The FDA has approved Viekira Pak (Abbvie), a fixed-dose combination of two new direct-acting antiviral agents (ombitasvir, paritaprevir) with the pharmacologic enhancer ritonavir in one tablet, co-packaged with a third new direct-acting antiviral agent (dasabuvir) in a second tablet, for oral treatment of chronic hepatitis C virus (HCV) genotype 1 infection. Genotype 1 is responsible for 70-80% of HCV infections in the US.

View Expanded Table: Some Biologic Drugs and JAK Inhibitors for Rheumatoid Arthritis

The oral Janus kinase (JAK) inhibitor baricitinib (Olumiant – Lilly) has been granted an FDA Emergency Use Authorization (EUA) for treatment of confirmed or suspected COVID-19 in hospitalized patients ≥2 years old who require supplemental oxygen, mechanical ventilation, or extracorporeal membrane oxygenation (ECMO); the EUA requires that baricitinib be used in combination with the IV antiviral drug remdesivir (Veklury). Baricitinib has been available for treatment of rheumatoid arthritis since 2018. Remdesivir was recently approved by the FDA for treatment of COVID-19 in...

In the printed version of our article entitled Antiviral Drugs for Influenza for 2023-2024 in issue 1689 (Med Lett Drugs Ther 2023; 65:177), the clinical studies section should have included a meta-analysis of 15 randomized trials in 6295 outpatient adolescents and adults with influenza that found that use of oseltamivir did not reduce the risk of hospitalization in the overall population or in those ≥65 years old compared to placebo or standard of care. It has been added in the online version of the article.

Famciclovir (Famvir - SmithKline Beecham) is now available in the USA for oral treatment of acute uncomplicated herpes zoster (shingles). The manufacturer claims that use of the drug reduces the duration of postherpetic neuralgia. Famciclovir is similar to acyclovir (Zovirax - Burroughs Wellcome), which has been the drug of choice for treatment of varicella-zoster and herpes simplex virus infections (Medical Letter, 36:27, 1994).

Healthcare providers are often asked if drugs can be used past their expiration date. Because of legal restrictions and liability concerns, manufacturers do not sanction such use and usually do not comment on the safety or effectiveness of their products beyond the date on the label. Since our last article on this subject, more data have become available.

About 2.5 million persons in the US had hepatitis C between 2017 and 2020. Guidelines from the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) on management of hepatitis C virus (HCV) infection were updated in 2023.

Results of a recent study suggested that zinc gluconate may be effective in treating the common cold (SB Mossad et al, Ann Intern Med, 125:81, July 15, 1996). Zinc gluconate lozenges, sometimes combined with vitamin C or other ingredients, are available in pharmacies and health food stores throughout the USA.

Phosphonoformic acid or foscarnet (Foscavir - Astra), a synthetic antiviral drug, has now been approved by the US Food and Drug Administration for intravenous (IV) treatment of cytomegalovirus (CMV) retinitis in patients with AIDS. CMV retinitis occurs in up to 30% of patients with AIDS and often causes blindness (MD de Smet and RB Nussenbatt, JAMA, 266:3019, Dec 4, 1991).

Valacyclovir (Valtrex - Glaxo Wellcome), an L- valyl ester of acyclovir (Zovirax), has been approved by the US Food and Drug Administration (FDA) for oral treatment of herpes zoster (shingles) in immunocompetent adults. Famciclovir (Famvir - Medical Letter, 36:97, 1994) is also available for this indication.