Thailand’s First Pediatric Liquid Favipiravir – An innovation from Chula Faculty of Pharmaceutical Sciences for COVID-19 Patients

A professor from Chula Pharmaceutical Sciences in collaboration with the Chulabhorn Royal Academy and the private sector, developed Thailand’s first favipiravir liquid formula for children and COVID-19 patients, which won the Prime Minister’s Award, Innovation for Crisis by the government sector category, at the Startup and Innovation Thailand Expo 2021 (SITE 2021) organized by the National Innovation Agency (NIA).

The COVID-19 pandemic in Thailand has left a large number of people infected, making access to medicines increasingly crucial. Favipiravir is one of the medicines used to treat COVID-19 according to the Ministry of Health’s 2019 Guidelines for the primary care, diagnosis, treatment, and infection prevention for the COVID-19 pandemic.

The Genesis of Pediatric Favipiravir Syrup

The recent COVID-19 pandemic has disrupted patients’ access to medicines.  In late May 2021, a joint consultation meeting was held between the Chulabhorn Royal Academy, Chula Faculty of Pharmaceutical Sciences, and a group of industrial pharmacists led by Professor Nithi Mahanonda, M.D., and Supasil Wisuthi Sra-ium of the Chulabhorn Royal Academy, together with Asst. Prof. Dr. Bodin Tuesuwan, and Assoc. Prof. Dr. Vorasit Vongsutilers of the Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, joined by Dr. Ariya Khunvichai, Promporn Jamnongtanachote, Dr.Wallapa Muannoom, and  Dr. Jirawee Pawitpok, industrial pharmacists, to find solutions through a wide range of pharmaceutical expertise.

Asst. Prof. Dr. Bodin Tuesuwan, and Assoc. Prof. Dr. Vorasit Vongsutilers of the Department of Food and Pharmaceutical Chemistry, Chula Faculty of Pharmaceutical Sciences, members of the team that jointly developed pediatric favipiravir syrup revealed that during the COVID-19 pandemic, adult patients who received 5 days of favipiravir would cost around 4,000 – 5,000 baht per person. So, the Chula Faculty of Pharmaceutical Sciences proposed a plan to develop their favipiravir formula to enable hospitals to prepare their medicines for patients, while the Chulabhorn Royal Academy already had the active ingredients of favipiravir, thus enabling the project to move forward quickly.

“During that time, we estimated that the number of pediatric patients in need of the medicine could be on the rise, and a syrup formula would give these patients the correct dosage, and is also convenient to take. That was how the development of favipiravir syrup formula started to help hospitals prepare the medicines in-house. Although the number of pediatric COVID-19 cases has now somewhat declined, the liquid favipiravir formula is still very necessary, since there is no similar product available on the market.

Dosage and Production Quality Control

The Chulabhorn Royal Academy’s formula of liquid favipiravir is a sugar-free, clear orange syrup with raspberry flavor and scent.  It comes in 2 sizes: 800 mg. in 60 ml, and 1,800 mg in 135 ml.  It is convenient to administer the medicine to young patients, or those having trouble swallowing tablets and should be taken on an empty stomach, twice a day, 12 hours apart.  At present, favipiravir is used in pediatric patients aged 2 months old and above.  However, favipiravir syrup is not restricted only to young patients, but can also be used in adults at different dosages for at least 5 days depending on the judgment of the attending physician.  Side effects are similar to favipiravir pills, for example, the dosage needs to be adjusted for those with moderate to severe liver conditions, and so on.

“The research team gives strong importance to quality control.  We set the standard for drug product specification of the original formula to ensure that the end product has the desired range of active ingredients. There are controls of impurity, preservative, and physical/chemical properties. Product stability has also been studied to ensure the potency and efficacy of the medication throughout its shelf life,” said Asst. Prof. Dr. Bodin.

How can patients gain access to favipiravir syrup?

For pediatric patients in need of favipiravir syrup. Asst. Prof. Dr. Bodin said the drug formula has now been distributed to many hospitals across the country.  You can also register online to receive the medicine via https://favipiravir.cra.ac.th  free of charge or contact the Chulabhorn Hospital directly. Patients must be supervised only by a doctor due to side effects.

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