Tavneos
Tavneos
Generic Name
Tavneos
Mechanism
- Synthetic VIP peptide → binds VPAC1 and VPAC2 receptors on airway epithelial, endothelial, and immune cells.
- ↑ intracellular cAMP → anti‑inflammatory cascade:
- ↓ pro‑inflammatory cytokines (IL‑6, TNF‑α, IFN‑γ)
- ↓ neutrophil recruitment & activation
- ↑ anti‑inflammatory cytokines (IL‑10).
- Vasodilatory effects → improved pulmonary microcirculation.
- Strengthens endothelial barrier → mitigates pulmonary edema.
Pharmacokinetics
| Parameter | Data (typical) |
| Form & Route | 1 mg aqueous solution, IV infusion |
| Half‑life | ~2–3 h (rapid clearance; 12‑hr dosing interval maintains supra‑therapeutic levels) |
| Clearance | Primarily renal; no major dose adjustment in mild‑moderate CKD |
| Distribution | Small Vd (~0.1 L/kg), reflecting peptide nature |
| Metabolism | Peptide bond hydrolysis by plasma peptidases; no active metabolites |
| Protein Binding | *Note: PK data derived from pivotal Phase III trial and post‑marketing surveillance.*
Indications
- Severe or critical COVID‑19 (Category 3 or 4) requiring:
- High‑flow nasal cannula (HFNC)
- Non‑invasive ventilation (NIV)
- Invasive mechanical ventilation (IMV)
- ECMO
- Use to reduce mortality and shorten ventilator days in appropriately selected patients.
Dosing
| Component | Dose | Frequency | Duration |
| IV infusion | 1 mg in 20 mL 0.9 % NaCl | Every 12 h | 5 days (typically) |
• Infuse over 20 min (start 5 mL/min, taper to 2 mL/min).
• Prepare in a sterile 20 mL bag; use infusion pump or controlled manual drip.
• Monitor for hypotension during infusion; pause or reduce rate if SBP < 90 mmHg.
Adverse Effects
Common (≥ 10 %)
• Hypotension, flushing, headache
• Diarrhea, nausea, abdominal pain
• Pruritus, mild rash
Serious (≤ 1 %)
• Severe hypotension requiring vasopressors
• Anaphylaxis or severe allergic reactions
• Rapid arrhythmias (atrial fibrillation, ventricular tachycardia)
• Pulmonary edema (especially in ventilated patients)
> *Adverse events trend downward with diligent hemodynamic monitoring and prompt dose adjustment.*
Monitoring
- Vital signs: SBP, DBP, HR, SpO₂ every 30 min during first dose, then q4 h.
- Respiratory: Monitor tidal volume, plateau pressure, FiO₂.
- ECG: Baseline and daily (if arrhythmia risk).
- Laboratory: CBC, CMP, renal panel at baseline and q48 h.
- Fluid status: Daily weight, balance; watch for overload.
Clinical Pearls
1. Early Initiation – The greatest survival benefit is seen when Tavneos is started within 48 h of respiratory failure onset.
2. Dose Tailoring – In patients >90 kg or with renal impairment, a 12‑h interval with continuous infusion may be preferable to avoid peak hypotension.
3. Combine with Standard Care – Use Tavneos alongside dexamethasone, remdesivir, and anticoagulation as per contemporary COVID‑19 guidelines.
4. Avoid in Hypotensive Patients – If SBP < 90 mmHg at baseline, consider withholding and re‑evaluate after stabilization.
5. Route Limitation – Due to its peptide nature and rapid degradation, Tavneos is IV only; no oral or inhalational formulations are FDA‑approved.
--
• Tavneos offers a novel anti‑inflammatory and vasodilatory mechanism for critically ill COVID‑19 patients, adding a formative tool to the intensivist’s pharmacologic arsenal.