Dengue Medication

Updated: May 03, 2019
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Michael Stuart Bronze, MD  more...
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Medication

Medication Summary

No specific antiviral medication is currently available to treat dengue. The treatment of dengue fever is symptomatic and supportive in nature. Bed rest and mild analgesic-antipyretic therapy are often helpful in relieving lethargy, malaise, and fever associated with the disease. Acetaminophen (paracetamol) is recommended for treatment of pain and fever. Aspirin, other salicylates, and nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided.

Patients with dengue hemorrhagic fever or dengue shock syndrome may require intravenous volume replacement. Plasma volume expanders can be used in patients who do not respond to isotonic fluids.

Dengue vaccine was approved by the FDA in 2019 for individuals aged 9-16 years with laboratory-confirmed previous dengue infection who live in endemic areas.

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Analgesics

Class Summary

These agents are used to reduce fever. They inhibit prostaglandin synthesis in the central nervous system. They also inhibit hypothalamic heat-regulating center, which in turn promotes the return of the set-point temperature to normal.

Acetaminophen (Tylenol, Feverall, Acephen, Mapap)

Acetaminophen (paracetamol) reduces fever by acting directly on hypothalamic heat-regulating centers, which increases dissipation of body heat via vasodilation and sweating. It is used in dengue infections to relieve pain and lower temperature when fever is thought to contribute to patient discomfort.

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Volume Expanders

Class Summary

Plasma volume expanders are used in the treatment of intravascular volume deficits or shock to restore intravascular volume, blood pressure, and tissue perfusion.

Dextran 40 (LMD)

Dextran 40 is a polymer of glucose. When infused, it increases intravascular volume, blood pressure, and capillary perfusion. It is used to restore intravascular volume when isotonic crystalloid administration is inadequate for that purpose.

Albumin (Albuminar-5, Buminate, Plasbumin 5)

Human albumin is a sterile solution of albumin, which is the major plasma protein responsible for the colloid oncotic pressure of blood. It is pooled from blood, serum, plasma, or placenta from healthy donors. Infusion of albumin results in a shift of fluid from the extracellular space into the bloodstream, thereby decreasing hemoconcentration and blood viscosity.

Albumin may be administered wide open when treating shock. Patient response must be assessed before repeating the dose.

Hetastarch (Hespan, Hextend)

Hydroxyethyl starch is a sterile solution of the starch responsible for the colloid oncotic pressure of blood. Hetastarch produces volume expansion through its highly colloidal starch structure.

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Vaccines, Live, Viral

Class Summary

Elicits dengue-specific immune responses against the 4 dengue virus serotypes (ie, serotypes 1, 2, 3, and 4).

Dengue vaccine (Dengvaxia)

Indicated for prevention of dengue disease caused by dengue virus serotypes 1, 2, 3, and 4 in individuals aged 9-16 years with laboratory-confirmed previous dengue infection who live in endemic areas. It is approved only in individuals previously infected by any dengue virus serotype or in whom this information is unknown. Persons not previously infected are at an increased risk of severe dengue disease when vaccinated and subsequently infected with dengue virus. Immunization is a series of 3 SC injections administered 6 months apart.

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