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Acyclovir ( Zovirax ® ) famciclovir ( Famvir ®)
valacyclovir ( Valtrex ®) Topical Products

Acyclovir ( Zovirax ® )  top of page

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.Zovirax ointment: apply ½" every 3 hours (6 times/day).

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 ®)  top of page

First episode genital: 250 mg orally three times daily for 7-10 days.
Recurrent herpes simplex (genital): 125 mg orally twice daily for 5 days.
Prophylaxis (Chronic suppression): 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 ®)   top of page

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.
Herpes labialis (cold sores) 2 gm q12h x 1 day.Supplied: [500,1000mg tabs]

Renal Dosing:
[CRCL >50]: No changes.

[30-49]: Zoster: 1 gram q12h. H. Labialis: 1 gram q12h x 2 doses. Initial episode GH: 1 gram q12h. Recurrent: 500mg q12h. Suppressive: 0.5 – 1 gm qd.

[10-29]: Zoster: 1 gram q24h. H. Labialis (lip): 500mg q12h x 2 doses. Initial episode G. Herpes: 1 gram q24h. Recurrent: 500mg q24h. Suppressive: 500mg q24-48h.

[<10]: Zoster: 500mg q24h. H. Labialis: 500mg x 1.
Initial episode G. Herpes: 500mg q24h. Recurrent: 500mg q24h. Suppressive: 500mg q24-48h. Hemo: 500 mg PO q24h (on dialysis days give dose after dialysis)

Anti-Herpetic (Topical):  top of page

acyclovir  ( Zovirax ®)

Apply every 3 hours (6 times / day) for 7 days.
Supplied: [5% ointment]

docosanol ( Abreva ®)

Abreva Cream (Docosanol 10%):
Uses
: Treats cold sore/fever blisters on the face or lips. Shortens healing time and duration of symptoms: tingling, pain, burning, and/or itching.
Directions
: adults and children 12 years or over: wash hands before and after applying cream. Apply to affected area on face or lips at the first sign of cold sore/fever blister (tingle). Early treatment ensures the best results. Rub in gently but completely. Use 5 times a day until healed.

penciclovir ( Denavir ®)

 Herpes labialis: apply 1% cream every 2 hours while awake for 4 days.
Herpes simplex