Patient’s Guide to Monkeypox Treatment with TPOXX

What You Need to Know
  • There are no treatments specifically for monkeypox. But because the viruses that cause monkeypox and smallpox are similar, antiviral drugs developed to protect against smallpox may be used to treat monkeypox effectively.
  • The antiviral drug tecovirimat (TPOXX) has been approved by the Food and Drug Administration (FDA) to treat smallpox in adults and children. Drugs developed to treat smallpox may be used to treat monkeypox.
  • If you are prescribed TPOXX, you will be asked to sign a consent form stating you understand TPOXX is an investigational drug that has not yet been approved by the FDA for treatment of monkeypox. Investigational means there is not currently enough data available from testing in people on the safety and effectiveness of TPOXX for treating people with monkeypox.
  • Research is currently happening to test the safety and effectiveness for all people with monkeypox.
  • TPOXX is currently only for people with severe monkeypox disease or who are at high risk of severe disease, like people with weakened immune systems or skin conditions, such as HIV that is not virally suppressed and eczema.
  • TPOXX may help prevent or minimize severe monkeypox disease involving the eyes, mouth, throat, genitals, and anus (butthole). It may provide relief for short-term symptoms such as pain, swelling, and abscesses and long-term effects such as scarring.
  • If you have monkeypox symptoms, visit a healthcare provider.

About TPOXX

Graphic of two bottles of TPOXX, one is open and spilling pills
  • TPOXX is for people with severe disease or those at high risk of developing severe disease.
  • TPOXX can reduce the amount of the virus in the body. TPOXX is considered investigational for the treatment of monkeypox because sufficient data are not yet available on the safety and effectiveness of TPOXX in treating people with monkeypox.
  • Research focused on safety in healthy people without monkeypox virus infection showed the drug was safe.
  • There are current studies looking at TPOXX as a treatment for monkeypox in people. Additionally, previous studies including a variety of animal species show TPOXX can be an effective treatment for orthopoxviruses (such as monkeypox) in animals.
  • Drugs that are effective in animal studies are not always effective in humans. Conducting studies to assess TPOXX’s safety and efficacy in humans with monkeypox infections is essential.

The FDA has not yet approved TPOXX for treatment against monkeypox. Under the expanded access investigational new drug (EA-IND) protocol, CDC, in partnership with FDA, has made TPOXX easier for healthcare providers to prescribe to people with monkeypox who have or who are at high risk of severe disease.

TPOXX is not right for everyone

  • Healthcare providers should not prescribe TPOXX to people with milder monkeypox symptoms.
  • When TPOXX is prescribed too often to people with milder monkeypox symptoms, it may increase the chance that the monkeypox virus develops resistance to the medication. This means the drug might no longer work for monkeypox.
  • The CDC and FDA are taking steps to reduce the possibility of resistance from happening by recommending that TPOXX only be prescribed to those who need it the most at this time.
  • Treatment for monkeypox should also include efforts to manage your symptoms. Medicines like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can help you feel better.

How to know if it is right for you

Most people with monkeypox recover fully within 2 to 4 weeks without the need for medical treatment. Learn more about taking care of yourself.

Graphic of a patient talking with health care worker

A healthcare provider may prescribe TPOXX for the following people:

  • With severe monkeypox disease such as:
    • bleeding or infected lesions/rash
    • lesions that have merged into larger lesions
    • any other conditions that require hospitalization
  • With immunocompromised conditions (such as HIV that is not virally suppressed, leukemia, lymphoma, persons undergoing chemotherapy, organ transplantation, or autoimmune diseases)
  • With rash or lesions in areas such as the eyes, mouth, throat, genitals, and anus (butthole) that are at risk for severe disease in both the short-term (pain, swelling, abscesses etc.) and the long-term (scarring, etc.)
  • With an active disease or condition that affects the skin (such as atopic dermatitis, eczema, psoriasis, impetigo, severe acne, herpes, or burns)
  • Who are children, particularly those under 8 years old
  • Who are pregnant or breastfeeding

If you are prescribed TPOXX, you will be asked to sign a consent form stating you understand TPOXX is an investigational drug that has not yet been approved by the FDA for treatment of monkeypox.

Based on community feedback and the need to understand TPOXX for treating monkeypox in people with severe and mild disease, the National Institutes of Health, in association with the AIDS Clinical Trials Group, will be conducting a research study to understand its effectiveness.

More details: For more information, visit the STOMP Page, a clinical study of tecovirimat for monkeypox.

How to pay for TPOXX

  • TPOXX is currently free.

Contact a healthcare provider

  • To find out if TPOXX is right for you.
  • If you have monkeypox symptoms.
  • If your monkeypox symptoms get worse.