Acyclovir | HSV and VZV infections: 400 mg orally three times daily or 200 mg orally five times daily; 30 mg/kg/day or 10 mg/kg every 8 hours intravenously for 7 days Acute herpes encephalitis: 10 mg/kg intravenously every 8 hours for 14–21 days | HSV, VZV | Neurotoxic reactions, reversible kidney dysfunction, local reactions |
Baloxavir | 40 mg dose if patient is 40 to < 80 kg 80 mg if patient is 80 kg or more Only use for patients 12 years and older | Influenza A and B strains | Diarrhea and bronchitis |
Cidofovir | 5 mg/kg intravenously weekly for 2 weeks, then every other week | CMV | Neutropenia, kidney disease, ocular hypotonia |
Famciclovir | Acute VZV: 500 mg orally three times daily for 7 days Genital or cutaneous HSV-1/HSV-2: 250 mg three times daily for 7–10 days; 125 mg twice daily for 5 days for recurrences (500 mg twice daily for 7 days if HIV-positive) | HSV, VZV | Early angioedema; later rarely, gastrointestinal symptoms, headaches, rashes |
Foscarnet | Induction: 90 mg/kg intravenously (90- to 120-minute infusion) every 12 hours or 60 mg/kg intravenously (minimum 1-hour infusion) every 8 hours over 2–3 weeks depending on clinical response Maintenance: 90–120 mg/kg intravenously (2-hour infusion) once daily | HSV resistant to acyclovir, CMV, VZV, HIV-1 | Nephrotoxicity, genital ulcerations, calcium disturbances |
Ganciclovir | Induction: 5 mg/kg intravenously every 12 hours for 14–21 days Maintenance: 6 mg/kg/day intravenously for 5 days each week | CMV | Neutropenia, thrombocytopenia, CNS side effects |
Idoxuridine | Topical, 0.1% every 1–2 hours for 3–5 days (not available in the United States) | HSV keratitis | Local reactions |
Interferon alfa-2b | HBV infection: 10 million international units subcutaneously three times weekly or 5 million units daily1 Condylomata: 1 million international units intralesionally in up to five warts three times weekly for 3 weeks | HBV, HCV, HPV | Influenza-like syndrome, myelosuppression, neurotoxicity |
Interferon alfa-n3 | Refractory or recurring external condylomata acuminata: 0.05 mL (250,000 international units) per wart intralesionally twice weekly for up to 8 weeks; 0.5 mL (2.5 million international units) is the maximum dose per treatment session | HPV, HCV | Local reactions Influenza-like syndrome, myelosuppression, neurotoxicity |
Oseltamivir | 75 mg orally twice daily for 5 days | Influenza A and B | Dose needs to be adjusted for kidney dysfunction |
Palivizumab | 15 mg/kg intramuscularly every month in RSV season | RSV | Upper respiratory infection symptoms |
Penciclovir | Topical 1% cream every 2 hours for 4 days | HSV | Local reactions |
Peramivir | Intravenous, 600-mg single dose | Uncomplicated influenza A | Nausea, vomiting, diarrhea, neutropenia |
Remdesivir | Intravenous, 200 mg first day followed by 100 mg/day for 4 days for non-ICU patients, 9 more days for ICU patients | Coronavirus-19 (COVID-19) | Transaminitis, fatigue, headaches, nausea |
Ribavirin | RSV infection: one vial (6 g) dissolved and delivered through a Small Particle Aerosol Generator (SPAG-2) over a continuous 12- to 18-hour period daily for 5 consecutive days | RSV, severe influenza A or B, Lassa fever | Wheezing, hemolytic anemia |
Trifluridine | Topical, 1% drops every 2 hours to 9 drops/day | HSV keratitis | Local reactions |
Valacyclovir | Acute VZV: 1 g orally three times daily for 7 days Primary genital HSV-1/HSV-2: 1 g twice daily for 10 days Recurrent genital HSV-1/HSV-2: 500 mg twice daily for 3 days Suppressive therapy: 1 g daily; 500 mg if fewer than 9 recurrences/year (Dose depends on immune status and number of recurrences.) | VZV, HSV | Thrombotic thrombocytopenic purpura or hemolytic-uremic syndrome in AIDS |
Valganciclovir | 900 mg orally twice daily for 3 weeks; 900 mg daily as maintenance | CMV | See ganciclovir |
Zanamivir | 5 mg inhalations twice daily for 5 days | Uncomplicated influenza A and B | Bronchospasm in patients with asthma |