CDC updates Tpoxx guidance: 4 things to know

In its second Tpoxx update in two days, the CDC said Sept. 15 the monkeypox antiviral treatment — which is difficult for patients to acquire — should be prescribed only to people with a high risk of severe disease. 

High-risk populations include children — especially those 8 and younger — pregnant or breastfeeding people, immunocompromised people and those with skin conditions such as eczema, burns or severe acne.

The antiviral, the generic name of which is tecovirimat, is approved to treat smallpox but is in a late-stage clinical trial to prove efficacy in treating monkeypox. This labels Tpoxx as an "investigational drug," meaning physicians first have to enroll in the trial and fill out forms for each patient to whom they wish to prescribe Tpoxx.  

Three more things to know: 

1. On Sept. 14, the agency advised physicians to be frugal while writing prescriptions for Tpoxx because if the virus mutates, overuse of the product can make it useless. 

2. When monkeypox cases were rising at a faster rate, LGBTQ leaders advocated for regulators to allow greater access to Tpoxx, calling it a "very good bureaucratic joke," but a joke that is "once again on the gay community."

3. Common side effects to the oral drug are headache and nausea. For the IV form, 73 percent of study participants reported infusion site pain and 39 percent reported infusion site swelling, according to the CDC. 

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