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Anti-Herpetic agents

NEW MONOGRAPHS

acyclovir
(Zovirax ®):
Mucocutaneous herpes simplex: IV: 
5 mg/kg/dose every 8 hours x 5-10 days.
Encephalitis
10mg/kg/dose IV every 8 hours. 
Primary HSV infection-genital (Oral therapy):
200mg every 4 hours while awake (5 times/day) or 400mg orally three times daily for 10 days. 
Recurrent genital:
400mg orally three times daily for  5 days.
Herpes Zoster:
800mg orally every 4 hours while awake (5 times/ day)  for  7 days. If severe give 10-12 mg/kg IV every 8 hours x 7-14 days.  
Chronic suppression (genital herpes):
400mg orally twice daily. 
Renal dosing:
50 - 90/ 5 to 12.4 mg/kg q8h || 10-50 / 5-12.4 mg/kg q12-24h || <10 / 2.5 to 6 mg/kg q24h.  Alternatively: (Oral): 10-25 / dose q8h || <10 / dose q12h. (IV): 25-50/ 5-10mg/kg q12h || 10-25/ 5-10mg/kg q24h || <10/ 2.5 to 5mg/kg IV q24h. || HD: dose after dialysis || CAPD: see < 10.
famciclovir
(Famvir ® ):
First episode genital:
250 mg orally three times daily for 7-10 days.
Recurrent:  
125 mg orally twice daily for 5 days.
Prophylaxis
250mg orally twice daily.
Recurrent (HIV patient):
500mg orally twice daily for 7 days. 
Zoster:
500mg orally three times daily for 7 days. 
Supplied:
125,250, 500 mg tabs
Renal dosing:
>60/ no change || 40-59/ 500mg q12h || 11-39/ 500mg q24h || <10/ 250 mg q48h || HD: 250mg after dialysis.
valacyclovir
(Valtrex ®): 
First episode genital:
1000mg orally twice daily for 10 days.
 Recurrent: 
500mg orally twice daily for 5 days.
 Prophylaxis:
500-1000mg orally once daily.
 Zoster: 
Supplied: [500,1000mg tabs]
Topical agents
acyclovir ointment
(Zovirax ®):
apply ½" every 3 hours (6  times/day).  Supplied: [5% ointment]
penciclovir
(Denavir ®):
Herpes labialis: apply 1% cream every 2 hours while awake for 4 days.
Anti-Herpetic agents – Empiric

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