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Tpoxx

Tpoxx (tecovirimat) is an antiviral medication used for the treatment of smallpox. It was developed to help combat the potential use of smallpox as a bioterrorism agent, though smallpox has been eradicated since 1980. Tpoxx works by inhibiting the function of a protein necessary for the virus to spread from infected cells, thus preventing the virus from continuing to replicate. Although smallpox is no longer naturally occurring, Tpoxx provides a critical treatment option in case of an outbreak due to accidental or deliberate release.



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Frequently Asked Questions

Is Tpoxx effective against other viruses?
Open FAQClose FAQ

Tpoxx is specifically designed to treat smallpox caused by the variola virus, but it has shown potential activity against other orthopoxviruses, such as monkeypox.

Can I use Tpoxx to prevent smallpox?
Open FAQClose FAQ

No, Tpoxx is not used for prevention but for treatment after infection. The smallpox vaccine is available for prevention in case of exposure or risk.

What should I do if I miss a dose of Tpoxx?
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If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and resume your normal schedule. Do not double up doses.

Can Tpoxx be used in children?
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Yes, Tpoxx is approved for pediatric use, with the dosage adjusted based on the child's weight.

How is Tpoxx different from the smallpox vaccine?
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Tpoxx is a treatment for people already infected with the smallpox virus, while the smallpox vaccine is used to prevent infection before exposure or after known exposure to the virus.

Comprehensive Drug Guide

How Does Tpoxx Work?

Tpoxx works by targeting and inhibiting the activity of the VP37 protein, which is essential for the smallpox virus to exit infected cells and spread to other cells. By preventing the virus from leaving infected cells, Tpoxx reduces viral replication and helps control the infection.



Common Dosages

  • Oral capsules: 200 mg each
  • Intravenous solution: 200 mg/20 mL (10 mg/mL)

Typical Dosing

  • The typical oral dose for adults is 600 mg (three 200 mg capsules) taken twice daily for 14 days with food.
  • For pediatric patients and patients unable to swallow capsules, the dosage is adjusted based on weight.
  • The intravenous formulation is given to patients who cannot take the oral capsules, with the dose administered over 6 hours every 12 hours for 14 days.

Typical Dosing

FDA Approved Indications

  • The treatment of smallpox caused by the variola virus in adults and pediatric patients.


Who Shouldn't Take Tpoxx?

  • Known hypersensitivity to tecovirimat or any component of the formulation.


Advice From The Pharmacist

  • Take Tpoxx with food to improve absorption and ensure its effectiveness.
  • Complete the full 14-day course even if you start feeling better, to ensure the virus is fully eradicated.
  • If using the intravenous formulation, ensure it is administered by a healthcare provider in a medical setting.
  • Keep Tpoxx capsules stored at room temperature and away from moisture or heat.
  • Contact your healthcare provider if you experience any side effects or signs of an allergic reaction.


Side Effects of Tpoxx

Common Side Effects

  • Headache
  • Nausea
  • Abdominal pain
  • Diarrhea
  • Fatigue


Uncommon/Severe Side Effects

  • Hypersensitivity reactions, such as rash, itching, or swelling
  • Severe abdominal pain or gastrointestinal symptoms requiring medical attention


Risks and Warnings of Tpoxx

  • Allergic Reactions: Although rare, Tpoxx can cause allergic reactions in some patients. Seek immediate medical attention if you experience rash, swelling, or difficulty breathing.
  • Use in Pregnancy and Breastfeeding: There is limited data on the use of Tpoxx during pregnancy and breastfeeding. Consult with a healthcare provider before using Tpoxx if pregnant or breastfeeding.


Interactions with Tpoxx

Common Drug Interactions

  • No significant drug interactions have been identified for Tpoxx. However, you should always inform your healthcare provider about any other medications, supplements, or treatments you are taking to ensure there are no potential interactions.


Alternatives to Tpoxx

  • Tpoxx is currently the only FDA-approved antiviral specifically for the treatment of smallpox. However, other supportive treatments may be used in conjunction, depending on the severity of the infection.
  • Cidofovir and Brincidofovir: Antiviral agents that have been studied for use against orthopoxviruses but are not specifically approved for smallpox.