TABLE 2.
Summary of 90 approved antiviral drugs in 13 drug groupsf
| Drug group | Drug name | Abbreviationc | Brand name(s)d | Approved clinical use(s) | Mechanism(s) of drug action | Approval datee |
|---|---|---|---|---|---|---|
| 5-substituted 2′-deoxyuridine analogues | Idoxuridine | IDU | Dendrid | HSV-1 | Substitutes for thymidine and targets HSV DNA polymerase to inhibit viral DNA synthesis | June 1963 |
| Trifluridine | TFT | Viroptic | HSV | Inhibits HSV DNA replication | Apr. 1980 | |
| Brivudine | BVDU | Zostex (Europe) | HSV-1, VZV | Brivudine triphosphate targets VZV DNA polymerase to inhibit viral DNA synthesis | 2000 | |
| Nucleoside analogues | Vidarabinea | VDR | Vira-A | HSV, VZV | Vidarabine triphosphate competes with dATP to inhibit the activity of viral DNA polymerase | Nov. 1976 |
| Entecavir | ETV | Baraclude | HBV | Inhibits the activity of HBV DNA polymerase | Mar. 2005 | |
| Telbivudine | LdT | Tyzeka | HBV | Inhibits the activity of HBV DNA polymerase | Oct. 2006 | |
| Pyrophosphate analogues | Foscarnet | PFA | Foscavir | HCMV, HSV (acyclovir resistant) | Inhibits the activity of viral DNA polymerase | Sept. 1991 |
| NRTIs | Zidovudine | AZT | Retrovir | HIV | Targets HIV RT and competes with dTTP to inhibit DNA synthesis | Mar. 1987 |
| Didanosine | ddI | Videx | HIV | Targets HIV RT and competes with dATP to inhibit DNA synthesis | Oct. 1991 | |
| Zalcitabinea | ddC | Hivid | HIV | Targets HIV RT and competes with dCTP to inhibit DNA synthesis | June 1992 | |
| Stavudine | d4T | Zerit | HIV | Targets HIV RT and competes with dTTP to inhibit DNA synthesis | June 1994 | |
| Lamivudine | 3TC | Epivir | HIV, HBV | Targets viral polymerase and competes with dCTP to inhibit DNA synthesis | Nov. 1995 | |
| Lamivudine + zidovudine | 3TC+AZT | Combivir | HIV | Twice-daily, fixed-dose, single-tablet drug used to inhibit the activity of HIV RT | Sept. 1997 | |
| Abacavir | ABC | Ziagen | HIV | Targets HIV RT and competes with dGTP to inhibit DNA synthesis | Dec. 1998 | |
| Abacavir + lamivudine + zidovudine | ABC+3TC+AZT | Trizivir | HIV | Twice-daily, fixed-dose, single-tablet drug of abacavir, lamivudine, and zidovudine used to inhibit the activity of HIV RT | Nov. 2000 | |
| Emtricitabine | (−)FTC | Emtriva | HIV | Targets HIV RT and competes with dCTP to inhibit DNA synthesis | July 2003 | |
| NNRTIs | Nevirapine | NVP | Viramune | HIV-1 | Binds directly to HIV RT and inhibits DNA synthesis | June 1996 |
| Delavirdinea | DLV | Rescriptor | HIV-1 | Binds directly to HIV RT and inhibits DNA synthesis | Apr. 1997 | |
| Efavirenz | EFV | Sustiva | HIV-1 | Binds directly to HIV RT and inhibits DNA synthesis | Sept. 1998 | |
| Etravirine | ETR | Intelence | HIV-1 | Binds directly to HIV RT and inhibits DNA synthesis | Jan. 2008 | |
| Rilpivirine | RPV | Edurant | HIV-1 | Binds directly to HIV RT and inhibits DNA synthesis | Aug. 2011 | |
| Protease inhibitors | Saquinavir | SQV | Invirase | HIV | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | Dec. 1995 |
| Ritonavir | RTV | Norvir | HIV | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | Mar. 1996 | |
| Indinavir | IDV | Crixivan | HIV | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | Mar. 1996 | |
| Nelfinavir | NFV | Viracept | HIV | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | Mar. 1997 | |
| Amprenavira | APV | Agenerase | HIV-1 | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | Apr. 1999 | |
| Lopinavir-ritonavir | LPV/r | Kaletra | HIV | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | Sept. 2000 | |
| Atazanavir | ATV | Reyataz | HIV | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | June 2003 | |
| Fosamprenavir | FPV | Lexia | HIV-1 | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | Oct. 2003 | |
| Tipranavir | TPV | Aptivus | HIV-1 | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | June 2005 | |
| Darunavir | DRV | Prezista | HIV | Blocks the active site of HIV protease to prevent cleavage of viral precursor proteins | June 2006 | |
| Darunavir + cobicistat | DRV+COBI | Prezcobix | HIV | HIV protease inhibitors can be combined with cobicistat to inhibit the activity of HIV protease | Jan. 2015 | |
| Atazanavir + cobicistat | ATV+COBI | Evotaz | HIV | Jan. 2015 | ||
| Telaprevira | TVR | Incivek | HCV genotype 1 | HCV protease drugs can inhibit the proteolytic activity of HCV NS3/4A protease; ribavirin and PegIFNα can interfere with HCV replication | May 2011 | |
| Boceprevira | BOC | Victrelis | HCV genotype 1 | May 2011 | ||
| Simeprevir | SMV | Olysio | HCV genotype 1 | Nov. 2013 | ||
| Asunaprevirb | ASV | Sunvepra (Japan) | HCV genotype 1 | July 2014 | ||
| Vaniprevir + ribavirin + PegIFNα-2b | VPV+RBV+PegIF-α2b | Vanihep (Japan) | HCV genotype 1 | Sept. 2014 | ||
| Paritaprevirb | PTV | Viekira Pak | HCV genotype 1 | Dec. 2014 | ||
| Technivie | HCV genotype 4 | July 2015 | ||||
| Grazoprevirb | GZR | Zepatier | HCV genotype 1 or 4 | Jan. 2016 | ||
| Integrase inhibitors | Raltegravir | RAL | Isentress | HIV | Targets HIV integrase to inhibit the integration of viral DNA into human chromosomes | Oct. 2007 |
| Elvitegravir | EVG | Vitekta | HIV | Targets HIV integrase to inhibit the integration of viral DNA into human chromosomes | Aug. 2012 | |
| Dolutegravir | DTG | Tivicay | HIV | Targets HIV integrase to inhibit the integration of viral DNA into human chromosomes | Aug. 2013 | |
| Dolutegravir + abacavir + lamivudine | DTG+ABC+3TC | Triumeq | HIV | Fixed-dose combinations with dolutegravir and NRTIs can target HIV integrase and RT to interrupt viral replication | Aug. 2014 | |
| Dolutegravir + lamivudine | DTG+3TC | Dutrebis | HIV | Feb. 2015 | ||
| Entry inhibitors | RSV-IGIVa | RSV-IGIV | RespiGam | RSV | RSV-neutralizing antibodies may prevent binding of RSV surface glycoproteins F and G | Jan. 1996 |
| Palivizumab | PZ | Synagis | RSV | Monoclonal antibody that targets the antigenic site of RSV glycoprotein F | June 1998 | |
| Docosanol | C22 | Abreva | HSV | May interfere with binding of viral envelope proteins to cell membrane receptors | July 2000 | |
| Enfuvirtide | EFV | Fuzeon | HIV-1 | Blocks HIV GP41 fusion to cell membrane | Mar. 2003 | |
| Maraviroc | MVC | Selzentry | HIV | Blocks GP120-CCR5 interaction to inhibit HIV entry | Aug. 2007 | |
| VZIGa | VZIG | VZIG | VZV | IgG antibodies protect patients from VZV infection | Feb. 1981 | |
| VariZIG | VariZIG | VariZIG | VZV | IgG antibodies protect patients from VZV infection | Dec. 2012 | |
| Acyclic guanosine analogues | Acyclovir | ACV | Zovirax | HSV, VZV | Acyclovir triphosphate competes with dGTP to inhibit viral DNA polymerase activity | Mar. 1982 |
| Ganciclovir | GCV | Zirgan, Vitrasert | HCMV | Ganciclovir triphosphate targets HCMV DNA polymerase to inhibit viral DNA synthesis | June 1989 | |
| Famciclovir | FCV | Famvir | HSV, VZV | Famciclovir triphosphate competes with dGTP to inhibit the activity of viral DNA polymerase | June 1994 | |
| Valacyclovir | VACV | Valtrex | HSV, VZV | Valacyclovir triphosphate competes with dGTP to inhibit the activity of viral DNA polymerase | June 1995 | |
| Penciclovir | PCV | Denavir | HSV | Penciclovir triphosphate targets HSV DNA polymerase to inhibit viral DNA synthesis | Sept. 1996 | |
| Valganciclovir | VGCV | Valcyte | HCMV | Valganciclovir triphosphate competes with dGTP to inhibit the activity of viral DNA polymerase | Mar. 2001 | |
| Acyclic nucleoside phosphonate analogues | Cidofovir | CDV | Vistide | HCMV retinitis (AIDS patients) | Inhibits the activity of HCMV DNA polymerase | June 1996 |
| Tenofovir disoproxil fumarate | TDF | Viread | HIV, HBV | Competes with dATP to inhibit the activity of HIV RT and HBV DNA polymerase | Oct. 2001 | |
| Adefovir dipivoxil | ADV | Hepsera | HBV | Adefovir diphosphate competes with dATP to inhibit the activity of HBV DNA polymerase | Sept. 2002 | |
| Tenofovir disoproxil fumarate + emtricitabine | TDF+(−)FTC | Truvada | HIV | Truvada is a once-daily fixed-dose single tablet containing 2 drugs to inhibit HIV replication | Aug. 2004 | |
| Tenofovir disoproxil fumarate + efavirenz + emtricitabine | TDF+EFV+(−)FTC | Atripla | HIV | Atripla is a once-daily fixed-dose single tablet containing 3 drugs to inhibit HIV replication | July 2006 | |
| Tenofovir disoproxil fumarate + rilpivirine + emtricitabine | TDF+RPV+(−)FTC | Complera, Eviplera | HIV | Complera is a once-daily fixed-dose single tablet containing 3 drugs to inhibit HIV replication | Aug. 2011 | |
| Tenofovir disoproxil fumarate + cobicistat + emtricitabine + elvitegravir | TDF+COBI+(−)FTC+EVG | Stribild | HIV | Stribild is a once-daily fixed-dose single tablet containing 4 drugs to inhibit HIV replication | Aug. 2012 | |
| Tenofovir alafenamide + cobicistat + emtricitabine + elvitegravir | TAF+COBI+(−)FTC+EVG | Genvoya | HIV | Genvoya is a once-daily fixed-dose single tablet containing 4 drugs to inhibit HIV replication | Nov. 2015 | |
| Tenofovir alafenamide + rilpivirine + emtricitabine | TAF+RPV+(−)FTC | Odefsey | HIV | Odefsey is a once-daily fixed-dose single tablet containing 3 drugs to inhibit HIV replication | Mar. 2016 | |
| Tenofovir alafenamide + emtricitabine | TAF+(−)FTC | Descovy | HIV | Descovy is a once-daily fixed-dose single tablet containing 2 drugs to inhibit HIV replication | Apr. 2016 | |
| HCV NS5A and NS5B inhibitors | Sofosbuvir + ribavirin | SOF+RBV | Sovaldi | HCV genotype 2 or 3 | Sofosbuvir binds to Mg2+ ions in NS5B polymerase and inhibits HCV replication; ribavirin and PegIFNα can interfere with HCV replication | Dec. 2013 |
| Sofosbuvir + ribavirin + PegIFNα | SOF+RBV+PegIFNα | Sovaldi | HCV genotype 1 or 4 | Dec. 2013 | ||
| Daclatasvir + asunaprevir | DCV+ASV | Daklinza + Sunvepra (Japan) | HCV genotype 1 | Targets NS5A and NS3/4A protease to prevent HCV replication | July 2014 | |
| Ledipasvir + sofosbuvir | LDV+SOF | Harvoni | HCV genotype 1 | Harvoni inhibits HCV NS5A and NS5B polymerase to prevent RNA replication | Oct. 2014 | |
| Sofosbuvir+ simeprevir | SOF+SMV | Sovaldi + Olysio | HCV genotype 1 | Sofosbuvir and simeprevir target HCV NS5B and NS3/4 protease, respectively | Nov. 2014 | |
| Ombitasvir + dasabuvir + paritaprevir + ritonavir | OBV+DAS+PTV+RTV | Viekira Pak | HCV genotype 1 | Viekira Pak is a multiclass combination drug approved for treatment of HCV genotype 1 infection; inhibits activities of HCV NS5A, NS5B polymerase, and NS3/4A protease | Dec. 2014 | |
| Ombitasvir + paritaprevir + ritonavir | OBV+PTV+RTV | Technivie | HCV genotype 4 | Technivie is used with ribavirin to treat HCV genotype 4 infection; inhibits HCV NS5A and NS3/4A protease | July 2015 | |
| Daclatasvir + sofosbuvir | DCV+SOF | Daklinza + Sovaldi | HCV genotype 3 | Inhibits activities of HCV NS5A and NS5B polymerase | July 2015 | |
| Elbasvir + grazoprevir | EBR+GZR | Zepatier | HCV genotype 1 or 4 | Elbasvir and grazoprevir inhibit activities of NS5A and NS3/4A protease, respectively | Jan. 2016 | |
| Influenza virus inhibitors | Amantadinea | AMT | Symmetrel | Influenza virus A | Targets viral matrix protein 2 to inhibit viral uncoating | Oct. 1966 |
| Ribavirin | RBV | Copegus, Rebetol, Virazole | HCV, RSV, hemorrhagic fever | Ribavirin triphosphate targets viral RNA polymerase to inhibit mRNA synthesis | Dec. 1985 | |
| Rimantadine | RIM | Flumadine | Influenza virus A | Targets matrix protein 2 to inhibit viral uncoating | Sept. 1993 | |
| Zanamivir | ZAN | Relenza | Influenza viruses A and B | Targets viral neuraminidase to inhibit virus release from host cells | July 1999 | |
| Oseltamivir | OTV | Tamiflu | Influenza viruses A and B | Targets viral neuraminidase to inhibit virus release from host cells | Oct. 1999 | |
| Laninamivir octanoate | LO | Inavir (Japan) | Influenza viruses A and B | Targets viral neuraminidase to inhibit virus release from host cells | Sept. 2010 | |
| Peramivir | PRV | Rapivab | Influenza viruses A and B | Targets viral neuraminidase to inhibit virus release from host cells | Dec. 2014 | |
| Favipiravir | FPV | Avigan (Japan) | Influenza viruses A, B, and C | Favipiravir-ribofuranosyl-5′-triphosphate inhibits the activity of influenza RNA polymerase | Mar. 2014 | |
| Interferons, immunostimulators, oligonucleotides, and antimitotic inhibitors | Pegylated interferon alfa 2b | PegIFNα-2b | Intron-A, PegIntron | HBV, HCV | PegIFNα-2b is used to treat patients with HBV and/or HCV infection | June 1986 |
| Interferon alfacon 1a | CIFN | Infergen | HCV genotype 1 | Interferon alfacon 1 can be used with ribavirin to treat HCV infection | Oct. 1997 | |
| Pegylated interferon alfa 2b + ribavirin | PegIFNα-2b+RBV | Rebetron | HCV | PegIFNα-2b is used with ribavirin to treat patients with HCV infection | June 1998 | |
| Pegylated interferon alfa 2a | PegIFN-α2a | Pegasys, Roferon-A | HBV, HCV | Used with or without ribavirin to treat patients with HCV and/or HBV infection | Oct. 2002 | |
| Fomivirsena | FMV | Vitravene | HCMV | Antisense RNA interrupts HCMV gene expression | Aug. 1998 | |
| Podofilox | PDX | Condylox | HPV-related diseases | Antimitotic drug that interrupts cell division | Dec. 1990 | |
| Imiquimod | IQM | Aldara | HPV-related diseases | Stimulates cytokines to clear external genital warts | Feb. 1997 | |
| Sinecatechins | SINE | Veregen | HPV-related diseases | Botanical drug that acts as an immunomodulator to interfere with HSV-induced pathways | Oct. 2006 |
Discontinued antiviral drug (amantadine, amprenavir, boceprevir, delavirdine, fomivirsen, RSV-IGIV, VZIG, telaprevir, vidarabine, zalcitabine, and interferon alfacon 1).
Different combination drugs. The combination of asunaprevir plus daclatasvir was approved to treat HCV genotype 1 infection in Japan, the combination of grazoprevir plus elbasvir was approved to treat HCV genotype 1 or 4 infection, the combination of paritaprevir plus ombitasvir plus dasabuvir plus ritonavir was approved to treat HCV genotype 1 infection, and the combination of paritaprevir plus ombitasvir plus ritonavir was approved to treat HCV genotype 4 infection.
Abbreviations commonly used in literature. The first four letters are used if drug abbreviations could not be found (e.g., sinecatechins are abbreviated SINE).
Antiviral drugs that have been approved in either Japan or Europe but not in the United States are indicated by “(Japan)” or “(Europe).”
Only the earliest time is listed if several approval dates for different clinical applications were found.
Table S1 in the supplemental material summarizes information on drug databases and chemical formulas. Information on dosage and administration of approved antiviral drugs is available online (see http://www.fda.gov/ and http://www.virusface.com/).