Smart Wartime tactic doubles power of Tamiflu

The November 1, 2005  issue of the prestigious academic journal Nature reports exciting news that the use of a common drug could stretch world stocks of Tamiflu.

Problem:

Tamiflu (oseltamivir phosphate) is the main antiflu medicine recommended by the World Health Organization (WHO).  The WHO suggests that, in anticipation of a flu pandemic, countries should stockpile enough for at least a quarter of their population.  But although Swiss drugmaker Roche, the sole supplier, has quadrupled its production capacity over the past two years, the current supply is thought to cover just 2% of the world population.

Smart Clever Solution:

Last week, Joe Howton, medical director at the Adventist Medical Center in Portland, Oregon, suggested a way to double supplies, after browsing basic safety data from Roche.

Doctors have known for years that:

"a simple benzoic acid derivative called probenecid, stops many drugs, including antibiotics, from being removed from the blood by the kidneys. Administering Tamiflu alongside this second drug, that stops it from being excreted in the urine means that only half doses of the treatment would be needed."

The technique was invented during the Second World War to extend precious penicillin supplies. 

"Probenecid is readily available and is still widely used alongside antibiotics to treat gonorrhoea and syphilis, and in emergency rooms, where doctors need their patients to have high, sustained levels of antibiotics in their blood."

Howton noticed from Roche's data that Tamiflu, like penicillin, is actively secreted by the kidneys, and that the process is inhibited by probenecid.  "Giving the flu drug together with probenecid doubles the time that Tamiflu's active ingredient stays in the blood, doubles its maximum blood concentration, and multiplies 2.5-fold the patient's total exposure to the drug (see graph, and G. Hill et al.  Drug Metab.  Dispos.  30, 13-19; 2002)"

In other words, you could get away with using half as much Tamiflu to get the same therapeutic effect.

Given that Roche published the probenecid data in 2002, has it considered this option? 

"It doesn't seem so," says Martina Rupp, a spokeswoman at Roche's headquarters in Basel. 

Studies are being proposed that will look at safety issues relating to probenecid and Tamiflu, although doctors argue that there are already enough data for the drug combination to be used, even without specific approval from regulatory agencies. 

Grattan Woodson of the Atlanta Research Center in Decatur, Georgia, has prescribed probenecid for more than 25 years and says he prescribes drugs for such off-label purposes every day.  "This is a perfectly acceptable and established practice," he says.

Peter Zed, a specialist in emergency medicine at Vancouver General Hospital in Canada, agrees.  He has published studies of the safety of probenecid and antibiotic combinations. 

"There would be nothing unique about using probenecid with Tamiflu," he says.

As Nature story concludes, many scientists are stumped by the apparent lack of interest from Roche, and the relevant authorities, such as the WHO.

Is it any wonder ?

The idea definitely merits investigation.  How about capsules containing both Tamiflu and probenecid packaged together?

Action?

Tell you Family Doctor Today !

It could save your life in the event of a pandemic

Related post from Oct 11, 2005; siRNA technology likely prevents Bird Flu-Our leaders missing the boat

© 2005

Walter Derzko

Expert, Consultant and Guest Speaker on emerging Smart Technologies, Strategic Planning, Business Development, Lateral Creative Thinking and author of an upcoming book on the Smart Economy "

To explore the opportunities and threats of any new smart technology in your industry - Contact Me

.....Strategy without action is a day-dream; action without strategy is a nightmare"

- old Japanese proverb

P. S. if this is your first visit to my blog, please go to our Welcome page.

Comments

[bing]

Awesome!!!a

[Elisabeth]

Where did you find this guestbook by the way??? I'd like to have one like this on one of my sites!!!