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.