Inosine pranobex (Isoprinosine) has got antiviral properties and also acts to potentiate the effects of T-lymphocytes and macrophages modulating cytokine production.

Inosine pranobex (Isoprinosine) Uses:

• It is indicated for the treatment of patients with slowly progressive subacute sclerosing panencephalitis (SSPE). The drug may prolong life expectancy and delay neurologic deterioration.

It has recently been studied in other viral infections that include [Ref]:

• Herpes virus infections (herpes labialis)
• Human papillomavirus infections (used as a cream for genital warts)
• Influenza and Rhinovirus infections
• Hepatitis B and C virus infections
• Persistent Generalized Lymphadenopathy (HIV infections)
• Immune-mediated diseases like rheumatoid arthritis
• Multiple sclerosis
• Chronic Fatigue syndrome
• Mycobacterium Tuberculosis

Inosine pranobex use in adults:

Inosine pranobex (Isoprinosine) Dose in Subacute sclerosing panencephalitis (SSPE):

• 50 mg/kg/day orally in 3 or 4 equally divided doses to a maximum dose of 3 g per day.

Dose in Children:

Refer to adults' dosing.

Pregnancy Risk Category: C

• Patients with SSPE can rapidly deteriorate during pregnancy. The disease could also progress due to altered immunity.
• Due to the rare nature of the disease, the drug was not tested in human pregnancies.
• Animal reproduction studies have not shown adverse fetal outcomes.

Dosage for kidney disease

The manufacturer's labeling does not include any information about dosage adjustments. 

The dosage for liver disease:

The manufacturer's labeling does not include any information about dosage adjustments.

Side effects of Inosine pranobex (Isoprinosine):

• Central nervous system:

  • Dizziness
  • Fatigue
  • Headache
  • Insomnia
  • Nervousness

• Dermatologic:

  • Pruritus
  • Skin rash

• Endocrine & metabolic:

  • Hyperuricemia

• Gastrointestinal:

  • Constipation
  • Diarrhea
  • Gastric distress

• Genitourinary:

  • Increased urine output

• Neuromuscular & skeletal:

  • Arthralgia

Contraindications to Inosine pranobex (Isoprinosine):

The manufacturer's product monograph does not contain any contraindications.

Warnings and precautions

• Uric acid

  • The rapid metabolization of the drug to uric acid occurs.
  • Patients with kidney disease, gout, or a history of urate stone formation should not use it.
  • To lower serum uric acids, patients may need drugs such as allopurinol and probenecid.

Monitoring parameters:

Monitor serum and urinary Uric acid levels. 

How to administer Inosine pranobex (Isoprinosine)?

Administer the drug orally in 3 or 4 equally divided doses while awake.

Mechanism of action of Inosine pranobex (Isoprinosine):

It is not known exactly how the drug works. The drug could increase the activity of T-lymphocytes, and macrophage cellular functions, and possibly influence cytokine formation. It may also have antiviral properties.

Metabolism:

• Rapid to uric Acid
• It is also subject to oxidation and glucuronidation

Half-life elimination:

• About 50 minutes.

Time to peak:

• 1 hour.

Excretion:

• Urine (as uric acid, glucuronide and oxide metabolites, and unchanged drug)

International Brand Names of Inosine pranobex:

• Imunovir
• Groprinosin
• Imin
• Imunovir
• Isoprinosine
• Isprinol
• Laprosin
• Neosine
• Noviron
• Prinol
• Prinosine
• Pronovir

Inosine pranobex Brand Names in Pakistan:

No Brands Available in Pakistan.