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Favipiravir + nitazoxanide is an investigational oral combination therapy of two small-molecule antivirals with distinct mechanisms of action. Favipiravir is a prodrug that is intracellularly converted to its active form, favipiravir-RTP, which selectively inhibits viral RNA-dependent RNA polymerase (RdRp), thereby blocking viral genome replication and transcription[5][1]. Nitazoxanide acts at a later stage in the viral life cycle by inhibiting maturation of the viral nucleocapsid N protein and thus preventing assembly of new virions[1]. Additionally, nitazoxanide has been shown to modulate host immune responses and inhibit multiple cellular pathways involved in viral entry and replication[4]. The combination has been studied primarily for early treatment of COVID-19 in clinical trials due to their potential additive or synergistic antiviral effects[1][2][3].
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