Antiviral Agents

Acyclovir, valacyclovir, and famiclovir (for HS, HZ) equal in efficacy

Valganciclovir, ganciclovir, and foscarnet (for CMV) equal in efficacy

Valganciclovir is the best long-term therapy for CMV retinitis

SE of valganciclovir and ganciclovir = Neutropenia and bone marrow suppression

Foscarnet = renal toxicity

Telaprevir, boceprevir, simeprevir, sofosbuvir (for chronic Hep C)

used in combination, though sofosbuvir does not need to be combined with interferon

Oseltamivir and zanamivir (neuraminidase inhibitors): Infuenza A and B

Consider in those who:

• are older than 65,
• are pregnant
• have high risk medical conditions such as pulmonary or cardiac disease
• are hospitalized, or involvement of lower respiratory tract

Most effective within 48 hours of onset

Ribavirin:

a nucleoside antimetabolite drug that interferes with duplication of viral genetic material. Its MOA is thought to be multifactorial including:

• lethal hypermutation
• inhibiting RNA polymerase
• inhibiting IMP dehydrogenase (depleting GTP)