Category:

• Antiviral

Description:

• Purine nucleotide that inhibits viral replication

  Indications:

• Genital herpes treatment and prophylaxis

• Mucosal and cutaneous herpes simplex (HSV-1 and HSV-2) treatment and prophylaxis

• Varicella-zoster (chickenpox & shingles)  

Precautions:

• Pregnancy category C

• Dosing modification is required for patients with impaired renal function.

• Avoid sexual contact when genital lesions are present.

• Medication treatment is not a cure for viral infection.

• Do not exceed recommended dose.

• Initiate therapy at earliest signs of symptoms.

• Use rubber gloves or a finger cot when applying topical cream to active lesions, so as not to inoculate other areas.

  Adverse Reactions (Side Effects):

• Malaise (11.5%)

• Nausea and vomiting (2-8%)

• Headache (6%)

• Pain / phlebitis at injection site (9%)

Dosage:

Administered as an oral tablet, capsule, topical cream or injection

Parenteral (avoid rapid IV, IM or SQ injections, administer via slow IV infusion):

Mucosal and cutaneous HSV infections:

• 5mg/kg infused over 1 hour, every 8 hours for 7 days

Varicella-zoster (shingles) infections:

• 10mg/kg infused over 1 hour, every 8 hours for 7 days

Herpes simplex encephalitis:

• 10mg/kg infused over 1 hour, every 8 hours for 10 days

Oral:

Herpes simplex:

• Initial infection: 200mg q4h (5 times a day) for 10 days

• Chronic suppression: 400mg bid for 12 months

• Intermittent therapy: 200mg q4h (5 times a day) for 5 days

Herpes zoster, acute treatment

• 800mg q4h (5 times a day) for 7-10 days

Chickenpox

• 20mg/kg (not to exceed 800mg) qid for 5 days

Topical:

• Apply a sufficient quantity to adequately cover all lesions q3h (6 times a day) for 7 days.

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001