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Why is reference to further clinical study weird? It is a credible alternative not a mainstream, thoroughly researched alternative.
"Is there something better than tamiflu?" - Thank you for posing this question, I enjoyed researching it.
I'm going to propose two candidates that could be superior against H5N1: Aspirin (acetylsalicylic acid) and Methylene blue (methylthioninium chloride).
Aspirin
First, consider aspirin’s safety profile. For short-term use—relevant in acute infections—the risks are minimal for most individuals. GI upset, often cited as a concern, is only marginally higher than placebo (source: PMC3586117). The notable exception is its association with Reye's syndrome in children, but this is exceptionally rare. The risk-benefit calculus remains favorable for adults, particularly in acute scenarios.
Efficacy-wise, aspirin’s NF-κB-inhibiting activity shows promise as an antiviral. It has demonstrated robust effects against H5N1 in vitro and in vivo (source: Wiley). This pathway is a compelling mechanism of action that Tamiflu does not directly address, positioning aspirin as a strong candidate for consideration.
Methylene blue
Next, methylene blue is another plausible alternative. Its safety profile for short-term use is generally acceptable, barring contraindications such as risk of serotonin syndrome, hypersensitivity, or severe renal impairment (source: Medsafe). For those without contraindications, it represents a well-tolerated option.
Methylene blue's broad-spectrum antiviral properties are underappreciated. It has shown potent virucidal activity against H1N1 (source: PMC8275569), and while H5N1-specific data is lacking, the mechanism of action suggests potential efficacy. Notably, there’s already a patent application exploring its antiviral indications (source: WO2007086995A2). Given this, methylene blue is a viable contender worthy of further clinical study.
Comparing with Tamiflu
Tamiflu has well-documented side effects—nausea, vomiting, diarrhea, and abdominal pain—that overlap with the profiles of both aspirin and methylene blue (source: Medsafe Tamiflu). While tolerable for most, its mild benefits against H5N1 are unlikely to significantly outperform the mechanistic potential of aspirin or methylene blue (source: JHEOR).
Conclusion
In a pandemic preparedness scenario, Aspirin and Methylene blue deserve serious consideration alongside Tamiflu. They offer distinct mechanisms of action, robust preliminary data, and manageable safety profiles. If you're prioritizing interventions that maximize cost-effectiveness and theoretical efficacy, these "old drugs" might hold the key to new antiviral strategies. Rational prioritization of research and clinical trials could unlock their full potential.
Disclaimer: I am not your doctor, please see a medical professional for personalized advice. The information presented is only for the interests of research and should not be interpreted as clinical advice.
“Xofluza is more effective than Tamiflu but I can’t find anywhere to buy it online”
- Both drugs are prescription-only medications so you would need a valid prescription to access it. Telehealth would suffice for prescription and online pharmacies can home deliver.
If I get more time later today I will update this comment.
I would update positively on your belief that gargling improved absorption. Route of administration is an extremely undervalued consideration by clinicians and patients when prescribing medication. Oral medication via pills need to pass through many more layers (GI tract, first pass metabolism in the liver) before it reaches your circulation by then effects can be greatly diluted. This has implications for pill design because manufactures need to coat it with excipients and coatings to 'deliver the package' so to speak. The understanding is that patients generally prefer tablets, but if you are targeting efficacy I would say other routes are almost always preferred (e.g. IV iron infusion over iron tablets, NSAID suppository for back pain over oral tablets). This information is for general education only and is not medical advice. Please consult your doctor for personalized guidance.
Thank you for your comment. I get what you mean. I predict with the increasingly intelligence and adoption of AI, that technical skills will become lower valued, whereas the creativity/generativity/coordination skills you refer to will take their place. I draw a comparison to how being able to "code a website" infers downtrending levels of skill today compared to 10 years ago, 20 years ... etc.