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A CURRENT REVIEW ON ANTIVIRAL DRUGS

 

Clinical courses

About Authors:
Mayure.Vijay Kumar*1, Mayure.Ashok2, Athiya Mohammadi1,  C.P.Meher1
Department of pharmaceutical chemistry
1Maheshwara College of Pharmacy, Chitkul (V), Isnapur “X” Road, Patancheru, Hyderabad,
2Gokaraju Rangaraju College of pharmacy, Hyderabad.
*mayurevijaykumar@gmail.com

ABSTRACT:
Viruses are the ultimate expression of parasitism:they not only take nutrition fom the host cell but also direct its metabolic machinery to synthesize new virus particle. viral chemotherapy, therefore, is difficult, as it would require interference with cellular metabolism in the host. for the treatment of viral infection numerous drugs are developed yet,also so many drugs are undergoing research for this aspect. The presented review article is deals with the various antiviral drugs having different pharmacological effects along with the adverse effect associated with it.

REFERENCE ID: PHARMATUTOR-ART-1654

INTRODUCTION:
Most viral diseases, with the exception of those caused by Human immunodeficiency virus, are self-limited illnesses that do not require specific antiviral therapy. The currently available antiviral drugs target 3 main groups of viruses: Herpes, Hepatitis and Influenza viruses. With the exception of the antisense molecule fomivirsen, all antiherpes drugs inhibit viral replication by serving as competitive substrates for viral DNA polymerase. Drugs for the treatment of Influenza inhibit the ion channel M2 protein or the enzyme neuraminidase. Combination therapy with interferon-α and Ribavirin remains the backbone treatment for chronic hepatitis C; the addiction of serine protease inhibitors improves the treatment outcome of patients infected with hepatitis C virus genotype with interferon or a combination of nucleoside (t)ide analogues. Notably, almost all the nucleos(t)ide analogues for the treatment of chronic hepatitis B possess anti-human immunodeficiency virus properties, and they inhibit replication of hepatitis B virus by serving as competitive substrates for its DNA polymerase. Some antiviral drugs possess multiple potential clinical applications, such as ribavirin for the treatment of chronic hepatitis C and respiratory syncytial virus and cidofovir for the treatment of cytomegalovirus and other DNA viruses. Drug resistance is an emerging threat to the clinical utility of antiviral drugs. The major mechanisms for drug resistance are mutations in the viral DNA polymerase gene or in genes that encode for the viral kinases required for the activation of certain drugs such as acyclovir and ganciclovir. Widespread antiviral resistance has limited the clinical utility of M2 inhibitors for the prevention and treatment of influenza infections. This article provides an overview of clinically available antiviral drugs for the primary care physician, with a special focus on pharmacology, clinical uses, and adverse effects. Antiviral drugs were invented to prevent viral infections. They are one class of antimicrobial and harmless to human body. Instead of destroying the target pathogen, antiviral drugs inhibit proteins that contribute one or several steps in viral infection. It is difficult to invent new safe and effective antivirals because the harm to host cells must be taken in to consideration and variation of viruses.


Four classes of antivirals:
1) Neuraminidase inhibitors.
2) Protease inhibitors.
3) Neutralizing antibodies.
4) Protein-based fusion inhibitors.

NAME OF THE DRUG


          USES

ADVERSE EFFECTS

REFERENCE

ABACAVIR:

Trade name: Ziagen

IUPAC name: {(1S, 4R)-4-[2-amino-6-(cyclopropylamino)-9H-purin-9-yl] cyclopent-2-en-1-yl} methanol.

Chemical formula: C14H18N6O

Molecular mass: 286.332 g/mol.

Bioavailability: 83%

Plasma half: 1.54±0.63h

Melt. Point: 165oC

Used to treat HIV and AIDS.

It is also used in combination with other antiretroviral agents.

 

 

Fatal hypersensitivity.

Anaphylaxis.

Stevens Johnson syndrome.

Pancreatitis.

Erythema multiforme.

Mallal S,et.al1

ACICLOVIR:

Trade name: Zovirax

IUPAC name: 2-amino-1, 9-dihydro-9-((2-hydroxyethoxy) methyl)-6H-purin-6-one.

Chemical formula: C8H11N5O3

Molecular mass: 225.21 g/mol.

Bioavailability: 10-20% (oral)

Half life: 2.2-20 hours.

Protein binding: 9-33%

Used for the treatment of Herpes Simplex virus infections, Varicella Zoster and Herpes Zoster

Diarrhea.

Headache.

Agitation.

Vertigo.

Oedema.

Arthralgia.

Neutropenia.

Anorexia.

Stevens Johnson syndrome.

Anaphylaxis.

Garrison,et.al2

ACYCLOVIR:

Trade name: Zovirax

IUPAC name: 2-amino-1, 9-dihydro-9-((2-hydroxyethoxy) methyl)-6H-purin-6-one.

Chemical formula: C8H11N5O3

Molecular mass: 225.21 g/mol.

Bioavailability: 10-20% (oral)

Half life: 2.2-20 hours.

Protein binding: 9-33%

Used for

the treatment of Herpes Simplex virus infections ,

Varicella Zoster and Herpes Zoster, Gential Herpes.

Diarrhea.

Headache.

Agitation.

Vertigo.

Oedema.

Arthralgia.

Neutropenia.

Anorexia.

Stevens Johnson syndrome.

Anaphylaxis.

 

Garrison,et.al3

ADEFOVIR:

Trade name: Hepsera.

IUPAC name: {[2-(6-amino-9H-purin-9-yl)ethoxy]methyl} phosphonic acid.

Chemical formula: C8H12N5O4P

Molecular mass: 273.186 g/mol.

Bioavailability: 59%

Half life: 7.5 hours

Hepatitis B.

Herpes simplex virus.

It is failed in treatment of HIV.

 

Marcellin P,et.al4

AMANTADINE:

Trade name: Symmetrel

IUPAC name:

adamantam-1-amine

Chemical formula: C10H17N

Molecular mass: 151.249 g/mol.

Bioavailability: well absorbed

Half life: 10-14 hours.

Protein binding: approx 67%

It is used both as antiviral and antiparkinsonian drug.

It is useful as a building block, allowing the insertion of an adamantly group.

Insomnia.

Agitation.

Anxiety.

Psychiatric symptoms.

Parkinson’s disease.

Stevens Johnson syndrome.

 

Maugh,et.al5

AMPRENAVIR:

Trade name: Agenerase

IUPAC name: (3S)-oxolan-3-yl N-[(2S, 3R)-3-hydroxy-4- [N-(2-methylpropyl) (4-aminobenzene) sulfonamido] -1-phenylbutan-2-yl]carbamate.

Chemical formula: C25H35N3O6S

Molecular mass: 505.628 g/mol.

Half life: 7.1-10.6 hours

Protein binding: 90%

Used to treat HIV Infection.

 

Shen,C.H,et.al6

Rintatolimod:

Trade name: Ampligen

IUPAC name: 5’-Inosinic acid, holopolymer, complex with 5’-cytidylic acid polymer with 5’-uridylic acid (1:1)

It is tested as a treatment for illness including chronic fatigue syndrome and acquired immunodeficiency syndrome.

Malaise.

Leukopenia.

Neutropenia.

Leukocytosis.

George,et.al7

ATAZANAVIR:

Trade name: Reyataz

IUPAC name: methyl N-[(1S)-1-{[(2S, 3S)-3-hydroxy-4-[(2S)-2-[(methoxycarbonyl) amino]-3, 3-dimethyl-N’-{[4-(pyridine-2-yl) phenyl]methyl}butanehydrazido]-1-phenylbutan-2-yl]carbamoyl}-2,2-dimethylpropyl]carbamate.

Chemical formula: C38H52N6O7

Molecular mass: 704.856 g/mol.

Bioavailability: 60-68%

Half life: 6.5 hours.

Protein binding: 86%

It is an antiretroviral drug of the protease inhibitor.

Used to treat HIV infection.

     Increase

in bilirubin levels in Blood.

It causes less interaction with glucose level.

Croom KF,et.al8

ATRIPLA: (Fixed dosage form)

Combination of Emtricitabine Nucleoside transcriptase inhibitor

Tenofovir disproxil fumarate Nucleotide analogue reverse transcriptase inhibitor

Efavirenz Non-nucleoside reverse transcriptase inhibitor.

It is taken to patients with renal and hepatic insufficiency. 

HIV infection.

Not recommended for patients with under 18 years age.

Tiredness.

Dizziness.

GI distress.

Skin discoloration.

Hallucinations.

Sleepness.

Depression.

Bristol-Myers Squibb,et.al9

BOCEPREVIR:

Trade name: Victrelis.

IUPAC name: (1R, 2S, 5S)-N-[(2Ξ)-4-amino-1-cyclobutyl-3, 4-dioxobutan-2-yl)]-3-{(2S)-2-[(tert-butylcarbamoyl) amino]-3, 3-dimethylbutanoyl}-6, 6-dimethyl-3-azabicyclo [3.1.0] hexane-2-carboxamide.

Chemical formula:C27H45N5O5

Used as a treatment for          HepatitisC

Genotype 1.

 

Degertekin B,et.al10

CIDOFOVIR:

Trade name: Vistide

IUPAC name: ({[(S)-1-(4-amino-2-oxo-1, 2-dihydropyrimidin-1-yl)-3-hydroxypropan-2-yl] oxy} methyl) phosphonic acid.

Chemical formula: C8H14N3O6P

Molecular mass: 279.187 g/mol.

Bioavailability: complete

Half life: 2.4-3.2 hours

Protein binding: 6%

Treatment of cytomegalovirus   retinitis in patients with AIDS.

Prevention of viral replication and transcription.

Nephrotoxic.

Probenecid.

 

Becker MN,et.al11

DARUNAVIR:

Trade name: Prezista.

IUPAC name: [(1R, 5S, 6R)-2, 8-dioxabicyclo [3.2.0] oct-6-yl] N-[(2S, 3R)-4-[(4-aminophenyl) sulfonyl-(2-methylpropyl) amino]-3-hydroxy-1-phenyl-butan-2-yl]carbamate.

Chemical formula: C27H37N307S

Molecular mass: 547.665 g/mol.

Bioavailability:

Half life: 15 hours

Protein binding: 95%

It is a protease inhibitor class.

It is an OARAC recommended treatment option for treatment option for treatment of naïve and treatment –experienced adults and adolescents.

 

Rodger

D MacArthura

,et.al12

DIDANOSINE:

Trade name: Videx.

IUPAC name: 9-((2R,5S)-5-(hydroxymethyl)tetrahydrofuran-2-yl)-3H-purin-6(9H)-one.

Chemical formula: C10H12N4O3

Molecular mass: 236.227 g/mol.

Bioavailability: 30-54%

Half life: 1.5 hours

Protein binding: <5%

It is a reverse transcriptase inhibitor, effective against HIV and used in combination with other antiretroviral drug therapy.

Neuropathy.

Pancreatitis.

Retinal changes.

Black box warning.

Optic neuritis.

Abdominal pain.

Diarrhea.

Moyle GJ,et.al13

DOCOSANOL:

Trade name: Behenyl alcohol.

IUPAC name: Docosan-1-ol[1]

Chemical formula: C22H46O

Molecular mass: 326.6 g/mol.

It is used traditionally as an Emollient, emulsifier, and thickner in cosmetics,

Skin irritation.

Headache.

Swelling.

Acne.

Burning.

Redness.

Acute diarrhea.

Soreness.

Liverstrong.com,et.al14

EFAVIRENZ:

Trade name: Sustiva

IUPAC name: (4S)-6-chloro-4-(2-cyclopropylethnyl)-4-(trifluoromethyl)-2,4-dihydro-1H-3,1-benzoxazin-2-one.

Chemical formula: C14H9clF3NO2

Molecular mass: 315.675 g/mol.

Half life: 40-55 hours.

Protein binding: 99.5-99.75%

It is used as part of highly active antiretroviral therapy (HARRT) for the treatment of HIV type 1.

Neurologic, psychiatric effects.

Insomnia.

Nightmares.

Depression.

Psychosis.

Cause birth defects.

False positive results in some urine tests for marijuana.

Hasse,B;et.al15

EMTRICITABINE:

Trade name: Emtriva

IUPAC name: 4-amino-5-fluoro-1-[(2S,5R)-2-(hydroxymethyl)-1,3-oxathiolan-5-yl]-1,2-dihydropyrimidin-2-one

Chemical formula: C8H10FN3O3S

Molecular mass: 247.248 g/mol.

Bioavailability: 93%

Half life: 10 hours

Protein binding: <4%

It is a nucleoside reverse transcriptase inhibitor for the treatment of HIV infection in adults and children.

Diarrhea.

Headache.

Nausea.

Rash.

Hyperpigmentation.

Hepatotoxicity.

Lactic acidosis.

Leaf,et.al16

FAMCICLOVIR:

Trade name: Famvir

IUPAC name: 2-[{acetyloxy)methyl]-4-(2-amino-9H-purin-9-yl)butylacetate

Chemical formula: C14H19N5O4

Molecular mass: 321.332 g/mol.

Bioavailability: 75-77%

Half life: 2-2.3 hours

Protein binding: 20-25%

 

Used in various Herpes virus infections.

Mild to extreme stomach upset, headaches, mild fever.

Luber AD,et.al17

FOSAMPRENAVIR:

Trade name: Lexiva

IUPAC name: {[(2S,3S)-1-[N-(2-methylpropyl)(4-aminobenzene)sulfonamido]-3-({[(3S)-oxolan-3-yloxy]carbonyl}amino)-4-phenylbutan-2-yl]oxy}phosphonic acid.

Chemical formula: C25H36N3O9PS

Molecular mass: 585.608 g/mol.

Bioavailability: Unknown

Half life: 7.7hours

Protein binding: 90%

It is a pro drug of the protease inhibitor and antiretroviral drug amprenavir.

 

Skin rash.

Diabetes.

Increased bleeding in haemophiliacs.

Kidney stones.

Eron J Jr,et.al18

FOSCARNET:

Trade name: Foscavir.

IUPAC name:

Phosphonoformic acid

Chemical formula:  CH3O5P

Molecular mass: 126.005 g/mol.

Bioavailability: NA

Half life: 3.3-6.8 hours

Protein binding: 14-17%

 

Used to treat Herpes viruses, including drug-resistant cytomegalovirus and herpes simplex virus type 1 and 2

Nephrotoxicity.

Gential ulceration.

Electrolyte disturbance.

 

Canestri A,et.al19

GANCICLOVIR:

Trade name: Cytovene

IUPAC name: 2-amino-9-{[(1,3-dihydroxypropan-2-yl)oxy]methyl}-6,9-dihydro-3H-purin-6-one.

Chemical formula: C9H13N5O4

Molecular mass: 255.23 g/mol.

Bioavailability: 5% (oral)

Half life: 2.5-5 hours

Protein binding:

Used to prevent cytomegalovirus infection.

CMV pneumonitis in bone marrow transplant recipients.

Haematological effects.

Granulocytopenia.

Neutropenia.

Anaemia.

Thrombocytopenia.

Dyspepsia.

Phlebitis.

Rossi S,et.al20

IBACITABINE:

IUPAC name: 4-amino-1-[(2R, 4S, 5R)-4-hydroxy-5-(hydroxymethyl) oxolan-2-yl]-5-iodopyrimidin-2-one.

Chemical formula: C9H12IN3O4

Molecular mass: 353.11375 g/mol.

It is used as an antiviral drug.

 

Ann Dermatol Venereol,et.al21

IMUNOVIR: (Inosine pranobex).

IUPAC name: 9-[(2R, 3R, 4S, 5R)-3, 4-dihydroxy-5-(hydroxymethyl) oxolan-2-yl]-3H-purin-6-one: 4-acetamidobenzoic acid: 1-(dimethylamino) propan-2-ol.

Chemical formula: C52H78N10O17

Molecular mass: 1115.23 g/mol.

Act as a powerful immunostimulant.

Treat measles complication subacute sclerosing panencephalitis in conjunction with intrathecalinterferon therapy.

No effects on viral particles itself.

Campoli-Richards DM,et.al22

IDOXURIDINE:

IUPAC name: 1-[(2R, 4S, 5R)-4-hydroxy-5-(hydroxymethyl) oxolan-2-yl]-5-iodo-1, 2, 3, 4-tetrahydropyrimidine-2, 4-dione.

Chemical formula: C9H11IN2O5

Molecular mass:  354.099 g/mol.

It is an anti-herpes virus antiviral drug.

Used topically due to cardiotoxicity.

Used for treatment of herpes simplex keratitis.

Photophobia.

Corneal clouding.

Blurred vision.

Eye irritation.

Seth A,et.al23

IMIQUIMOD:

Trade name: Aldara

IUPAC name: 3-(2-methylpropyl)-3,5,8-triazatricyclo[7.4.0.02,6] trideca-1(9), 2(6),4,7,10,12-hexaen-7-amine.

Chemical formula: C14H16N4

Molecular mass: 240.304 g/mol.

Half life: 30 hours.

 

Acts as an immune response modifier.

Used in skin cancers, Bowen’s disease, squamous cell carcinoma, malignant melanomas, actinic keratosis ,etc.

Headaches.

Back pain.

Muscle aches.

Tiredness.

Flu-.

Swollen lymph nodes.

Diarrhea.

Fungal infections.

Van Egmond S,et.al24

INDINAVIR:

Trade name: Crixivan

IUPAC name: (2S)-1-[(2S,4R)-4-benzyl-2-hydroxy-4-{[(1S,2R)-2-hydroxy-2,3-dihydro-1H-inden-1-yl]carbamoyl}butyl]-N-tert-butyl-4-(pyridine-3-ylmethyl)piperazine-2-carboxamide.

Chemical formula: C36H47N504

Molecular mass: 613.79 g/mol.

Half life: 1.8(±0.4) hours.

Protein binding: 60%

It is a protease inhibitor used as a component of highly active antiretroviral therapy to treat HIV infection and AIDS.

Kidney stones.

Kidney failure.

Hyperlipidemia.

Reduced creatinine clearance.

Atherosclerotic disease.

Shankar SS,et.al25

INOSINE

Trade name:

IUPAC name: 9-[(2R, 3R, 4S, 5R)-3, 4-dihydroxy-5-(hydroxymethyl) oxolan-2-yl]-6, 9-dihydro-3H-purin-6-one.

Chemical formula: C10H12N4O5

Molecular mass: 268.23 g/mol.

It is used in the treatment of a variety of autoimmune diseases including Wegener’s granulomatosis.

Spinal cord injury.

Produces uric acid ingestion.

Peroxynitrite scavenger.

Takeda,et.al26

LAMIVUDINE:

Trade name: Zeffix

IUPAC name: 4-amino-1-[(2R,5S)-2-(hydroxymethyl)-1,3-oxathiolan-5-yl]-1,2-dihydropyrimidin-2-one.

Chemical formula: C8H11N3O3S

Molecular mass: 229.26 g/mol.

Bioavailability: 86%

Half life: 5-7 hours

Protein binding: <36%

It is used in treatment of HIV.

Chronic Hepatitis.

Improves the Seroconversion of e-antigen positive hepatitis B and also improves staging of the liver.

Allergic reactions.

Hives.

Difficult breathing.

Swelling of face, tongue, or throat.

Koziel MJ,et.al27

LOPINAVIR:

Trade name: Kaletra

IUPAC name: (2S)-N-[(2S, 4S, 5S)-5-[2-(2,6-dimethylphenoxy) acetamido]-4-hydroxy-1,6-diphenylhexan-2-yl]-3-methyl-2-(2-oxo-1, 3-diazinan-1-yl) butanamide.

Chemical formula: C37H48N4O5

Molecular mass: 628.810 g/mol.

Bioavailability: Unknown

Half life: 5-6 hours

Protein binding: 98-99%

It is an antiretroviral of the protease inhibitor class.

It is used as a fixed-dose combination with another protease inhibitor

Side effects have only be evaluated in the drug combination Lopinavir/Ritonavir.

Capparelli E,et.al28

MARAVIROC:

Trade name: Selzentry

IUPAC name: 4,4-difluoro-N-{(1S)-3-[3-(3-isopropyl-5-methyl-4H-1,2,4-triazol-4-yl)-8-azabicyclo[3.2.1] oct-8-yl]-1-phenylpropyl}cyclohexanecarboxamide.

Chemical formula: C29H41F2N5O

Molecular mass: 513.666 g/mol.

Bioavailability: 23%

Half life: 16h

It is an antiretroviral drug in the CCRS receptor antagonist class under in the treatment of HIV infection.

It is also appered to reduce graft-versus-host disease in patients treated with allogeneic bone marrow transplantation for leukemia, in phase ½ study.

Allergic reactions.

Hives.

Difficult breathing.

Swelling of face, tongue, or throat.

Abel S,et.al29

MOROXYDINE:

Trade name: moroxidine

IUPAC name:

N-(Diaminomethylidene) morpholine-4-carboximidamide.

Chemical formula: C6H13N5O

Molecular mass: 171.20 g/mol.

It is an antiviral drug used for the treatment of influenza .

It has potential applications against a number of RNA and DNA viruses.

Headache.

Disturbed sleep.

Blurred vision.

Constipation.

Tiredness.

Sheppard, S.et.al30

METHISAZONE:

Trade name: metisazone

IUPAC name: [(1-methyl-2-oxoindol-3-ylidene)amino] thiourea.

Chemical formula: C10H10N4OS

Molecular mass: 234.28 g/mol.

Used to treat smallpox

It is effective for prophylaxis.

11-66% of vomiting is reported.

Weiss MM,

et.al31

NEVIRAPINE:

Trade name: Viramune.

IUPAC name: 11-cyclopropyl-4-methyl-5,11-dihydro-6H-dipyridol[3,2-b:2’,3’-e][1,4]diazepin-6-one

Chemical formula: C15H14N4O

Molecular mass: 266.888 g/mol.

Bioavailability: 93%±9%

Half life: 45h

It is a non nucleoside reverse transcriptase inhibitor used to treat HIV-1 infection and AIDS.

Used as an initial antiretroviral therapy.

Stevens-johnson syndrome.

Toxic epidermal necrolysis.

Hypersensitivity

 

Patel SS,et.al32

CONCLUSION:
Like antibiotics, specific antivirals are used for specific viruses. Antiviral drugs are one class of antimicrobials, a larger group which also includes antibiotics, anti-fungal and anti-parasitic drugs. They are relatively harmless to the host, and therefore can be used to treat infections. The antiviral chemotherapy aims at selective inhibition of viral encoded or virus induced enzyme by an agent that does not specifically affect the enzymes normally involved in similar biochemical process of the host cell.

REFERENCE:
1) Mallal S, Phillips E, Carosi G et.al. (February 2008). “HLA-B* 5701 screening for hypersensitivity to abacavir”.N. Engl. J. Med. 358 (6): 568-79.
2)  garrison, Tom (1999). Oceanography: An Invitation to Marine Science, 3rd ed.. Belmont, CA: Wadsworth Publishing Company. p. 471.
3)  garrison, Tom (1999). Oceanography: An Invitation to Marine Science, 3rd ed.. Belmont, CA: Wadsworth Publishing Company. p. 471.
4)  Marcellin P, Chang TT, Lim SG, et.al. (February 2003). “Adefovir dipivoxil  for the treatment of hepatitis B e antigen- positive chronic hepatitis B”. N. Engl. J. Med. 348 (9): 808-16.
5)  Maugh, T. H. (1976). “Amantadine: an Alternative for Prevention of Influenza”. Science 192 (4235): 130-1.
6)  Shen, C.H.; Wang, Y.F.; Kovalevsky, A. Y.; Harrison, R, W.; Weber,I.T.(2010). “ Amprenavir complexes with HIV-1 protease and its drug-resistant mutants altering hydrophobic clusters”. FEBS Journal 277 (18): 3699-3714.
7)  George, John (Modified: Thursday, December 3, 2009). “FDA reject Hemispherx’s chronic fatigue drug Ampligen”. Philadelphia Business Journal.
8)  Croom KF, Dhillon S, Keam SJ. [1]. Drugs 2009; 69 (8): 1107-1140.
9)  “Medicines You Should Not Take with ATRIPLA”. Bristol-Myers Squibb and Gilead Sciences, LLC. 2008.
10)  Degertekin B, Lok As (may 2008). “Update on viral hepatitis: 2007”. Curr . Opin. Gastroenterol. 24 (3): 306-11.
11)  Becker MN, Obraztsova M, Kern ER, et.al (2008). “Isolation and characterization of cidofovir- resistant vaccinia viruses”. Virol. J. 5: 58.
12)  Rodger D MacArthura, Darunavir: promosing initial results
13)  Moyle GJ. Use of viral resistance patterns to antiretroviral drugs in optimising selection of drug combinations and sequence. Drugs 1996; 52: 168-185.
14)  “Abreva Side Effects”. Liverstrong .com. Retrieved 2010 - 05 - 20.
15)  Hasse, B; Gunthard, HF; Bleiber, G; Krause, M (2005).  “Efavirenz intoxication due to slow Hepatic Metabolism”. Clinical Infections Diseases 40 (3):e22-3.
16)  Leaf, Clifton (September 19, 2005). “The Law of Unintended Consequences”. CNN.
17)  Luber Ad, Flaherty JF (1996). “Famciclovir for the Treatment of Acute Herpes Zoster: Effects on Acute Disease and Postherapetic Neuralgia”. Ann.Intern. Med. 123 (2): 89-96.
18)  Eron J Jr, Yeni P, Gathe J Jr,et.al. (2006). “The KLEAN study of fosamprenavir-ritonavir versus lopinavir-ritonavir, each in combination with abacavir-lamivudine, for initial treatment of HIV infection over 48 weeks: a randomised non-inferiority trial”. Lancet 368 (9534): 476-82.
19)  Canestri A, Ghosn J, Wirden M,et.al (2006). “Foscarnet salvage therapy for patients with late-stage HIV disease and multiple drug resistance”. Antivir. Ther. (Lond). 11 (5): 561-6.
20) Rossi S, editor, Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook: 2006.
21)  “[Contact dermatitis to topical antiviral drug]”. Ann Dermatol Venereol 127 (2): 191-3.
22)  Campoli-Richards DM, Sorkin EM, Heel RC. (nov 1986). “Inosine pranobex. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficiency”. Drugs 32 (5): 383-424.
23)  Seth A, Misra A, Umrigar D(2004). “Topical liposomal gel of idoxuridine for the treatment of herpes simplex: pharmaceutical and clinical implications”. Pharm Dev Techol 9 (3): 277-289.
24)  Van Egmond S, Hoedemaker C, Sinclair R (2006). “Successful treatment of perianal Bowen’s disease with imiquimod”. Int J Dermatol 46 (3): 318-9.
25)  Shankar SS, Dube MP, Gorski JC, Klaunig JE, Steinberg HO, Indinavir impairs endothelial function in healthy HIV-negative men. Am Heart J. 2005 Nov: 150 (5): 933.
26)  Takeda, M.Takii, K.& Matsui, K. (1984). Identification of feeding stimulants for juvenile eel. Bull. Jap. Soc. Scient. Fish., 50: 645-651.
27)  Koziel Mj, Peters MG (2007). “viral hepatitis in HIV infection”. N Engl J Med 356 (14): 1445-54.
28)  Capparelli E, Holland D, Okamoto C, et.al. (2005). “ Lopinavir concentrations in cerebrospinal fluid exceed the 50% inhibitory concentration for HIV”. AIDS (London, England)19 (9).
29)  Abel S, Back DJ, Vourvahis M(2009). “Maraviroc: pharmacokinetics and drug interactions”. Antiviral Therapy 14 (5):607-18.
30)  Sheppard,S.(1994). “Moroxydine: The story of a mislaid antiviral”. Acta dermato-venereologica. Supplementum 183: 1-9.
31)  Weiss MM,Weiss PD, Mathisen G, Guze P (December 2004). “Rethinking smallpox”. Clin. Infect. Dis.39 (11): 1668-73.
32)  Patel SS, Benfield P (Oct 1996). “New drug profile: nevirapine”. Clinical immunotherapeutics  (4): 307-317.

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