Tecovirimat, sold under the brand name Tpoxx among others, is an antiviral medication with activity against orthopoxviruses such as smallpox and monkeypox. It is the first antipoxviral drug approved in the United States. It is an inhibitor of the orthopoxvirus VP37 envelope wrapping protein.The drug works by blocking cellular transmission of the virus, thus preventing the disease. Tecovirimat has been effective in laboratory testing; it has been shown to protect animals from monkeypox and rabbitpox and causes no serious side effects in humans. Tecovirimat was first used for treatment in December 2018, after a laboratory-acquired vaccinia virus infection.Two million doses of tecovirimat are stockpiled in the US Strategic National Stockpile should an orthopoxvirus-based bioterror attack occur. The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication. Medical uses
In the United States, tecovirimat is indicated for the treatment of human smallpox disease. In the European Union it is indicated for the treatment of smallpox, monkeypox, and cowpox. Mechanism of action
Tecovirimat inhibits the function of a major envelope protein required for the production of extracellular virus. The drug prevents the virus from leaving an infected cell, hindering the spread of the virus within the body. Chemistry
The first synthesis of tecovirimat was published in a patent filed by scientists at Siga Technologies in 2004. It is made in two steps from cycloheptatriene. A Diels–Alder reaction with maleic anhydride forms the main ring system and a subsequent reaction with 4-trifluormethylbenzhydrazide gives the cyclic imide of the drug.
Society and culture
Legal status
In November 2021, the Committee for Medicinal Products for Human Use of the European Medicines Agency adopted a positive opinion, recommending the granting of a marketing authorization under exceptional circumstances for the medicinal product tecovirimat siga, intended for the treatment of orthopoxvirus disease (smallpox, monkeypox, cowpox, and vaccinia complications) in adults and in children who weigh at least 13 kilograms (29 lb) The applicant for this medicinal product is Siga Technologies Netherlands B.V. Tecovirimat was approved for medical use in the European Union in January 2022.In December 2021, Health Canada approved oral tecovirimat for the treatment of smallpox in people weighing at least 13 kilograms (29 lb).As of August 2022, Tpoxx is available in the US only through the Strategic National Stockpile as a Centers for Disease Control and Prevention investigational new drug. Intravenous Tpoxx has no lower weight cap and can be used in infants under the investigational new drug protocol. References
External links
"Tecovirimat". Drug Information Portal. U.S. National Library of Medicine. "Tecovirimat monohydrate". Drug Information Portal. U.S. National Library of Medicine.