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Other Treatments Global Adoption
 
Favipiravir COVID-19 studies. Recently added: Atipornwanich Unal Bosaeed Alamer. Favipiravir has been officially adopted for early treatment in all or part of 11 countries. Submit updates/corrections.
 
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Jan 16
Early, Late, PrEP, PEP Covid Analysis (Preprint) (meta analysis)
meta-analysis
Favipiravir for COVID-19: real-time meta analysis of 26 studies
Details   • Statistically significant improvements are seen for progression, recovery, and viral clearance. 17 studies from 17 independent teams in 12 different countries show statistically significant improvements in isolation (9 for the most seri..
Jan 12
In Vitro Unal et al., bioRxiv, doi:10.1101/2022.01.11.475889 (Preprint) (In Vitro)
In Vitro
Favipiravir, umifenovir and camostat mesylate: a comparative study against SARS-CoV-2
Details   In Vitro and In Silico study showing that the combination of favipiravir and umifenovir or camostat mesylate has greater antiviral efficacy than single drug treatment.
Jan 11
Early Bosaeed et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2021.12.026 (Peer Reviewed)
ICU, ↑618.8%, p=0.11
Efficacy of favipiravir in adults with mild COVID-19: a randomized, double-blind, multicenter, placebo-controlled trial clinical trial
Details   RCT with 112 favipiravir and 119 control patients showing no significant differences in outcomes. Viral clearance and clinical recovery for patients treated within 48 hours was better than those treated later. NCT04464408.
Dec 7
Late Finberg et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab56310 (Peer Reviewed)
death, ↑200.0%, p=1.00
US201 Study: A Phase 2, Randomized Proof-of-Concept Trial of Favipiravir for the Treatment of COVID-19
Details   Small very late treatment RCT in the USA, with 25 favipiravir and 25 control patients, showing faster viral clearance with treatment. The benefit was only seen in patients <8 days from symptom onset. There were no significant differences ..
Nov 30
Early Alattar et al., medRxiv, doi:10.1101/2021.11.29.21267042 (Preprint)
death, ↓33.3%, p=0.50
Favipiravir for the Treatment of Coronavirus Disease 2019; a propensity score-matched cohort study
Details   PSM retrospective with 1,493 patients, showing significantly improved viral clearance with favipiravir. There were no signficant differences in clinical improvement or mortality. Mortality was lower (2.1% vs 3.1%), without statistical sig..
Nov 24
Early Holubar et al., medRxiv, doi:10.1101/2021.11.22.21266690 (Preprint)
hosp., ↓89.0%, p=0.06
Favipiravir for treatment of outpatients with asymptomatic or uncomplicated COVID-19: a double-blind randomized, placebo-controlled, phase 2 trial
Details   Small RCT 116 mITT patients in the USA, 59 treated with favipiravir, showing no significant differences with treatment.
Nov 19
Late Chuah et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab962 (Peer Reviewed)
death, ↑1154.0%, p=0.08
Efficacy of Early Treatment with Favipiravir on Disease Progression among High Risk COVID-19 Patients: A Randomized, Open-Label Clinical Trial
Details   RCT 500 hospitalized patients in Malaysia, showing no significant differences with favipiravir treatment.
Nov 9
Late Shenoy et al., medRxiv, doi:10.1101/2021.11.08.21265884 (Preprint)
death, ↑29.5%, p=0.54
Favipiravir In Adults with Moderate to Severe COVID-19: A Phase 3 Multicentre, Randomized, Double-Blind, Placebo-Controlled Trial
Details   Late stage RCT with 353 hospitalized patients, showing no significant differences with favipiravir treatment overall, however a trend towards benefit was seen within patients treated relatively early, including a statistically significant..
Nov 1
Late Damayanti et al., Kesmas: National Public Health Journal, doi:10.21109/kesmas.v16i4.5433 (Peer Reviewed)
no recov., ↓54.5%, p=0.03
The Effectiveness and Safety of Favipiravir in COVID-19 Hospitalized Patients in Bali, Indonesia
Details   Retrospective 192 hospitalized patients in Indonesia, 96 patients treated with favipiravir, showing improved recovery with treatment. Only the abstract is currently available.
Oct 5
Late Atipornwanich et al., SSRN Electronic Journal, doi:10.2139/ssrn.3936499 (Peer Reviewed)
death, ↓23.1%, p=0.66
Various Combinations of Favipiravir, Lopinavir-Ritonavir, Darunavir-Ritonavir, High-Dose Oseltamivir, and Hydroxychloroquine for the Treatment of COVID-19: A Randomized Controlled Trial (FIGHT-COVID-19 Study)
Details   RCT 200 moderate/severe patients in Thailand, showing significantly lower progression with favipiravir vs. oseltamivir. NCT04303299.
Sep 30
Late Tabarsi et al., Iranian Journal of Pharmaceutical Research, doi:10.22037/ijpr.2021.115510.15401 (Peer Reviewed)
death, ↓29.7%, p=0.70
Favipiravir Effects on the Control of Clinical Symptoms of Hospitalized COVID-19 Cases: An Experience with Iranian Formulated Dosage Form
Details   Small 62 patient late stage RCT in Iran comparing favipiravir and lopinavir/ritonavir, showing significant improvement in fever, cough, and dyspnea with favipiravir on day 5. There was no significant difference in mortality, ICU admission..
Sep 14
Late Alotaibi et al., International Journal of General Medicine, 2021:14 (Peer Reviewed)
death, ↓57.2%, p=0.05
Effectiveness and Safety of Favipiravir Compared to Hydroxychloroquine for Management of Covid-19: A Retrospective Study
Details   Retrospective hospitalized patients in Saudi Arabia, showing lower mortality with favipiravir compared to HCQ, not quite reaching statistical significance. Authors do not indicate the factors behind which therapy was chosen. Confounding b..
Sep 9
Early Sawanpanyalert et al., Southeast Asian Journal of Tropical Medicine and Public Health, 52:4 (Peer Reviewed)
progression, ↓68.0%, p=0.003
Assessment of outcomes following implementation of antiviral treatment guidelines for COVID-19 during the first wave in Thailand
Details   Retrospective 744 hospitalized patients in Thailand, showing lower risk of a poor outcome for favipiravir treatment within 4 days of symptom onset. Early treatment with CQ/HCQ and lopinavir/ritonavir or darunavir/ritonavir also showed low..
Sep 2
Late Chen et al., Frontiers in Pharmacology, doi:10.3389/fphar.2021.683296 (Peer Reviewed)
ICU, ↑3.4%, p=1.00
Favipiravir Versus Arbidol for Clinical Recovery Rate in Moderate and Severe Adult COVID-19 Patients: A Prospective, Multicenter, Open-Label, Randomized Controlled Clinical Trial
Details   Very late stage (9 days from symptom onset) RCT with 116 favipiravir patients and 120 arbidol patients in China, showing no significant difference in clinical recovery (relief of fever and cough, respiratory frequency ≤24 times/min, and o..
Aug 31
Late Kulzhanova et al., (Peer Reviewed)
no improv., ↓88.0%, p<0.0001
Clinical efficacy of the antiviral drug favipiravir in the complex treatment of patients with COVID-19 coronavirus infection
Details   Retrospective 40 favipiravir patients in Kazakhstan and 40 controls, showing faster recovery and viral clearance with treatment.
Aug 28
Late Assiri et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.030 (Peer Reviewed)
death, ↑79.3%, p=0.50
COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study
Details   Retrospective 118 ICU patients in Saudi Arabia showing no significant differences in unadjusted results with zinc, vitamin D, and favipiravir treatment.
Aug 27
Late Shinkai et al., Infectious Diseases and Therapy, doi:10.1007/s40121-021-00517-4 (Peer Reviewed)
imp. time, ↓37.1%, p=0.01
Efficacy and Safety of Favipiravir in Moderate COVID-19 Pneumonia Patients without Oxygen Therapy: A Randomized, Phase III Clinical Trial
Details   RCT 156 patients in Japan, 107 treated with favipiravir, showing significant improvement in a composite outcome defined as the time to improvement in temperature, SpO2, CT findings, and recovery to PCR-.
Aug 24
Late Almoosa et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.022 (Peer Reviewed)
death, ↑42.3%, p=0.10
Favipiravir versus Standard of Care in Patients with Severe COVID-19 Infections: A Retrospective Comparative Study
Details   Retrospective 226 COVID-19 pneumonia patients, 110 treated with favipiravir, showing higher mortality (p=0.1) and ICU admission (p=0.02) with treatment in multivariate analysis.
Jul 20
Meta Hung et al., SSRN, doi:10.2139/ssrn.3889346 (Preprint) (meta analysis)
meta-analysis
The Efficacy and Adverse Effects of Favipiravir on COVID-19 Patients: A Systematic Review and Meta-Analysis of Published Clinical Trials and Observational Studies
Details   Systematic review and meta analysis of 15 favipiravir trials, showing improved viral clearance and recovery.
May 19
Late Alamer et al., Current Medical Research and Opinion, doi:10.1080/03007995.2021.1920900 (Peer Reviewed)
death, ↑56.0%, p=0.26
Effectiveness and safety of favipiravir compared to supportive care in moderately to critically ill COVID-19 patients: a retrospective study with propensity score matching sensitivity analysis
Details   Retrospective 234 favipiravir and 223 control patients in Saudi Arabia, showing shorter time to discharge and lower progression to ventilation, but no significant difference in mortality.
Apr 29
Late Aghajani et al., Journal of Medical Virology, doi:10.1002/jmv.27053 (Peer Reviewed)
death, ↓26.1%, p=0.28
Decreased In-Hospital Mortality Associated with Aspirin Administration in Hospitalized Patients Due to Severe COVID-19
Details   Retrospective 991 hospitalized patients in Iran focusing on aspirin use but also showing results for HCQ, remdesivir, and favipiravir.
Apr 21
Late Zhao et al., International Immunopharmacology, doi:10.1016/j.intimp.2021.107702 (Peer Reviewed)
viral+, ↓59.0%, p=0.06
Favipiravir in the treatment of patients with SARS-CoV-2 RNA recurrent positive after discharge: a multicenter, open-label, randomized trial
Details   RCT with 55 patients (36 favipiravir, 19 control) who were PCR+ after recovery, showing improved viral clearance with treatment.
Apr 19
Late Favipiravir Observational Study Group, Fujita Health University (Preprint) Favipiravir Observational Study Interim Report 3
Details   Retrospective analysis of favipiravir use in 10,986 hospitalized patients, including analysis of changes in clinical status and side effects. Common adverse events were uric acid level increase and liver function enzyme increase. Authors ..
Apr 17
Early Fujii et al., Journal of Infection and Chemotherapy, doi:10.1016/j.jiac.2021.04.013 (Peer Reviewed) Early favipiravir treatment was associated with early defervescence in non-severe COVID-19 patients
Details   Retrospective 41 favipiravir patients finding that early treatment was more successful.
Mar 11
Late Solaymani-Dodaran et al., International Immunopharmacology, doi:10.1016/j.intimp.2021.107522 (Peer Reviewed)
death, ↑19.2%, p=0.54
Safety and efficacy of Favipiravir in moderate to severe SARS-CoV-2 pneumonia
Details   RCT late stage patients (median SpO2 89), 193 treated with favipiravir, 187 with lopinavir/ritonavir, showing no significant differences in mortality, intubation, or ICU admission.
Mar 8
Late Fateh et al., medRxiv, doi:10.1101/2021.03.05.21251351 (Preprint) A single-center retrospective cohort study of Covid-19 medications: Remdesivir, Favipiravir, Methylprednisolone, Dexamethasone, and Interferon β1a and their combinations
Details   Retrospective 324 hospitalized patients in Iran reporting on the use Remdesivir, Favipiravir, Methylprednisolone, Dexamethasone, and Interferon β1a and their combinations. There is no control group in this study.
Feb 4
Early, Late Uçan et al., Research Square, doi:10.21203/rs.3.rs-175340/v1 (Preprint) Benefits of Treatment With Favipiravir in Hospitalized Patients for COVID-19: a Retrospective Observational Case-control Study
Details   Retrospective 144 COVID-19 patients in Turkey, one group receiving FPV after a mean of 4.7 days, a second group after a mean of 8.6 days, and all groups receiving HCQ. No improvement in clinical outcomes was seen with the addition of FPV,..
Jan 25
Early Dabbous et al., Archives of Virology, doi:10.1007/s00705-021-04956-9 (Peer Reviewed) Efficacy of favipiravir in COVID-19 treatment: a multi-center randomized study
Details   This study was retracted.
Jan 14
Early Karatas et al., Research Square, doi:10.21203/rs.3.rs-142868/v1 (Preprint) Early Onset Favipiravir Saves Lives
Details   Retrospective 180 hospitalized patients showing lower mortality when Favipiravir is given earlier. 17% of patients given Favipiravir within 3 days died, compared to 38% when given after 3 days.
Nov 17
2020
Late Doi et al., Antimicrobial Agents and Chemotherapy, doi:10.1128/AAC.01897-20 (Peer Reviewed) A Prospective, Randomized, Open-Label Trial of Early versus Late Favipiravir Therapy in Hospitalized Patients with COVID-19
Details   Small RCT comparing late and very late (7 and 14 days from fever onset) favipiravir. Viral clearance was non-statistically significantly improved with relatively early treatment. There was a reduction in time to defervescence, and a signi..
Nov 16
2020
Early Udwadia et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.11.142 (Peer Reviewed)
recov. time, ↓40.0%, p=0.03
Efficacy and Safety of Favipiravir, an Oral RNA-Dependent RNA Polymerase Inhibitor, in Mild-to-Moderate COVID-19: A Randomized, Comparative, Open-Label, Multicenter, Phase 3 Clinical Trial
Details   RCT with 75 favipiravir patients and 75 control patients showing reduced time to clinical cure and reduced time of viral shedding.
Nov 9
2020
Late Khamis et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.11.008 (Peer Reviewed)
death, ↓14.8%, p=1.00
Randomized Controlled Open Label Trial on the Use of Favipiravir Combined with Inhaled Interferon beta-1b in Hospitalized Patients with Moderate to Severe COVID-19 Pneumonia
Details   Small 89 patient RCT comparing favipiravir and inhaled interferon with HCQ for moderate to severe COVID-19 pneumonia, not finding significant differences. There was no control group.
Nov 5
2020
Late Pushkar et al., NCT04542694 (Preprint)
no recov., ↓14.1%, p=0.06
Study of Favipiravir Compared to Standard of Care in Hospitalized Patients With COVID-19
Details   RCT 200 patients showing improvements in clinical recovery and viral clearance with favipiravir. There is no paper available but results are posted in clinicaltrials.gov.
Oct 26
2020
Early Ruzhentsova et al., SSRN, doi:10.2139/ssrn.3696907 (Preprint)
hosp., ↓6.0%, p=0.49
Phase 3 Trial of Coronavir (Favipiravir) in Patients with Mild to Moderate COVID-19
Details   RCT 168 patients, 112 receiving favipiravir and 56 SOC, showing shorter time to clinical improvement and faster viral clearance with favipiravir.
Sep 30
2020
Late Zhaao et al., Biomedicine & Pharmacotherapy, doi:10.1016/j.biopha.2020.110825 (Peer Reviewed) Tocilizumab combined with favipiravir in the treatment of COVID-19: A multicenter trial in a small sample size
Details   Small study with 14 combined favipiravir/tocilizumab, 7 favipiravir, and 5 tocilizumab patients suggesting that tocilizumab combined with or without favipiravir can improve pulmonary inflammation and inhibit progression.
Aug 9
2020
Late Ivashchenko et al., Clin. Infect. Dis., doi:10.1093/cid/ciaa1176 (Peer Reviewed)
viral+, ↓46.4%, p=0.03
AVIFAVIR for Treatment of Patients with Moderate COVID-19: Interim Results of a Phase II/III Multicenter Randomized Clinical Trial
Details   Intermin results for a small RCT with 40 favipiravir and 20 control patients showing faster viral clearance with favipiravir. There is limited data in this report to evaluate the results. The report indicates that 75% of the control group..
Mar 18
2020
Late Cai et al., Engineering, doi:10.1016/j.eng.2020.03.007 (Peer Reviewed)
pneumonia, ↓68.7%, p=0.04
Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study
Details   Comparison of 35 FPV patients and 35 LPV/RTV patients, showing significant improvements in chest CT and faster viral clearance with FPV.
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