Antiviral Medications for Infectious Disease
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| 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
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| 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
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| Foscarnet (Foscavir) | CMV; acyclovir resistant HSV and VZV; IV administration only | Nephrotoxicity; Electrolyte imbalances | Use caution in patients with renal unsufficiencies
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| 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)
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| 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
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| Cidofovir (Vistide) | CMV; HSV; Adenovirus; Papillomavirus; Poxvirus Parental administration | Nephrotoxicity; | Use caution in patients with renal insufficiency
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| 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)
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| 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
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| 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
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| 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)
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| Ribavarin | Hepatitis B and C | Hemolytic anemia; depression; fatigue; rash; cough; insomnia; nausea | Contraindicated in: anemia, renal failure, severe heart disease, pregnancy
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| Lamivudine | HIV (main use); Hepatitis B | No significant side effects | NRTI; Dose should be adjusted for renal insufficiency
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| 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
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