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Preparing for the flu pandemic

A combination of antiviral drugs should be stockpiled for use in an influenza pandemic, say researchers.

There are currently two classes of drugs that are effective against influenza viruses: the ion channel inhibitors (amantadine and rimantadine) and the neuraminidase inhibitors (oseltamivir and zanamivir). Although ion channel inhibitors are effective against several strains of influenza viruses, they are not being widely stockpiled for a future flu pandemic because they cause unacceptable side-effects and their use is associated with a rapid emergence of resistance.

But researchers argue that combining the two types of drugs may reduce side-effects and the risk of resistance, and could play an important role in our armoury against a future flu pandemic.

In laboratory tests, the combination of ion channel and neuraminidase inhibitors reduced the emergence of resistance and even prevented the emergence of resistant strains of the highly pathogenic avian influenza H5N1 virus.

Several countries, including the USA, UK and Greece, are already stockpiling ion channel inhibitors. Other countries should consider following suit. Failure to stockpile both types of antiviral drugs could prove costly.