L-7 Anti Viral

MIND NURTURE KRISHNA Page 1 of 4
ANTI-VIRAL DRUGS
These are drugs active against human immunodeficiency virus (HIV) which is a retrovirus. They are useful in
prolonging and improving the quality of life and postponing complications of acquired immunodeficiency
syndrome (AIDS) or AIDS-related complex (ARC), but do not cure the infection.
➢ Classification
➢ Dose
• Zidovudine (AZT)- Adults 300 mg BD; Children 180 mg/m2 (max 200 mg) 8 hourly.
• Didanosine (ddI)- Dose: 400 mg/day (for > 60 kg BW), 250 mg/day (< 50 kg BW) 1 hour before or 2 hour
after meals.
• Stavudine (d4T)- 30 mg BD
• Lamivudine (3TC)- Dose: For chronic hepatitis B—100 mg OD. For HIV infection— 150 mg BD, or 300 mg OD.
• Abacavir (ABC)- Dose: 300 mg BD or 600 mg OD.
• Emtricitabine (FTC)- Dose: 200 mg OD, as FDC tablets.
• Nevirapine (NVP)- Dose: Initially 200 mg/day, to be increased after 2 weeks to 200 mg twice daily (because
autoinduction reduces levels).
• Efavirenz (EFV)- Dose: 600 mg OD on empty stomach.
• Etravirine- Dose: 200 mg BD after meals.
• Atazanavir (ATV)- Dose: 300 mg OD with ritonavir 100 mg taken at meal time
• Dose: 800 mg TDS (BD if taken with 100 mg RTV).
• Nelfinavir (NFV)- Dose: 750 mg TDS;
• Raltegravir-Dose: 400 mg BD
• Dolutegravir- Dose: 50 mg once daily; 50 mg twice daily with enzyme inducers, or if integrase-resistance is
suspected.
➢ Indications
• Herpes virus
• HIV
• Influenza virus
• HCV
• HBV
• Cytomegalovirus (CMV)
• Retinitis
➢ Contraindication
• Hypersensitivity
• Renal impairment
• Pregnancy
• Lactation
• Severe CNS disorder
❖ Non-retroviral drugs
➢ Dose
• Idoxuridine-Dose: 0.1% eye drops to be instilled hourly, then 2 hourly and 4 hourly; apply 0.1% eye
ointment at night
• Acyclovir-
i) Genital Herpes simplex-5% ointment is applied locally 6 times a day for 10 days. For severe cases
-2 g/day in 5 divided doses or 800 mg TDS for 10 days
ii) Mucocutaneous H. simplex-15 mg/kg/day for 7 days
iii) H. simplex encephalitis-10 to 20 mg/kg/8 hr i.v. for >10 days
iv) Herpes zoster: 10 mg/kg/8 hr i.v. for 7 days. Oral therapy with 800 mg 5 times daily is beneficial
only if started early.
v) Chickenpox-15 mg/kg/day i.v. × 7 days
• Valacyclovir- Dose: For genital herpes simplex—first episode 1.0 g BD ×10 days; recurrent episode 1.0 g
BD × 3–5 days; suppressive treatment 0.5 g OD × 6–12 months (max 5 years). For orolabial herpes 2 g BD
× 1 day; in immunocompromised patient 1 g BD × 5 days. For herpes zoster 1 g TDS × 7 days.
• Famciclovir-Dose: Genital herpes (1st episode) 250 mg TDS × 5 days; recurrent cases 250 mg BD for up
to 1 year. Herpes zoster and orolabial herpes 500 mg TDS for 7–10 days.
• Valganciclovir-Dose: 900 mg OD, BD.
• Amantadine-Dose: prophylactic 100 mg OD, therapeutic 100 mg BD for 5 days.
• Rimantadine-Dose: prophylactic 100 mg OD, therapeutic 100 mg BD.
• Oseltamivir- Dose: therapeutic 75 mg oral BD for 5 days; prophylactic 75 mg OD.
• Zanamivir-Dose: 10 mg through breath actuated inhaler or rotacaps, BD × 5 days for treatment, and OD
for prophylaxis
• Entecavir-Dose: 0.5 mg OD; for lamivudine resistant cases 1.0 mg OD.
• Adefovir dipivoxil-Dose: 10 mg/day;
• Telbivudine-Dose: 600 mg OD;
• Ribavirin-Dose: 200 mg QID; 400 mg TDS for body weight > 75 kg (children 15 mg/kg/day).
• Sofosbuvir-Dose: 400 mg daily with meals.
• Simeprevir-Dose: 150 mg/day
➢ Indication and contraindication same as above
ANTI-AMOEBIC AGENTS
These are drugs useful in infection caused by the anaerobic protozoa Entamoeba histolytica.
❖ Classification
➢ Dose and Indication

1. Metronidazole
• It is the prototype nitroimidazole
• Contraindications- Metronidazole is contraindicated in neurological disease, blood dyscrasias, first
trimester of pregnancy
Uses and dose
i) Amoebiasis-For invasive dysentery and liver abscess—800 mg TDS (children 30–50 mg/kg/day) for
7–10 days
ii) Giardiasis- 400 mg TDS for 7 days
iii) Trichomonas vaginitis-400 mg BD–TDS may be used for 7 days.
iv) Anaerobic bacterial infections-For serious cases i.v. administration is recommended: 15 mg/kg
infused over 1 hr followed by 7.5 mg/kg every 6 hrs till oral therapy can be instituted with 400–800
mg TDS.
v) Pseudomembranous enterocolitis-Oral metronidazole 400–800 mg BD–TDS for 10–14 days
vi) Acute necrotizing ulcerative gingivitis (ANUG)- Metronidazole 200–400 mg TDS (15–30 mg/kg/day) is
often combined with amoxicillin, tetracycline or erythromycin.
vii) Helicobacter pylori gastritis/peptic ulcer- Metronidazole 400 mg TDS or tinidazole 500 mg BD are
combined with amoxicillin/clarithromycin and a proton pump inhibitor
2. Tinidazole
• Intestinal amoebiasis: 2 g OD oral for 3–6 days (children 30–50 mg/kg/day), or 0.6 g BD for 5–10
days.
• Amoebic liver abscess: The 2 g oral daily dose may be continued for 3–6 days
• Trichomoniasis and giardiasis: 2 g single oral dose or 0.6 g OD for 7 days.
• Anaerobic bacterial infections:- 2 g followed by 0.5 g BD oral for 5 days. In severe cases, i.v.
tinidazole may be used as described above.
• H. pylori: 500 mg BD oral for 1–2 weeks.
3. Secnidazole- Dose: 2 g single dose (children 30 mg/kg) for mild intestinal amoebiasis, giardiasis,
trichomonas vaginitis and nonspecific bacterial vaginosis. For acute amoebic dysentery 0.5 g TDS for 5
days is recommended.
4. Ornidazole-Dose and duration of regimens for amoebiasis, giardiasis, trichomoniasis, anaerobic infections
and bacterial vaginosis
5. resemble those for tinidazole
6. Satranidazole-Dose: Amoebiasis 300 mg BD for 3–5 days, giardiasis and trichomoniasis 600 mg single
dose.
7. Dehydroemetine- Dose: 60–100 mg s.c./i.m.OD for not more than 10 days.
8. Chloroquine- Dose for amoebic liver abscess: 600 mg (base) for two days followed by 300 mg daily for 2–3
weeks.
9. Diloxanide furoate-Dose: 500 mg TDS for 5–10 days; children 20 mg/kg/day.
10. Nitazoxanide-Dose: 500 mg (children 7.5 mg/kg) BD × 3 days
11. Quniodochlor (Iodochlorohydroxyquin, Clioquinol): 250–500 mg TDS; (not to exceed 1.5 g/day for 14
days).
12. Diiodohydroxyquin (Iodoquinol): 650 mg TDS; (not to exceed 2.0 g/day for 14 days).
13. Paromomycin-Dose: Oral: 500 mg (children 10 mg/kg) TDS, for 7 days for
amoebiasis/giardiasis/cryptosporidiosis.
➢ Contraindication
• Hypersensitivity
• First trimester of pregnancy
• Lactation
• Avoid alcohol
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MIND NURTURE KRISHNA Page 1 of 4

➢ Dose and Indication

Note : Mind nurture App is available at play store now.

*For any query contact at - 8176841533

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