What is the recommended dose of isoprinosine (inosine pranobex) for dengue in adults and children?

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Last updated: February 7, 2026View editorial policy

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Isoprinosine Dosing for Dengue

There are no established guidelines or evidence supporting the use of isoprinosine for dengue treatment, and it should not be used for this indication.

Critical Evidence Gap

The provided evidence contains no guidelines, drug labels, or research studies addressing isoprinosine use in dengue fever. All available evidence relates to other viral infections (influenza, HIV, COVID-19, respiratory infections) or entirely unrelated conditions (plague, MRSA, malaria) 1, 2, 3.

What the Evidence Actually Shows

Isoprinosine has been studied for other viral infections, but not dengue:

  • COVID-19: A 2022 trial used 50 mg/kg/day (maximum 4 g/day) divided into 3-4 doses for 10 days in mild-to-moderate COVID-19, showing some benefit when started early 4.

  • HIV infection: Historical data from 1990 used 1 g three times daily (3 g/day total) for 24 weeks, though this is no longer standard practice 5.

  • Respiratory infections in children: Studies used 50 mg/kg/day for varying durations, but showed no benefit in preventing recurrent respiratory infections 6, 7.

  • Influenza: Old data from 1972 showed variable antiviral activity in vitro and animal models, but this does not translate to clinical recommendations 8.

Why This Matters for Dengue

Dengue is a completely different pathophysiology requiring supportive care, not immunomodulation:

Dengue management focuses on fluid resuscitation, monitoring for plasma leakage, and managing complications during the critical phase. There is no role for antiviral or immunomodulatory agents like isoprinosine in current dengue treatment protocols. Using unproven therapies may delay appropriate supportive care and worsen outcomes.

Common Pitfalls to Avoid

  • Do not extrapolate dosing from other viral infections to dengue - the mechanism of dengue pathogenesis (vascular permeability, thrombocytopenia) differs fundamentally from respiratory viruses or HIV 4, 5.

  • Avoid using immunomodulators without evidence - dengue's critical phase involves immune-mediated vascular leak; inappropriate immunomodulation could theoretically worsen outcomes.

  • Focus on evidence-based dengue management - adequate hydration, close monitoring for warning signs, and timely intervention for severe dengue are the only proven interventions.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Chloroquine Prophylaxis Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Hydroxychloroquine Dosing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

[Immunological and clinical study on therapeutic efficacy of inosine pranobex].

Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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