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oseltamivir Oseltamivir phosphate is an ethyl ester prodrug requiring ester hydrolysis for conversion to the active form, oseltamivir carboxylate. Oseltamivir carboxylate is an inhibitor of influenza virus neuraminidase affecting release of viral particles. The median IC50 values of oseltamivir against influenza A/H1N1, influenza A/H3N2, and influenza B clinical isolates were 2.5 nM (range 0.93-4.16 nM, N=74), 0.96 nM (range 0.13 - 7.95 nM, N=774), and 60 nM (20-285 nM, N=256), respectively, in a neuraminidase assay with a fluorescently labeled MUNANA substrate. Although oseltamivir was suggested as a potential treatment and included in various antiviral regimens used during the early stages of the COVID-19 pandemic, the drug does not appear to have in vitro activity against SARS-CoV-2 and there are no data to support the use of oseltamivir or other neuraminidase inhibitors in the treatment of COVID-19.

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