Contents
Brivudine is an active substance that is used to treat viral diseases, especially shingles.
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Basics
Brivudine is an active ingredient that is used to treat viral diseases. It is an antiviral agent and is used specifically for shingles, which is caused by the herpes zoster virus . Brivudine inhibits the multiplication of viruses, thereby reducing the viral load. The active ingredient is also a prodrug and is only converted into the active form in infected cells. A prodrug is an inactive substance that is only converted into its active form in the body, where it is supposed to work.

Effect
Brivudine works by inhibiting the DNA polymerase of the viruses. DNA polymerase is an enzyme that is essential for the replication of viruses. By inhibiting DNA polymerase, replication (i.e. multiplication) is stopped. This works by incorporating brivudine as a DNA building block. However, because our body recognizes the active substance as non-self, the replication process is stopped.
Dosage
Always take Brivudine exactly as described in the package leaflet or as advised by your doctor.
Adults:
The usual recommended dose is 125 mg daily .
Treatment should be started no later than 72 hours after the onset of the first symptoms and should NOT last longer than 7 days.
Side effects
The following side effects may occur:
Frequent:
- Nausea
Occasional:
- Change in the number of blood cells
- Allergic reactions
- Loss of appetite
- Insomnia
- Anxiety disorders
- headaches
- drowsiness
- dizziness
- somnolence
- Paresthesia (paresthesia)
- high blood pressure
- vomiting
- diarrhea
- dyspepsia
- abdominal pain
- constipation
- flatulence
- fatty liver
- elevated liver enzymes
- weakness
- fatigue
- flu-like symptoms
Rarely:
- Reduction in the number of blood platelets
- hallucinations
- State of confusion
- Taste disturbances
- Trembling
- earache
- low blood pressure
- liver inflammation
- increased bilirubin concentrations
- bone pain
Frequency unknown:
- Balance disorders
- vasculitis
- acute liver failure
- fixed exanthema
- exfoliative dermatitis
- erythema multiforme
- Stevens-Johnson syndrome
Interactions
Interactions may occur if the following medicines are taken at the same time:
- Fluoropyrimidines; Interactions with fluoropyrimidines can be fatal and should and should be avoided in any case. These include:
- 5-Fluorouracil (5-FU)
- capecitabine
- Tegafur
- other 5-fluoropyrimidines
- flucytosine; Interactions with flucytosine can also be fatal.
- Drugs for the treatment of Parkinson's disease
Contraindications
Brivudine must NOT be taken in the following cases:
- With existing, past or future use of certain chemotherapies(capecitabine, 5-fluorouracil, tegafur, etc.): Fatal interactions are possible.
- with existing, past or future treatment of fungal infections with flucytosine: fatal interactions are possible.
- in case of allergy to brivudine
Age restriction
Brivudine should NOT be taken under the age of 18, as safety and efficacy have not been studied at this age.
Pregnancy & breastfeeding
Brivudine should NOT be used during pregnancy. There is evidence from animal experiments of toxic effects after high doses.
Brivudine should NOT be used during breast feeding. The main degradation product of brivudine passes into breast milk.
History of the active ingredient
The active ingredient brivudine has been produced in England since the 1970s. It was approved for the treatment of herpes simplex infections until 2000. Since 2001, it has only been used for herpes zoster.

Author
Thomas Hofko
Pharmacy student
Thomas Hofko is in the final third of his bachelor's degree in pharmacy and is an author and lecturer on pharmaceutical topics. He is particularly interested in the fields of clinical pharmacy and phytopharmacy.
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