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Anti herpes drug

  1. Acyclovir
    1. Prodrug; requires intracellular phosphorylation     
    2. Resistance develops due to defective phosphorylation
    3. Inhibits viral replication                        
    4. Blocks uncoating          
    5. Short acting (half life 1 hour)                
    6. Not metabolized           
    7. Eliminated unchanged                          
    8. C/I-renal failur

Side effects

  1. Nephrotoxicty (Dose dependent decrease in GFR)          
  2. Hyperkalemia
  3. Neurotoxicty        
  4. Renal stone formation          
  5. Does not cause azoospermia  


  1. DOC-herpes viral infections (Genital herpes, neonatal herpes, herpes encephalitis, herpes zoster)
  2. Offers no protection against herpes neuralgia
  3. No action on CMV viruses  

2. Other antiherpes


Panciclovir, velaciclovir

  1. Prodrugs of acylovir
  2. Used in recurrent herpes 


3. Foscarnet

  1. Most toxic antiviral
  2. Not a prodrug
  3. Does not require phosphorylation
  4. Nephrotoxic, hypokalemia, hyperkalemia, hypomagnesimia, renal stone formation

Anti CMV drugs

  1. Ganciclovir (DOC CMV)
    1. Short acting                  
    2. Prodrug          
    3. Blocks viral replication                  
    4. Bone marrow depression is side effect  
  2. Fomivirsen
    Oligonucleotide , Block uncoating of virus 
  3. Cidofovir
    1. Nephrotoxic drug; eliminated unchanged              
    2. Avoided in renal failure

Anti-influenza drugs

  1. Amantadine/rimantadine
    1. Act by blocking M protein
    2. Short acting, cleared by kidneys
    3. Inhibit viral replication, release of virons
    4. Rimantadine is more potent, longer acting
    5. Food increases their absorption
    6. MAINLY used for prophylaxis; but also useful in treatment  


  1. Ostelmavir/zanamavir
    1. Long acting; neuraminidase inhibitors
    2. Zanamavir is more potent
    3. Food increases their absorption
    4. Ostelmavir (TAMIFLU) is DOC (Swine flu-H1N1/bird flu-avian influenza)
    5. Used MAINLY for treatment 

Treatment of swine flu:

75mg BD for 5 days

Prophylaxis is 75 mg OD as long as epidemic is present.

Safe in pregnancy but approved for individual more than 1year of age.

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