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Infection

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: 
1000 mg orally three times daily for 7 days.  
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.

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References - Infectious Disease Section

Infectious Disease References

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.
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