat monkeypox infections, particularly in certain high-risk situations.

Your doctor might recommend tecovirimat if you have monkeypox and fall into one of these categories: you have a weakened immune system, you're pregnant, you're breastfeeding, or you have severe symptoms. The medication can also be considered for people with skin conditions like eczema, as they may face higher risks of complications.

While tecovirimat can be used for other poxvirus infections, these situations are quite rare. Most people with monkeypox recover without needing antiviral treatment, so this medication is typically reserved for cases where extra support is needed.

How Does Tecovirimat Work?

Tecovirimat works by targeting a specific protein called VP37 that poxviruses need to spread throughout your body. Think of it like blocking a key that the virus uses to unlock doors between cells.

When you take tecovirimat, it prevents the virus from packaging itself properly and moving from infected cells to healthy ones. This doesn't kill the virus directly, but it significantly slows down its ability to spread and cause more damage.

The medication is considered moderately strong as antiviral drugs go. It's specifically designed for poxviruses, which makes it very targeted but also means it won't work against other types of viral infections like the flu or common cold.

How Should I Take Tecovirimat?

Take tecovirimat exactly as your doctor prescribes it, typically twice daily with food. The medication works best when taken with a meal that contains some fat, as this helps your body absorb it more effectively.

You should take each dose about 12 hours apart, so if you take your first dose at 8 AM with breakfast, take your second dose at 8 PM with dinner. Try to eat something substantial with each dose rather than just a light snack.

Swallow the capsules whole with water. Don't crush, chew, or open them, as this can affect how the medication works. If you have trouble swallowing capsules, talk to your doctor about other options.

Continue taking the medication for the full course your doctor prescribes, even if you start feeling better. Stopping early might allow the virus to become active again.

How Long Should I Take Tecovirimat For?

The typical course of tecovirimat lasts 14 days, though your doctor might adjust this based on your specific situation. Most people take it for exactly two weeks, taking two capsules daily.

Your doctor will determine the right duration based on several factors: how severe your infection is, how your immune system is functioning, and how you're responding to treatment. Some people might need a shorter course, while others might need slightly longer treatment.

Don't stop taking tecovirimat early, even if your symptoms improve. Poxvirus infections can be tricky, and stopping treatment too soon might lead to the infection returning or becoming more severe.

What Are the Side Effects of Tecovirimat?

Most people tolerate tecovirimat well, but like all medications, it can cause side effects. The good news is that serious side effects are uncommon, and most people experience only mild symptoms if any.

Here are the most common side effects you might experience while taking tecovirimat:

• Headache
• Nausea or stomach upset
• Abdominal pain
• Vomiting
• Fatigue or feeling tired
• Dizziness

These symptoms are usually mild and often improve as your body adjusts to the medication. Taking the medication with food can help reduce stomach-related side effects.

Less common but more serious side effects can include severe allergic reactions, though these are rare. Contact your doctor immediately if you experience difficulty breathing, severe rash, or swelling of your face, lips, tongue, or throat.

Some people might experience changes in their blood test results, particularly related to liver function. Your doctor might monitor these levels if you're taking the medication for an extended period.

Who Should Not Take Tecovirimat?

Tecovirimat is generally safe for most people, but there are some situations where it might not be the right choice. Your doctor will carefully consider your medical history before prescribing it.

You should not take tecovirimat if you're allergic to it or any of its ingredients. Tell your doctor about any previous allergic reactions to medications, especially if you've had severe reactions in the past.

People with severe liver disease might need special monitoring or a different treatment approach. The medication is processed by your liver, so significant liver problems could affect how well it works or increase the risk of side effects.

If you're pregnant or breastfeeding, your doctor will weigh the benefits against potential risks. While tecovirimat can be used during pregnancy for severe infections, this decision requires careful consideration of your specific situation.

Tecovirimat Brand Name

Tecovirimat is sold under the brand name TPOXX in the United States. This is currently the only brand name available for this medication, as it's manufactured by a single company.

You might see it referred to as ST-246 in some medical literature, which was its research name before it became commercially available. However, when you get your prescription, it will be labeled as TPOXX.

The medication comes in 200-milligram capsules, and there's currently no generic version available. This means all tecovirimat prescriptions will be for the brand-name TPOXX.

Tecovirimat Alternatives

Currently, there are very few direct alternatives to tecovirimat for treating poxvirus infections. The main alternative is cidofovir, an older antiviral medication that can be used for severe monkeypox cases.

Cidofovir is given intravenously (through an IV) and requires hospitalization for administration. It's typically considered when tecovirimat isn't available or suitable, but it has more significant side effects and requires careful monitoring.

Brincidofovir is another potential alternative that's being studied for poxvirus infections. It's related to cidofovir but can be taken by mouth, though it's not yet widely available for this use.

For most people with monkeypox, supportive care without antiviral medication is often sufficient. This includes pain management, wound care, and monitoring for complications.

Is Tecovirimat Better Than Cidofovir?

Tecovirimat is generally considered better than cidofovir for most people who need antiviral treatment for poxvirus infections. The main advantage is that tecovirimat can be taken at home as oral capsules, while cidofovir requires hospitalization for IV administration.

Tecovirimat also has fewer serious side effects compared to cidofovir. Cidofovir can cause kidney damage and other significant complications, requiring frequent blood tests and careful monitoring during treatment.

However, cidofovir has been used longer and has more extensive data on its effectiveness. In some very severe cases, doctors might prefer cidofovir despite its drawbacks, especially if someone isn't responding well to tecovirimat.

Your doctor will choose the best option based on your specific situation, considering factors like how severe your infection is, your overall health, and whether you can take oral medications.