Brivudin (Bromovinyl Deoxyuridine)
▴ Brivudin is an oral thymidine analogue indicated for the early treatment of acute herpes zoster in immunocompetent adults. It has high, selective activity against varicella zoster virus (VZV), inhibiting VZV replication, possibly through competitive inhibition of viral DNA polymerase, or by acting as an alternative substrate to deoxythymidine triphosphate, causing viral DNA strand breakage.
▴ In a large, 7-day, phase III trial in immunocompetent patients with herpes zoster, once-daily brivudin 125mg was significantly more effective than oral acyclovir 800mg five times daily in reducing the mean time from start of treatment to last vesicular eruption, and was as effective as acyclovir at healing lesions and alleviating acute zoster-related pain.
▴ The likelihood of developing post-herpetic neuralgia (PHN) in immunocompetent patients aged ≥50 years was significantly lower with brivudin than with acyclovir.
▴ Brivudin was as effective as oral famciclovir 250mg three times daily in terms of the prevalence of PHN, the time to last vesicular eruption and lesion healing in another large, 7-day, phase III study in immunocompetent patients with herpes zoster.
▴ Oral brivudin is generally well tolerated, with a similar tolerability profile to those of oral acyclovir or famciclovir. Nausea was the most commonly reported adverse event.
KeywordsHerpes Zoster Acyclovir Varicella Zoster Virus Immunocompetent Patient Famciclovir
- 4.Wassilew SW, Wutzler P. Oral brivudin in comparison with acyclovir for improved therapy of herpes zoster in immunocompetent patients: results of a randomized, double-blind, multicentered study. On behalf of the Brivudin Herpes Zoster Study Group. Antiviral Res 2003 Jun; 59(1): 49–56PubMedCrossRefGoogle Scholar
- 5.Shigeta S, Yokota T, De Clercq E. Therapy of varicella-zoster virus infection: mechanism of action of (E)-5-(2-bromovinyl)-2′-deoxyuridine. Antiviral Res 1985; Suppl. 1: 35–44Google Scholar
- 6.Menarini International Operations Luxembourg S.A., Berlin-Chemie AG. Premovir® 125mg European SmPC. Menarini International Operations Luxembourg S.A. Berlin-Chemie AG, 2004Google Scholar
- 15.Keizer HJ, Cleton FJ, de Bruyn EA, et al. Pharmacokinetic and phase-1 studies of oral low dose bromovinyldeoxyuridine (BVdUrd) and 5-fluorouracil (FUra) infusion [abstract no. 132]. Invest New Drugs 1989 Nov; 7(4): 381Google Scholar
- 17.Wutzler P, Wassilew S. Brivudin in the treatment of herpes zoster [abstract no. SA 183 plus poster]. 23rd International Congress of Chemotherapy; 2003 Jun 7–9; Durban, 23Google Scholar