Antivirals Chart 2024 PDF

**OTHER ANTIVIRAL AGENTS** +-----------------+-----------------+-----------------+-----------------+ | Brand/Generic/ | Key P'col | BBW/Warnings/Pr | Side | | Route | | ecautions | Effects/Drug | | | |...

**OTHER ANTIVIRAL AGENTS** +-----------------+-----------------+-----------------+-----------------+ | Brand/Generic/ | Key P'col | BBW/Warnings/Pr | Side | | Route | | ecautions | Effects/Drug | | | | | Inx | | | | | Unique/Consider | | | | | ations | +=================+=================+=================+=================+ | **Anti-Influenz | | | | | a | | | | | Agents** | | | | +-----------------+-----------------+-----------------+-----------------+ | **Inhibitors of | | | | | Viral | | | | | Uncoating** | | | | +-----------------+-----------------+-----------------+-----------------+ | MOA: Inhibit | | | | | influenza A | | | | | uncoating by | | | | | blocking M2, a | | | | | proton channel | | | | | that acidifies | | | | | the interior of | | | | | the virus | | | | | (necessary for | | | | | dissociation of | | | | | the viral | | | | | matrix protein | | | | | from the | | | | | viralribonucleo | | | | | protein) | | | | +-----------------+-----------------+-----------------+-----------------+ | Rimantadine | Hepatic | **BBW:** | **Common:** | | (Flumadine^®^) | metabolism -- | **None** | Nausea; | | | adjust dose in | | Vomiting; | | PO | severe | **CI:** None | Anorexia; | | | | | Xerostomia; | | Amantadine | Renal excretion | Influenza A | Impaired | | (Symmetrel^®^) | -- adjust dose | only -- | concentration; | | | in severe | prophylaxis or | Dizziness; | | PO | | treatment | Insomnia | | | Reduce dose in | | | | | elderly | Begin taking | **Serious:** | | | | within 48 | Seizures; | | | Drug resistance | hours; Take | Hallucinations | | | common | with food | | | | | | **Drug Inx:** | | | | Neurologic | Live influenza | | | | effects more | vaccine | | | | with Amantidine | | | | | and greater | | | | | dose adjustment | | | | | in CrCl | | +-----------------+-----------------+-----------------+-----------------+ | **Inhibitors of | | | | | Viral Release** | | | | +-----------------+-----------------+-----------------+-----------------+ | MOA: Inhibits | | | | | influenza virus | | | | | neuraminidase, | | | | | causing | | | | | newly-synthesiz | | | | | ed | | | | | virions to | | | | | remain attached | | | | | to host cell | | | | +-----------------+-----------------+-----------------+-----------------+ | Oseltamivir | Oseltamivir | **BBW:** | **Common:** | | (Tamiflu^®^) | phosphate | **None** | Nausea; | | | prodrug -- | | Vomiting; | | PO | hepatic | **CI:** None | Abdominal pain | | | activation via | | | | | ester | Influenza A&B | **Serious:** | | | hydrolysis | -- prophylaxis | Rash | | | | and treatment | (SJS/TENS); | | | Renal: adjust | | Neuropsychiatri | | | dose | Begin taking | c | | | | within 48 | events | | | Recommended by | hours; Take | | | | CDC | with food | **Drug Inx:** | | | | | Live influenza | | | | | vaccine | +-----------------+-----------------+-----------------+-----------------+ | Zanamivir | Bioavailability | **BBW:** | **Common:** | | (Relenza^®^) | 4-17% | **None** | Cough; Nasal | | | | | stuffiness; | | Inhalation | Renal | **CI:** None | Pain in throat | | | elimination | | | | | | Influenza A&B | **Serious:** | | | Administer via | -- prophylaxis | Bronchospasm; | | | diskhaler | and treatment | Neuropsychiatri | | | device | | c | | | | | events | | | | | | | | | | **Drug Inx:** | | | | | Live influenza | | | | | vaccine | +-----------------+-----------------+-----------------+-----------------+ | Peramivir | 600 mg single | | **Common:** | | (Rapivab^®^) | dose | | Hyperglycemia; | | | | | increased BP | | | Adjust if CrCl | | | | | \< 50 mL/min | | **Serious:** | | | | | Neuropsychiatri | | | | | c | | | | | events; | | | | | SJS/TEN; | | | | | anaphylaxis | | | | | | | | | | **Drug Inx:** | | | | | Live influenza | | | | | vaccine | +-----------------+-----------------+-----------------+-----------------+ | **Endonuclease | | | | | Inhibitor** | | | | +-----------------+-----------------+-----------------+-----------------+ | MOA: Baloxavir | | | | | marboxil is a | | | | | prodrug that is | | | | | converted by | | | | | hydrolysis to | | | | | baloxavir, | | | | | which inhibits | | | | | the | | | | | endonuclease | | | | | activity of the | | | | | polymerase | | | | | acidic (PA) | | | | | protein, an | | | | | influenza | | | | | virus-specific | | | | | enzyme in the | | | | | viral RNA | | | | | polymerase | | | | | complex | | | | | required for | | | | | viral gene | | | | | transcription, | | | | | resulting in | | | | | inhibition of | | | | | influenza A and | | | | | B viral | | | | | replication | | | | +-----------------+-----------------+-----------------+-----------------+ | Baloxavir | Single oral | **BBW:** | **Common:** | | (Xofluza^®^) | dose (80 hour | **None** | Nausea; | | | half-life) | | Headache; | | PO | | **CI:** None | **Skin | | | Avoid divalent | | reactions** | | | cations | | | | | | | **Serious:** | | | Renal: None | | Secondary | | | | | bacterial | | | | | infection may | | | | | occur | | | | | | | | | | **Drug Inx:** | | | | | Divalent | | | | | cations | +-----------------+-----------------+-----------------+-----------------+ | **Agents for | | | | | Human papilloma | | | | | virus (HPV)** | | | | +-----------------+-----------------+-----------------+-----------------+ | *Immune | | | | | modulating* | | | | +-----------------+-----------------+-----------------+-----------------+ | MOA: Interacts | | | | | with Toll-like | | | | | receptor 7 to | | | | | boost innate | | | | | immunity, | | | | | including | | | | | interferon | | | | | secretion | | | | +-----------------+-----------------+-----------------+-----------------+ | Imiquimod | Uses: | **BBW: None** | **Common:** | | (Aldera^®^, | | | Site reactions; | | Zyclara^®^) | Condyloma | | Edematous skin; | | | acuminatum | | Erythema; | | Topical | (anogenital | | Pruruitis; | | | warts) | | Peeling skin; | | | | | Burning | | | Actinic | | sensation; | | | Keratosis / | | | | | Basal cell | | **Severe:** | | | carcinoma | | Phototoxicity; | | | | | Vulvular | | | | | swelling; | | | | | Ulceration; | | | | | Flu-like | | | | | symptoms | +-----------------+-----------------+-----------------+-----------------+ +-----------------+-----------------+-----------------+-----------------+ | Brand/Generic/ | Key P'col | BBW/Warnings/Pr | Side | | Route | | ecautions | Effects/Drug | | | | | Inx | | | | | Unique/Consider | | | | | ations | +=================+=================+=================+=================+ | **Agents for | | | | | Herpes Simplex | | | | | Virus (HSV) and | | | | | Varicella-Zoste | | | | | r | | | | | Virus (VZV)** | | | | +-----------------+-----------------+-----------------+-----------------+ | Fusion | | | | | inhibitor | | | | +-----------------+-----------------+-----------------+-----------------+ | MOA: Inhibits | | | | | fusion between | | | | | the plasma | | | | | membrane and | | | | | the HSV | | | | | membrane -- | | | | | prevents viral | | | | | entry into cell | | | | | and resultant | | | | | replication | | | | +-----------------+-----------------+-----------------+-----------------+ | Docosanol | Herpetic | **BBW: None** | **Common:** | | (Abreva^®^) | lesions on lips | | Rash; Skin | | | and face only | 10% cream -- | irritation | | | | OTC for Herpes | | | | Shortens | labialis | | | | duration of | | | | | symptoms | | | +-----------------+-----------------+-----------------+-----------------+ | **Nucleoside | | | | | and Nucleotide | | | | | Analogues** | | | | +-----------------+-----------------+-----------------+-----------------+ | MOA: | | | | | Phosphorylation | | | | | of prodrug by | | | | | viral kinases | | | | | leads to | | | | | inhibition of | | | | | DNA polymerase | | | | | and resultant | | | | | inhibition of | | | | | synthesis in | | | | | virus-infected | | | | | cells. | | | | +-----------------+-----------------+-----------------+-----------------+ | Acyclovir | poorly absorbed | **BBW:** | **Common:** | | (Zovirax^®^) | (dose-related) | **None** | Rash; N/V; Abd. | | | | | pain; Headache; | | PO/IV/Topical | Renal: adjust | **CI:** None | Fatigue; | | | dose | | BUN/Scr | | | | | (transient); | | | HSV / VZV / | | Phelbitis (IV | | | Viral | | only) | | | Encephalitis | | | | | | | **Serious:** | | | Dose based upon | | CNS | | | **[ideal body | | (encephalopathy | | | weight]{.underl | | , | | | ine}** | | confusion, | | | | | delirium, | | | Stable in | | seizures); | | | normal saline | | Crystalluria; | | | (not D5W) | | Renal failure; | | | | | Thrombotic | | | | | thrombocytopeni | | | | | c | | | | | purpura; | | | | | Hemolytic | | | | | uremic | | | | | syndrome; | | | | | SJS/TENS | | | | | | | | | | Maintain | | | | | adequate | | | | | hydration | +-----------------+-----------------+-----------------+-----------------+ | Valacyclovir | prodrug of | **BBW:** | **Common:** | | (Valtrex^®^) | acyclovir -- | **None** | Rash; N/V; Abd. | | | via GI | | pain; Headache; | | PO | esterases | **CI:** None | Fatigue | | | | | | | | Better | | **Serious:** | | | bioavailability | | Thrombotic | | | | | thrombocytopeni | | | Renal: adjust | | c | | | dose | | purpura; | | | | | Crystalluria; | | | HSV / VZV | | Hemolytic | | | | | uremic | | | | | syndrome; | | | | | Seizures; CNS | | | | | (encephalopathy | | | | | , | | | | | confusion, | | | | | delirium) | | | | | | | | | | Maintain | | | | | adequate | | | | | hydration | +-----------------+-----------------+-----------------+-----------------+ | Famciclovir | Prodrug of | **BBW:** | **Common:** | | (Famvir^®^) | penciclovir | **None** | Headache; N/V/D | | | | | | | PO | Renal | **CI:** None | **Serious:** | | | (penciclovir): | | Erythema | | | adjust dose | | multiforme; | | | | | SJS; | | | Activity | | | | | persists | | Nephrotoxicity | | | without | | (esp. if | | | extracellular | | increased dose) | | | drug | | | | | | | Maintain | | | HSV / VZV | | adequate | | | | | hydration | +-----------------+-----------------+-----------------+-----------------+ | Penciclovir | Herpetic | | **Common:** | | (Denavir^®^) | lesions on lips | | Local | | | and face only | | irritation; | | Topical cream | | | Headache | | | Shortens | | | | | duration of | | **Serious:** | | | symptoms | | None | | | | | | | | Avoid eyes and | | | | | mucous | | | | | membranes | | | +-----------------+-----------------+-----------------+-----------------+ | Trifluridine | Keratoconjuctiv | MOA: | **Common:** | | (Viroptic^®^) | itis, | Incorporated | Burning; Edema | | | acute (HSV) | into viral DNA | | | | Ophthalmic | in place of | **Serious:** | | | solution -- | thymidine | None | | | refrigerated | resulting in | | | | | faulty DNA | | +-----------------+-----------------+-----------------+-----------------+ | Idoxuridine | Keratoconjuctiv | | **Common:** | | (Herplex^®^) | itis, | | Photophobia; | | | acute (HSV) | | Local | | | | | irritation | | | Ophthalmic | | | | | solution -- | | **Serious:** | | | [not currently | | None | | | avail.]{.underl | | | | | ine} | | | +-----------------+-----------------+-----------------+-----------------+ | Vidarabine | Keratoconjuctiv | | **Common:** | | | itis, | | Photophobia; | | (Vira-A^®^) | acute (HSV) | | Local | | | | | irritation | | | Topical | | | | | ointment -- | | **Serious:** | | | [not currently | | None | | | avail.]{.underl | | | | | ine} | | | +-----------------+-----------------+-----------------+-----------------+ +-----------------+-----------------+-----------------+-----------------+ | Brand/Generic/ | Key P'col | BBW/Warnings/Pr | Side | | Route | | ecautions | Effects/Drug | | | | | Inx | | | | | Unique/Consider | | | | | ations | +=================+=================+=================+=================+ | **Agents for | | | | | Cytomegalovirus | | | | | infections** | | | | +-----------------+-----------------+-----------------+-----------------+ | **Nucleoside | | | | | and Nucleotide | | | | | Analogues** | | | | +-----------------+-----------------+-----------------+-----------------+ | MOA: | | | | | Phosphorylation | | | | | of prodrug by | | | | | viral kinases | | | | | inhibits DNA | | | | | polymerase with | | | | | decreased | | | | | synthesis in | | | | | virus-infected | | | | | cells. | | | | | Cidofovir is | | | | | phosphorylated | | | | | by cellular | | | | | enzymes. | | | | +-----------------+-----------------+-----------------+-----------------+ | Ganciclovir | Renal: adjust | **BBW: | **Common:** | | (Cytovene^®^) | dose | Myelosuppressio | Fever; Nausea; | | | | n; | Vomiting; | | PO; IV; | CMV / HSV | Carcinogenic; | Diarrhea; | | Ophthalmic | | Teratogenic; | Anorexia | | | Special | Aspermatogenesi | | | | chemotherapy | s** | **Serious:** | | | handling | | Myelosuppressio | | | | **CI:** None | n; | | | Previously | | Seizures; Scr | | | Ocular implant | **Pregnancy: C, | | | | (Vitrasert®) | but | **Drug Inx:** | | | | teratogenic** | Zidovudine | | | | | (myelosuppressi | | | | | on) | +-----------------+-----------------+-----------------+-----------------+ | Valganciclovir | Prodrug of | **BBW: | **Common:** | | (Valcyte^®^) | ganciclovir via | Myelosuppressio | Fever; Nausea; | | | GI esterases | n; | Vomiting; | | PO | | Carcinogenic; | Diarrhea; | | | Renal: adjust | Teratogenic; | Anorexia | | | dose | Aspermatogenesi | | | | | s** | **Serious:** | | | CMV / HSV / VZV | | Myelosuppressio | | | | **CI:** None | n | | | Take with food | | (less common) | | | | **Pregnancy: C, | | | | Special | but | **Drug Inx:** | | | chemotherapy | teratogenic** | Limited | | | handling | | | +-----------------+-----------------+-----------------+-----------------+ | Cidofovir | Renal: adjust | **BBW: Above + | **Common:** | | (Vistide^®^) | dose | Dose-related | Similar to | | | | Nephropathy; | Ganciclovir; | | IV | CMV retinitis | CI:** Scr\>1.5; | Proteinuria | | | | CrCl\