(For additional information
see "Inosine pranobex (United States: Not available): Patient drug information")
For abbreviations, symbols, and age group definitions used in Lexicomp (
show table)
Dosing: Adult
Subacute sclerosing panencephalitis
Subacute sclerosing panencephalitis:
Oral: 50 mg/kg/day in 3 to 4 equally divided doses (maximum: 3 g daily).
Dosing: Kidney Impairment: Adult
There is no dosage adjustment provided in manufacturer’s labeling.
Dosing: Hepatic Impairment: Adult
There is no dosage adjustment provided in manufacturer’s labeling.
Dosing: Older Adult
Refer to adult dosing.
Dosing: Pediatric
Subacute sclerosing panencephalitis
Subacute sclerosing panencephalitis (SSPE): Refer to adult dosing.
Dosing: Kidney Impairment: Pediatric
There is no dosage adjustment provided in manufacturer’s labeling.
Dosing: Hepatic Impairment: Pediatric
There is no dosage adjustment provided in manufacturer’s labeling.
Adverse Reactions
The following adverse drug reactions are derived from product labeling unless otherwise specified.
Frequency not defined:
Dermatologic: Pruritus, skin rash
Endocrine & metabolic: Hyperuricemia
Gastrointestinal: Constipation, diarrhea, gastric distress
Genitourinary: Hyperuricuria, increased urine output
Nervous system: Dizziness, fatigue, headache, insomnia, nervousness
Neuromuscular & skeletal: Arthralgia
Contraindications
There are no contraindications listed in the manufacturer’s product monograph.
Warnings/Precautions
Concerns related to adverse effects:
• Uric acid: Inosine undergoes rapid metabolism to uric acid. Use with caution in patients with a history of gout, urolithiasis, nephrolithiasis, or kidney impairment. Uricosuric agents (eg, probenecid) or antihyperuricemic therapy (eg, allopurinol) may be necessary for extremely elevated serum uric acid levels.
Product Availability
Not available in the US
Generic Equivalent Available: US
No
Dosage Forms: Canada
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, Oral:
Imunovir: 500 mg
Administration: Adult
Oral: Administer orally in 3 to 4 equally divided doses while awake.
Administration: Pediatric
Oral: Administer orally in 3 to 4 equally divided doses while awake.
Use: Labeled Indications
Note: Not approved in the US.
Treatment of slowly progressive subacute sclerosing panencephalitis; may delay neurologic deterioration and prolong life expectancy.
Metabolism/Transport Effects
None known.
Drug Interactions
There are no known significant interactions.
Pregnancy Considerations
Adverse effects to the fetus were not observed in animal reproduction studies. Due to the altered immune status of patients who are pregnant, subacute sclerosing panencephalitis may be exacerbated during pregnancy and may progress rapidly. Because this condition is rare, use of inosine pranobex in pregnancy is limited to case reports (Cole 2007).
Monitoring Parameters
Uric acid (serum and urine)
Mechanism of Action
Exact mechanism has not been fully elucidated; may possess antiviral and immunomodulating effects by potentiating T-lymphocyte and macrophage cell function and by influencing cytokine production (Milano, 1991; Petrova, 2010; Wybran, 1978).
Pharmacokinetics (Adult Data Unless Noted)
Metabolism: Rapid to uric acid; also undergoes glucuronidation and oxidation
Half-life elimination: ~50 minutes (Campoli-Richards, 1986)
Time to peak: 1 hour (Campoli-Richards, 1986)
Excretion: Urine (as uric acid, glucuronide and oxide metabolites, and unchanged drug)
Brand Names: International
International Brand Names by CountryFor country code abbreviations (
show table)
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(AE) United Arab Emirates: Immunovir | Isoprinosine;
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(BE) Belgium: Isoprinosine;
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(BG) Bulgaria: Ino protect | Isoprinosine | Izoreks | Viruprinol;
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(CL) Chile: Isoprinosine;
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(CO) Colombia: Deltax | Pranosina;
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(CZ) Czech Republic: Isoprinosine | Modimunal;
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(DE) Germany: Delimmun;
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(DO) Dominican Republic: Isoprinosine;
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(EC) Ecuador: Inmuflu | Isoprinosine | Virux;
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(EG) Egypt: Isoprinosine;
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(ES) Spain: Bodaril;
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(FR) France: Isoprinosine;
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(GB) United Kingdom: Imunovir | Imunovir nye;
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(GR) Greece: Isoprinosine;
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(HK) Hong Kong: Imin | Isoprinosine;
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(HR) Croatia: Isoprinosine ewopharma;
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(HU) Hungary: Isoprinosine | Isoprivir;
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(ID) Indonesia: Beprin | Isoprinosine | Isprinol | Lanavir | Laprosin | Methisoprinol | Methopi | Moprin | Pronovir | Soprinol | Visoprine;
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(IE) Ireland: Imunovir | Isoprinosine;
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(IN) India: Viralex;
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(IT) Italy: Viruxan;
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(JP) Japan: Isoprinosine;
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(KR) Korea, Republic of: Inoflic | Inoplix | Inopurix | Inosiplex | Prinosine | Serinosin;
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(KW) Kuwait: Isoprinosine;
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(LT) Lithuania: Delimmun | Isoprinosine | Modimunal;
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(LU) Luxembourg: Isoprinosine;
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(LV) Latvia: Delimmun | Groprinosin | Isoprinosine | Modimunal;
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(MA) Morocco: Isoprinosine;
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(MX) Mexico: Isoprinosine | Pranosine;
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(NO) Norway: Isoprinosine | Isoprinosine ewopharma;
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(NZ) New Zealand: Imunovir;
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(PE) Peru: Isoprinosine | Pranogir;
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(PH) Philippines: Immunosin | Inosiplex | Isoprinosine;
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(PK) Pakistan: Isoprinosine;
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(PL) Poland: Eloprine | Groprinosin | Inuprin | Isoprinosine | Modimunal | Neosine | Neosine forte | Viruzine forte;
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(PT) Portugal: Isovir;
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(PY) Paraguay: Viruxan;
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(RO) Romania: Isoprinosine ewopharma;
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(RU) Russian Federation: Groprinosin | Isoprinosin | Isoprinosine | Normomed;
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(SG) Singapore: Imin | Isoprinosine;
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(SK) Slovakia: Inomed | Isoprinosine;
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(TH) Thailand: Isoprinosine;
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(TN) Tunisia: Isoprinosine;
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(TW) Taiwan: Imin | Ishutin | Isolin | Isoprin | Isoprinosine | Methisine | Virux;
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(UA) Ukraine: Gropivirin | Groprim | Groprinosin | Inoseda | Isoprinosine | Normomed | Novirin | Novirin forte