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Antivirals

Antiviral Medications for Infectious Disease

Antiviral MedicationUsed for?Side Effects Special Considerations:
Valacyclovir (Valtrex) HSV I and II; VZV; CMV (prevention in organ transplantation) N/V/D; Headache Pro-drug of acyclovir; better bioavailability and dosing options; more expensive than acyclovir
Famcyclovir (Famvir) HSV I and II; EBV, VZV Nausea; Headache; Mild fever Pro-drug of Pencyclovir; Administer with food or milk; well tolerated, but expensive
Foscarnet (Foscavir) CMV; acyclovir resistant HSV and VZV; IV administration only Nephrotoxicity; Electrolyte imbalances Use caution in patients with renal unsufficiencies
Ganciclovir (Cytovene) First line choice for CMV; also effective for HSV I and II and EBV Oral, IV and ocular implant forms available Neutropenia; CNS effects; fever; rash; abnormal LFT's; Possible carcinogen, teratogen and mutagen; may inhibit spermatogenesis Sometimes paired with Foscarnet; Teratogen; not for use in pregnancy Used widely in AIDS patients (ocular implant used to treat Retinitis)
Valganciclovir (Valcyte) CMV Neutropenia; N/V/D; Retinal detachment; CNS symptoms (headache, parathesias, insomnia) Pro-drug of ganciclovir (good bioavailability); should be taken with fatty foods
Cidofovir (Vistide) CMV; HSV; Adenovirus; Papillomavirus; Poxvirus Parental administration Nephrotoxicity; Use caution in patients with renal insufficiency
Oseltamivir (Tamiflu) Influenza PO N/V/D; abdominal pain, Headache Pro-drug; Neuraminidase inhibitor (used for influenza prophylaxis; treatment lasts for 5 days; approved for age 1 and up; sometimes prescribed with Probenecid (reduces renal excretion of active metabolite)
Zanamivir (Relenza) Influenza prophylaxis Parental/Inhalation Bronchospasm (caution for asthmatics) Neuraminidase inhibitor; Poor oral bioavailability; approved for patients 7+ years old; Treatment lasts 5 days; cautious use in asthmatics
Amantadine (Symmetrel) Influenza A; Parkinson's disease CNS effects; anxiety; insomnia Adamantane derivative (proton channel through nuclear envelope) Generally well tolerated; increasing incidence of resistance; some dopaminergic activity, which helps with Parkinsons
Interferon Alfa Hepatitis B and C Many: flu-like symptoms, thrombocytopenia, granulocytopenia, headache, rash, alopecia, anorexia, edema Suppressive (rather than curative) therapy; contraindicated in psychosis, depression, cirrhosis, pregnancy (among others)
Ribavarin Hepatitis B and C Hemolytic anemia; depression; fatigue; rash; cough; insomnia; nausea Contraindicated in: anemia, renal failure, severe heart disease, pregnancy
Lamivudine HIV (main use); Hepatitis B No significant side effects NRTI; Dose should be adjusted for renal insufficiency
Acyclovir (Zovirax) HSV I and II (mainly recurrent infections); Varicella Zoster (VZV); Epstein-Barr Virus (EBV); Cytomegalovirus (CMV) Reduces viral shedding in HSV-II and decreases recovery time PO, IV and Topical forms Nausea; Diarrhea; Headache; Renal and neural toxicity Renal and Neurological toxicities
Created by: kacycee15
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