Mpox Treatment

The antiviral medication tecovirimat (TPOXX) is now available to treat Mpox infections. Although most people with Mpox have a mild, self-limited disease and do not require treatment, some may have or be at-risk for severe disease or complications. These people may be benefit from treatment. If you believe you have symptoms of Mpox, especially if you have or are at-risk for severe disease or complications, you should talk to your health care provider.

What is tecovirimat (TPOXX)?

TPOXX is an antiviral medication that is currently approved by the U.S. Food and Drug Administration (FDA) for the treatment of smallpox in adults and children who weigh at least 3 kg (about 6 pounds). Because no specific treatment is available for Mpox, and because there is some data suggesting that it may be effective in treating similar types of viruses, TPOXX is being made available under an expanded access Investigational New Drug or “compassionate use” protocol to treat Mpox.

How can I get TPOXX?

TPOXX is only available by prescription from your health care provider. Your health care provider will need to determine if you are eligible; if so, they will prescribe the medication for you, and you can pick it up at the Southern Nevada Health District Pharmacy, located at 280 S. Decatur Blvd., Las Vegas, NV 89107.

Am I eligible for TPOXX?

The Centers for Disease Control and Prevention (CDC) has developed criteria that health care providers can use to determine if their patients should be prescribed TPOXX. These criteria include persons:

With severe disease (e.g., hemorrhagic disease, confluent lesions, sepsis, encephalitis, or other conditions requiring hospitalization)
Who are at high risk of severe disease:
People with immunocompromising conditions (e.g., HIV/AIDS, leukemia, lymphoma, generalized malignancy, solid organ transplantation, therapy with alkylating agents, antimetabolites, radiation, tumor necrosis factor inhibitors, high-dose corticosteroids, being a recipient with hematopoietic stem cell transplant <24 months post-transplant or ≥24 months but with graft-versus-host disease or disease relapse, or having autoimmune disease with immunodeficiency as a clinical component)
Pediatric populations, particularly patients younger than 8 years of age
Pregnant or breastfeeding women
People with a history or presence of atopic dermatitis, people with other active exfoliative skin conditions (e.g., eczema, burns, impetigo, varicella zoster virus infection, herpes simplex virus infection, severe acne, severe diaper dermatitis with extensive areas of denuded skin, psoriasis, or Darier disease [keratosis follicularis])
People with one or more complications (e.g., secondary bacterial skin infection; gastroenteritis with severe nausea/vomiting, diarrhea, or dehydration; bronchopneumonia; concurrent disease or other comorbidities)
With aberrant infections involving accidental implantation in eyes, mouth, or other anatomic areas where Mpox virusinfection might constitute a special hazard (e.g., the genitals or anus).

Again, only your health care provider can determine if you are eligible and only your health care provider can prescribe it.

How is TPOXX taken?

TPOXX is available both as a pill or an injection. If you are prescribed the pill form, you will need to take it two to three times daily for 14 days. The pills must be taken within 30 minutes after a full meal containing a moderate or high amount of fat. Pills may be opened and mixed in food for young children and those who have difficulty swallowing pills. The injectable form must be given through an intravenous infusion in an outpatient or inpatient setting.

Is TPOXX effective?

There are currently no data on the effectiveness of TPOXX in treating Mpox infections in people, but studies using a variety of animal species have shown that it is effective in treating disease caused by similar types of viruses.

What are the side effects of TPOXX?

In clinical trials, the most common side effects of the oral form of the drug were headache, nausea, abdominal pain, and vomiting (although none of these could be attributed to the drug itself). The most common side effects of the injectable form were administration site reactions and headache (though again, none of these could be attributed to the drug).

Is there a cost for getting TPOXX?

TPOXX is available at no cost.

Can TPOXX be given to pregnant or nursing mothers and to children?

Although TPOXX has not been studied in pregnant and nursing women or in children, they are not excluded from treatment if their health care provider determines that treatment is appropriate, and they or their parent/guardian consent to treatment.

What is an “compassionate use protocol” and what must I do to follow this protocol?

TPOXX is not FDA approved for the treatment of Mpox, so it must be provided under a compassionate use protocol. This requires patients receive, read, and sign an Informed Consent which provides information on the medication and its risks and benefits. If your health care provider determines that you are eligible for treatment, they will provide you with this form and help you to complete it.

Updated on: November 30, 2022 2:13 pm