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In vitro Inhibitory Effects of Combinations of anti-Influenza Agents

To assess the possible interactions among candidate anti-influenza agents, dual combinations of rimantadine, ribavirin, 2′-deoxy-2′-fluoroguanosine (2-FDG) and 4-guanidino-Neu5Ac2en (GG167) were tested against clinical isolates of influenza A H3N2 and H1N1 subtype viruses in MDCK cells by ELISA. Each of the dual combinations showed additive effects, except for the combination of 2-FDG and ribavirin which was synergistic against the influenza A (H1N1) virus. However, this combination also showed enhanced cytotoxicity. In this assay system, influenza agents with differing mechanisms of antiviral interaction interacted in an additive fashion with respect to inhibition of viral replication.