Antiviral agent


پروفسور محمد حسین سلطان زاده

استاد دانشگاه علوم پزشکی شهید بهشتی

متخصص کودکان ونوزادان

 History& Background

   The age of modern antiviral therapy began in the early 1950

   When Methisazone was found have activity against vaccinia & variola virus

    In 1959 the 1st anti herpes compound :

     Idoxuridine was synthesized

    In 1962 it was approved for the topical treatment of herpetic keratitis

    In 1964 the 1st description of Vidarabine against HSV

    In 1966 Amantadine was shown against Influenza virus

    in 1968 Amantadine was approved for prophylaxis & treatment of Influenza A 

    In 1972 Vidarabine was approved for the treatment of Herpes Encephalitis

    The year 1972,  1st description of Ribavirin as a broad-spectrum anti viral agent against both DNA & RNA virus

    In 1985 the aerosolized form of the drug was approved for treatment RSV Bronchiolitis

   In 1972 Acyclovir was reported to be a potent & selective inhibitor of both HSV & VZV

   In 1990  : Cidofovir , Zanamivir , Oseltamivir which treat both influenza A & B viruses

Antiviral agents active against RNA viruses

    Influenza viruses : Influenza syndrome

    Para enfluenza viruses : laryngotracheobronchitis , pneumonitis

    RSV : Bronchiolits, Pneumonitis

    Measles viruses : Measles syndrom, Encephalitis, Pneumonitis

Antiviral agents active against RNA viruses

   Enteroviruses: Aseptic meningitis , meningoencephalitis ,Myocarditis , Neonatal disease

   Arenavirus: Lassa fever

   Hepatits C virus : Active & chronic hepatitis

Antivirus agents active against RNA viruses

    Amantadine & Rimantadine:

    Against Influenza  A& Rimantadine 4-10 times more active

    Amantadine Against Rubella virus

    Against Influ.B& Parainfluenza

    Against HCV

    2/2-4/4 mg /kg/dose po bid


Antiviral agents active against RNA viruses

   Zanamivir & Oseltamivir:

    Effective in treating both Inf. A&B

    Both effective for the prophylaxis of inf. A&B in both adults & children

    Oseltamivir 2mg/kg/dose po bid

    Zanamivir 5 mg /dose inhaled bid


    Ribavirin :can be administered topically by aerosol , orally , IV

    Ribavirin aerosol is licensed for the treatment of RSV bronchiolitis & pneumonia in children

     6mg /dose /300 ml inhaled daily

    HVC  600 mg po bid with interferon

   Pleconaril : currently is not licensed for therapeutic use

    Has shown efficacy in early clinical trial against Picornaviruses in adults & children & neonates

     5- 5/7 mg/kg of the oral solution every 8-12 hr for 7 days

Antiviral agents active against DNA viruses







    Variola virus


Antiviral agents active against DNA viruses

    Acyclovir: HSV

    Valacyclovir : HSV

    Famiciclovir : HSV

    Ganciclovir  : CMV

    Valganciclovir : CMV

    Foscarnet : CMV

    Cidofovir : CMV

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