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2-DG

Antiviral and anti-inflammatory drug

Discovered by the Institute of Nuclear Medicine & Allied Sciences of India’s Defence Research and Development Organisation (DRDO), 2-DG has been codeveloped by Dr. Reddy’s Laboratories as an adjunct therapy for Covid-19.

Where can you find 2-DG?

We are committed to making 2-DG available to the maximum number of people in our fight against COVID-19. If you are trying to source 2-DG, please search below. If unable to find a convenient location,
please write to us at 2DG@drreddys.com or call us on 18004250014 (Timing: 8 AM to 6 PM - Monday to Friday)

What is 2-DG?

2-DG or 2-Deoxy-D-Glucose is an antiviral and anti-inflammatory drug codeveloped and manufactured by Dr. Reddy’s Laboratories. We conducted clinical trials for 2-DG in India, in collaboration with DRDO.

2-DG is administered orally at 45mg/kg twice a day before meals.

Based on the results of Phase II and Phase III trials, 2-DG has received Emergency Use Authorisation to be used as an adjunct therapy in moderate to severe COVID-19 patients in a hospital setting.

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Key Highlights

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2-DG has a purity of 99.5%.
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It is available in sachets of 2.34g.
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We are conducting extensive Continuing Medical Education sessions and webinars for doctors to disseminate information on 2-DG.

2-DG has an antiviral effect as it acts on host cells

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  • 2-DG selectively accumulates in virally infected cells because of higher glucose demand
  • 2-DG inhibits the energy production required for viral multiplication
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  • 2-DG alters glycosylation of viral glycoprotein, rendering new virions incapable of infecting human cells
  • It inhibits aerobic glycolysis in the virally infected host cell

How can 2-DG help in the fight against Covid-19?

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Per Phase III studies of 2-DG, preliminary data indicates that:
  • 2-DG led to a higher proportion of subjects improving to the scores of 4 (42% vs 31% ) and 3 (11% Vs 6%) on the WHO Ordinal Scale by Day 3. This is in comparison to standard-of-care treatment alone, indicating early relief from oxygen therapy/dependence.
  • This improvement in oxygen dependence was observed to the same extent in patients aged 65 years or above.
  • Upon discharge, 9% more patients turned RT-PCR negative in the 2-DG arm as compared to those receiving standard-of-care therapy alone.
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According to data, no significant safety issues were reported in both trial phases (176 subjects). No related SAEs to 2-DG were reported in both trials.
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The demonstrated efficacy of 2-DG in providing early relief from oxygen dependence in moderate to severe COVID-19 patients indicates major benefits during this pandemic.
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Doctors and healthcare professionals have one more option to include in their multi-modal treatment regimen for COVID-19 with 2-DG.

For availability related queries for 2DG

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Please report any side effects or adverse events to Dr. Reddy's Laboratories. Call our
Toll-free number: 18004250014 Monday to Friday from 8 AM to 6 PM or email customerservices@drreddys.com.
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Frequently asked questions
What is 2-DG?
Sputpnik
2-DG stands for 2-Deoxy-D-Glucose. Structurally, it is a glucose molecule, which has the 2-hydroxyl group replaced by hydrogen.
How does 2-DG act in COVID-19?
Sputpnik
2-DG exerts antiviral and anti-inflammatory effects. The drug acts by inhibiting viral replication and by inhibiting the release of cytokines from inflammatory cells. The drug has been shown to potently inhibit SARS-CoV-2 replication in an in vitro study.
What is the approved indication of 2-DG? Where will it be available?
Sputpnik
2-DG has been granted Emergency Use Authorisation as an adjunct therapy to standard-of-care treatment of hospitalised patients with moderate to severe Covid-19. It will only be available in hospitals and pharmacies linked to hospitals.
What is the dosage form of 2-DG?
Sputpnik
2-DG is available in sachets containing 2.34g powder for oral use.
What is the dose, route and method of administration for 2-DG?
Sputpnik
2-DG can be administered orally at 45mg/kg per dose twice daily on empty stomach. To prepare one dose, the entire contents of one or two sachets of 2-DG should be completely dissolved in 100ml drinking water. Based on a patient’s body weight, the required quantity of the 2-DG solution should be measured out and administered.
How long can 2-DG be administered
Sputpnik
2-DG should be taken twice daily for 10 consecutive days or until discharge, whichever is earlier.
Can 2-DG be used in an out-patient setting?
Sputpnik
2-DG has been approved for use only in a hospital setting. There is currently no clinical data to support its use in an out-patient setting.
What are the contraindications for 2-DG use?
Sputpnik
Patients with known hypersensitivity to 2-DG or any of its analogs such as fluorodeoxyglucose should not take 2-DG. Other contraindications include pregnancy and lactation.
Can 2-DG be used for the paediatric population?
Sputpnik
The safety and efficacy of 2-DG has not been determined in the paediatric population. 2-DG can only be used in adults aged 18 years or above.
Can 2-DG be given to patients with diabetes mellitus?
Sputpnik
In clinical studies, blood glucose levels had been observed to increase after the administration of 2-DG. Hence, caution should be exercised while giving 2-DG to diabetic patients and anti-diabetic medications may need adjustment. Daily random blood sugar monitoring is recommended as long as the patient receives 2-DG.
Can 2-DG be given to patients with hepatic and renal impairment?
Sputpnik
In Phase III trials for Glioblastoma Multiforme, few patients had altered levels of AST and ALT though not clinically significant. There were no cases with abnormal values in serum creatinine and blood urea levels. It is advisable to exercise caution while administering 2-DG to patients with hepatic or renal impairment.
What are the possible side effects of 2-DG?
Sputpnik
Nausea, vomiting, sweating, dizziness, tiredness, confusion, tremors, tachycardia, hyperglycaemia, abdominal pain, diarrhoea and fatigue have been observed as side effects during clinical studies.
Will 2-DG damage lung cells that are not infected with the virus?
Sputpnik
No, 2-DG preferentially accumulates in virally infected cells. Uninfected normal lung cells will take up very minimal amount of 2-DG, which will not affect cellular function.
Is there any data of effect of 2-DG on inflammatory markers?
Sputpnik
There are several pre-clinical studies in which the anti-inflammatory effect of 2-DG has been validated.
What is the best time to start administering 2-DG?
Sputpnik
Currently, it is permitted for moderate to severe hospitalised COVID-19 patients. So, all such patients are eligible to receive this drug.
Since viral replication is limited in severe disease, how will 2-DG be beneficial in these patients?
Sputpnik
It will benefit because of its anti-inflammatory properties.
If the drug causes hyperglycaemia, will it increase the chances of mucormycosis?
Sputpnik
No clinically significant increase in blood glucose was observed with the doses of 2-DG administered during Phase 2 and Phase 3 clinical studies to COVID-19 patients, as compared to patients who only got standard-of-care treatment. Based on literature, 2-DG has anti-fungal properties as well.
Could you share some information about the clinical studies?
Sputpnik
2-DG has undergone full clinical development, with Phase 2 and Phase 3 studies conducted among hospitalised patients with moderate to severe COVID-19. In Phase 2, various doses of the drug were studied, and 90mg/kg a day was found to be the most effective. In Phase 3, 90mg/kg of 2-DG a day led to faster clinical improvement in patients with moderate to severe COVID-19 when added to standard-of-care treatment, as compared to standard-of-care therapy alone.
Can 2-DG be used instead of Remdesivir?
Sputpnik
No. 2-DG is part of a multimodal treatment regimen, as an adjunct to other standard-of-care medications.
How much does 2-DG cost?
Sputpnik
The maximum retail price of 2-DG manufactured has been fixed at INR 990 per sachet. A subsidised rate has been offered to government institutions. All enquiries can be sent to 2DG@drreddys.com
2-DG in the news
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