Monkeypox or MPXV: Management & Medications

Treatment - Management

(AMA) There is no treatment specifically for monkeypox, but because the monkeypox and smallpox viruses are closely related, drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.  Treatment will depend on how sick someone gets or whether they are likely to get severely ill. Most people with monkeypox recover fully within 2 to 4 weeks without the need for treatment. 

• Monkeypox Treatment (ClinicalKey)
• Pain Management (US Dept. HHS)
• Complications and Prognosis (ClinicalKey)
• How to care for yourself and others (patient information sheet) (San Francisco Health Dept)
• Availability, scope and quality of monkeypox clinical management guidelines globally: a systematic review. (BMJ Glob Health 2022-AUG)

Medication

Anti-Virals

(AMA) The antiviral drug tecovirimat (also known as TPOXX) was developed to fight smallpox, but the U.S. Food and Drug Administration allows CDC to use it to treat monkeypox during an outbreak.

• Tecovirimat (TPOXX or ST-246)
  • Tecovirimat Use Under Expanded Access/Investigation Protocol during 2022 Monkeypox Cases. (CDC)
  • Obtaining Tecovirimat (CDC)
  • Obtaining Tecovirimat (AZ Dept. of Health) (See "How to Obtain Tecovirimat (TPOXX)" FAQ)
• Cidofovir (Vistide)  is an antiviral medication approved by the FDA for the treatment of cytomegalovirus (CMV) retinitis in patients with Acquired Immunodeficiency Syndrome (AIDS).
• Brincidofovir (CMS001 or Tembexa) is an antiviral medication that was approved by the FDA in 2021 for the treatment of human smallpox disease.
• Antivirals with activity against Monkeypox: A clinically oriented review (Clin Infec Dis 29-JUL-2022)
• An overview of tecovirimat for smallpox treatment and expanded anti-orthopoxvirus applications (Expert Rev Anti-Infec Ther 03-SEP-2020)

Immune Globulin

• Intravenous Immune Globulin (VIGIV)  is licensed by FDA for treating complications from smallpox vaccination. CDC has permission to use of VIGIV for the treatment of orthopoxviruses, including monkeypox, during an outbreak.