Isoprinosine

Dosage and Administration

To date, Isoprinosine® is only available in the form of tablets containing 500 mg of inosine pranobex. The dosage of Isoprinosine® is calculated individually based on the patient’s weight. The dosage does not depend on age. The optimal daily dosage is 50 mg / kg (or 1 tablet per 10 kg of weight). The resulting number should be divided into 3-4 intakes. The duration of the treatment is determined individually depending on the patient's condition.

In some cases, the daily dosage for adults can be doubled by the doctor up to 100 mg / kg of the body weight. Increasing the dosage for children is strictly contraindicated. If the calculated dosage needs to be rounded, always round down.

Tablets are recommended to be taken after meals with some water without chewing.

Side Effects

Isoprinosine seems to be fairly well tolerated. However some studies report possible side effects including dizziness, stomach upset, and allergic response. Inosine pranobex may increase blood levels of uric acid, which can increase the risk of gout or kidney stones.

Contraindications:

Contraindications are quite few. They include pregnancy and lactation, children below 3 y.o. (body weight less than 15-20kg) and individual hypersensitivity. Contraindications also include arrhythmia, diseases of the urinary system and gout.

Caution should be taken by patients with liver failure. This is because of the fact that the components of the drug are metabolized in the liver.

Note:

Since Isoprinosine causes an increase in the concentration of uric acid in the blood, the concentration of uric acid in the blood and urine should be monitored every two weeks during the treatment with Isoprinosine. It is also necessary to monitor this indicator after the end of the treatment. Also, it is recommended to perform monthly monitoring of possible changes of the white blood cell formula, liver enzymes, and creatinine levels in the blood.

Isoprinosine is NOT compatible with alcohol. In case of the simultaneous use of Isoprinosine with ethanol, the patient may experience side effects such as renal colic, arrhythmia, renal failure, pyelonephritis and allergic reactions. Isoprinosine also affects the liver, and its combination with alcohol can lead to jaundice, biliary retention in the liver and hepatitis. An increase in interferon production caused by the drug may cause interferon to increase alcohol toxicity. As a result, psychopathology, depression and other central nervous system dysfunctions may develop in the patient. Therefore, during the drug treatment, the alcohol consumption should be avoided even in small doses.

Analogs:

To date, the only structural analogue of Isoprinosine is Groprinosin, which also contains inosine pranobex and is available in the same dosage as Isoprinosine. The difference between the drugs is the country of manufacture and the set of auxiliary ingredients. One should consider individual tolerability to the components and consult a doctor before choosing a particular drug.

Warts, papillomas, herpes, shingles and other skin problems often become source of inconvenience for patients. These diseases are caused by smallest infectious particles - viruses. Isoprinosine is promoted as an effective antiviral compound.

The use of Isoprinosine has a long history. It was patented in the late 1960s, and has been studied against a number of viral conditions as far back as the early 1970s. Today it is sold in Europe and elsewhere as a treatment against a number of viral diseases including herpes, influenza, and viral hepatitis.

Isoprinosine (Inosine Pranobex) - is a synthetic compound formed from purine. It is based on inosine and dimepranol acedoben molecules. Inosine is a natural biological substance found in any cell. Inosine is a nucleotide that is part of the transport RNA necessary for the translation of some compounds important for the cell. It also plays an important role in the mechanism of muscle contractions and is a precursor of the ATP molecule.

But the most important and useful property that is attributed to the drug is its antiviral activity. The effectiveness of Isoprinosine is achieved by inhibition of RNA in the nucleus of a bacterial microorganism. The drug is known to block enzyme bonds, inhibiting the synthesis of the virus. Some assert that it may inhibit the activity of a number of viruses (preventing them from forcing cells to synthesize their RNA) and restore the function of lymphocytes in immunosuppression. Early results suggest beneficial clinical effects in several diseases and infections including mucocutaneous Herpes simplex infections, subacute sclerosing panencephalitis, genital warts, influenza, zoster, and type B viral hepatitis. 

Some practitioners recommend it as a means to promote the normal functioning of the myocardium affected by ischemia. By improving microcirculation, the drug may enhance the size of the necrosis zone. Proponents claim that it has an antiarrhythmic effect, maintains the energy balance of the myocardium, improves coronary circulation, enhances myocardial contractions, has a positive effect on metabolic processes in the heart muscle, and contributes to a greater relaxation of the myocardium during systole. The positive effect of the drug may be also demonstrated in case of ischemic kidney damage. The compound may contribute to the activation of metabolism in case of hypoxia and the absence of ATP.

Promoted as an immunomodulation compound, Isoprinosine is asserted to exhibit the following properties:

  • Stimulate cellular immunity, increase the activity of monocytes and macrophages, activate the work of leukocytes and lymphocytes;
  • Stimulate the production of antibodies by B-lymphocytes and cytoplasmic cells;
  • Prevent a decrease in white blood cell activity under the influence of glucocorticosteroids;
  • Restore the function of white blood cells in immunosuppression;
  • Increase the level of gamma-interferon, interleukins 1 and 2;
  • Reduce the level of special substances - cytokines that may cause the development of inflammation;
  • Stimulate the formation and maturation of immune cells in the bone marrow;
  • Improve the recognition of foreign substances and proteins by the immune system.

  • Pompidou A et al (1985). In-vitro inhibition of LAV / HTLV-III infected lymphocytes by dithiocarb and inosine pranobex. https://www.ncbi.nlm.nih.gov/pubmed/2417079
  • Campoli-Richards DM et al (1986). Inosine pranobex. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. https://www.ncbi.nlm.nih.gov/pubmed/2431857
  • Davidson-Parker J et al (1988). Immunotherapy of genital warts with inosine pranobex and conventional treatment: double blind placebo controlled study. https://www.ncbi.nlm.nih.gov/pubmed/2465265
  • Brzeski M et al (1990). Randomized, double blind, placebo controlled trial of inosine pranobex in rheumatoid arthritis. https://www.ncbi.nlm.nih.gov/pubmed/1693065
  • Pedersen C et al (1990). The efficacy of inosine pranobex in preventing the acquired immunodeficiency syndrome in patients with human immunodeficiency virus infection. The Scandinavian Isoprinosine Study Group. https://www.ncbi.nlm.nih.gov/pubmed/1693173
  • Kinghorn GR et al (1992). Acyclovir vs isoprinosine (immunovir) for suppression of recurrent genital herpes simplex infection. https://www.ncbi.nlm.nih.gov/pubmed/1385295
  • Milligan NM et al (1994). A placebo-controlled trial of isoprinosine in patients with multiple sclerosis. https://www.ncbi.nlm.nih.gov/pubmed/7510330
  • Yarom M et al (1998). Identification of inosine as an endogenous modulator for the benzodiazepine binding site of the GABAA receptors. https://www.ncbi.nlm.nih.gov/pubmed/9691220
  • Lasek W et al (2015). Immunomodulatory effects of inosine pranobex on cytokine production by human lymphocytes. https://www.ncbi.nlm.nih.gov/pubmed/26011933
  • Breusov AA et al (2015). Optimal Approach to Combined Treatment of Patients with Urogenital Papillomatosis. https://www.ncbi.nlm.nih.gov/pubmed/26859953
  • Majewska A et al (2016). Interferon-α and inosine pranobex-mediated inhibition of reploication of human RNA viruses in vitro. https://www.ncbi.nlm.nih.gov/pubmed/28146624
  • Beran J et al (2016). Inosine pranobex is safe and effective for the treatment of subjects with confirmed acute respiratory viral infections: analysis and subgroup analysis from a Phase 4, randomized, placebo-controlled, double-blind study. https://www.ncbi.nlm.nih.gov/pubmed/27821093
  • Mishra AK et al (2018). Evaluation of isoprinosine to be repurposed as an adjunct anti-tuberculosis chemotherapy. https://www.ncbi.nlm.nih.gov/pubmed/29685203
  • Tobólska S et al (2018). Influence of Inosine Pranobex on Cell Viability in Normal Fibroblasts and Liver Cancer Cells.  https://www.ncbi.nlm.nih.gov/pubmed/30364913
  • Sliva J et al (2019). Inosine Pranobex: A Key Player in the Game Against a Wide Range of Viral Infections and Non-Infectious Diseases.  https://www.ncbi.nlm.nih.gov/pubmed/31168764
  •  McCarthy MT et al (2020). Inosine pranobex enhances human NK cell cytotoxicity by inducing metabolic activation and NKG2D ligand expression.  https://www.ncbi.nlm.nih.gov/pubmed/31434164

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