Recently, the latest data from the Chinese Center for Disease Control and Prevention shows that the positive rate of influenza virus continues to rise, with H1N1 being the main type. What is the difference between oseltamivir and mabaloxavir, two flu antiviral drugs, and how should I choose? Can healthy individuals prevent H1N1 influenza by taking antiviral drugs in advance? Don't worry, Dr. Ma Yanliang, Chief Physician of the Department of Respiratory and Critical Care Medicine at Peking University People's Hospital, and Dr. Chen Yue, Chief Pharmacist of the Pharmacy Department, will assist you in recruiting children. The appearance of these three symptoms is highly suspected to be caused by the H1N1 influenza virus, which is an acute respiratory infectious disease. The main symptoms of H1N1 influenza include sudden high fever, cough (usually dry cough), sore throat, muscle soreness (especially systemic), runny nose, sneezing, nasal congestion, etc. Some patients may experience headaches, fatigue, and some may also experience digestive symptoms such as nausea, vomiting, and diarrhea. How to determine if you have H1N1 or a common cold? H1N1 influenza and common cold are both respiratory diseases, and there are some significant differences between them. From a symptom perspective, H1N1 influenza mainly affects the whole body, with the most typical symptoms being high fever and muscle soreness throughout the body. The common cold often mainly affects the upper respiratory tract, characterized by symptoms such as runny nose, sneezing, and sore throat. Although there may be fever, it is usually low-grade and lasts for a short period of time. Another key point is the epidemiological history. If you have recently come into contact with someone who has the same high fever and body aches, your chances of being hit are even higher. Special Reminder! If there are the following situations, a high suspicion of H1N1 infection should be made: 1. Rapid increase in body temperature, often accompanied by chills, and fever can usually reach above 39 ℃. 2. Muscle and joint pain, especially in the head, temples, and brow area. 3. There may be obvious chest tightness and shortness of breath, and severe cases may be accompanied by symptoms of hypoxia. Medical attention should be sought in a timely manner. Taking medication within 48 hours to seize the golden period of treatment. There are good treatment methods for H1N1 influenza, but medication should be taken as early as possible. The shorter the time interval between symptom onset and medication, the faster the medication will take effect. In clinical practice, it is often said to 'seize the golden period of 48 hours of treatment'. At present, the specific drugs for influenza virus are oseltamivir and mabaloxavir, which can quickly take effect, prevent virus replication, and rapidly alleviate symptoms. Oseltamivir and Mabaloxavir are both prescription drugs, and it is necessary to choose the medication that is more suitable for oneself under the guidance of a physician or pharmacist. Mechanistically, oseltamivir inhibits the release of the virus from infected cells, reducing virus spread. Mabaloxavir inhibits the replication of influenza virus, preventing the production of new viruses in the body; Compared with oseltamivir, Mabaloxavir improves flu symptoms in a similar amount of time, but shows certain advantages in anti influenza, which can shorten detoxification time by 48 hours. In the treatment process, in addition to antiviral drugs, antipyretic and analgesic drugs can also be selected to alleviate fever, body aches and other discomfort. In addition to traditional Chinese patent medicines and simple preparations for clearing heat and detoxification, it can be far away from the interference of A flow as soon as possible. Influenza is a self limiting disease that can self heal for most patients with normal immune function. So for those with mild symptoms or not belonging to high-risk groups, they can choose to rest at home and receive targeted treatment. But once the disease progresses rapidly and there is a high-risk group for severe influenza, it is necessary to seek medical attention as soon as possible to avoid delaying the condition. The significance of early medication for healthy people is not significant. Some netizens believe that "antiviral drugs such as oseltamivir can be taken in advance to prevent influenza", and even regard oseltamivir as a "miracle drug". However, the role of oseltamivir mainly lies in early treatment and post exposure prevention. Short term use of oseltamivir can reduce the risk of infection in high-risk populations such as the elderly, pregnant women, immunocompromised individuals, and those with a history of close contact with influenza patients. But for the general population, the significance of taking it in advance is not significant. It should be emphasized that improper use of oseltamivir may promote the development of resistance in influenza viruses and reduce the effectiveness of the drug. In addition, oseltamivir cannot completely prevent infection with influenza virus, especially in cases where the virus is not clearly prevalent, taking it in advance cannot guarantee the preventive effect. Compared to oseltamivir, Mabaloxavir is more prone to developing resistance. In the United States and Japan, it has been found that the incidence of drug resistance in children is significantly higher than in adults, so it is not recommended for use in children under 5 years old. However, no recent resistance of influenza viruses to Mabaloxavir has been found in our country. How to choose between two drugs? Taking into account six factors, the indications for oseltamivir include the treatment and prevention of influenza A and B. Mabaloxavir has not been approved for the prevention of influenza A/B. In terms of age range, oseltamivir has a wide range of applications. Suspension formulations can be used for infants and young children over 2 weeks old, while capsules or granules can be used for children over 1 year old and adults; Mabaloxavir has a narrower age range and can only be used for children over 5 years old and adults weighing over 20 kilograms. If you are already pregnant or suspect that you are pregnant, it is recommended to use oseltamivir under the guidance of a doctor. It should be noted that Oseltamivir granules should not be taken for more than 5 days for children aged 1 year and under who are in the stage of growth and development and whose body organs have not fully matured. In addition, patients with poor gastric function or sensitive stomach can take medication during meals. For Mabaloxavir, pregnant women should avoid using it as its potential risks are not yet known. Breastfeeding women should stop breastfeeding or avoid taking it. In terms of ease of use, the advantage of Mabaloxavir is very obvious, as it only needs to be taken once throughout the entire process. Oseltamivir requires multiple doses of medication, usually taken twice a day for 5 consecutive days during treatment. With the emergence of generic drugs and the implementation of national centralized procurement policies, the price advantage of oseltamivir over Mabaloxavir is very obvious, which is related to the manufacturer. The interaction between the combined medication oseltamivir and other drugs is relatively small, which Mabaloxavir cannot compare to. Due to the fact that drugs containing multivalent cations can affect the blood concentration of Mabaloxavir, thereby reducing its efficacy, if Mabaloxavir needs to be used, it should be avoided from being used together with multivalent cation laxatives or antacids, or oral supplements containing iron, zinc, selenium, calcium, and magnesium. The two should be separated by at least 2 hours. The common adverse reactions of oseltamivir are nausea, vomiting, and headache, which usually subside within 1-2 days. In addition, there have been reports of psychoneurological adverse events such as hallucinations, delirium, and behavioral abnormalities. Mabaloxavir can cause allergic reactions such as rash, and has also been reported to cause black stool, colitis, rhabdomyolysis, etc. Close observation should be made during use, and medical attention should be sought promptly if it occurs. Experts remind that getting vaccinated against influenza is the most effective preventive measure. The vaccines administered that year were determined based on the previous year's viral strains, and to a certain extent, they could cover common types of influenza viruses. Especially for those who are susceptible to influenza virus, for those with underlying diseases, elderly people, including family members, it is recommended that these family members also get vaccinated as soon as possible. In addition, scientific prevention of influenza requires the following daily tasks: wash hands frequently, wear masks, reduce visits to crowded places, especially relatively enclosed spaces such as shopping malls and cinemas, and avoid contact with infectious sources; Enhance one's resistance, maintain a balanced diet, get enough sleep, and engage in moderate exercise; Open windows for ventilation at regular intervals every day, with a minimum ventilation time of 30 minutes. (Xinhua News Agency) by Zhong Yanyu (Peking University People's Hospital)