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SIZE:
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GENERIC NAME:
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MANUFACTURER:
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UNIT:
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ADMINISTRATION ROUTE:
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FDA PREGNANCY GROUP:
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C; B
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INDICATIONS:
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Herpes genitalis |
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Herpes labialis |
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Herpes simplex encephalitis |
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Herpes zoster |
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Infection, herpes simplex |
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Infection, varicella- zoster |
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Varicella |
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SIDE EFFECTS:
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elevated liver function tests |
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fever |
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hallucinations |
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leukopenia |
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lymphadenopathy |
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peripheral edema |
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seizures |
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skin reactions, such as erythema multiforme, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, or urticaria |
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visual abnormalities |
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Gastrointestinal disturbances |
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lightheadedness |
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Malaise |
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Gastrointestinal disturbances |
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headache |
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lightheadedness |
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Agitation |
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alopecia |
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dizziness |
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myalgia |
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paresthesia |
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somnolence |
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Phlebitis or inflammation at the injection site |
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Acute renal failure |
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Encephalopathic changes |
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hematologic abnormalities, such as anemia |
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leukocytosis, neutropenia or neutrophilia |
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thrombocytopenia or thrombocytosis |
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hematuria |
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urticaria |
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Disseminated intravascular coagulation (DIC) |
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hemolysis |
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hypotension |
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psychological disturbances, such as delirium |
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mental obtundation |
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psychosis |
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Anaphylaxis |
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confusion |
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ABSOLUTE
CONTRAINDICATIONS :
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RELATIVE
CONTRAINDICATIONS : |
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>> Dehydration |
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>> Renal function impairment, pre-existing |
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Hypersensitivity to acyclovir, ganciclovir, or valacyclovir |
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Neurological abnormalities |
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Prior neurologic reactions to cytotoxic medications |
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ADULT DOSE:
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Genital herpes infections, severe, initial episode-Intravenous infusion, 5 mg (base) per kg of body weight every eight hours for five days. Administer at a constant rate over at least a one-hour period.
Herpes simplex (HSV-1 and HSV-2) infections, mucocutaneous, in immunocompromised patients-Intravenous infusion, 5 mg (base) per kg of body weight every eight hours for seven days. Administer at a constant rate over at least a one-hour period.
Herpes simplex encephalitis -Intravenous infusion, 10 mg (base) per kg of body weight every eight hours for ten days. Administer at a constant rate over at least a one-hour period.
Herpes zoster, caused by varicella zoster virus, in immunocompromised patients-Intravenous infusion, 10 mg (base) per kg of body weight every eight hours for seven days. Administer at a constant rate over at least a one-hour period.
Note: Adults with acute or chronic renal impairment require a reduction in dose and/or dosing interval as follows :
Creatinine clearance (mL/min)/(mL/sec) Dose (base) Dosing interval (hr)
> 50/0.83 100% 8
25-50/0.42-0.83 100% 12
10-25/0.17-0.42 100% 24
0-10/0-0.17 50% 24
Hemodialysis patients require administration of an additional dose following each hemodialysis session .
No additional dosing is required for peritoneal dialysis patients . |
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MAXIMUM ADULT DOSE:
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30 mg (base) per kg of body weight, or 1.5 grams per square meter of body surface area, daily.
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PEDIATRIC DOSE:
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Genital herpes infections, severe, initial episode-Infants and children up to 12 years of age: Intravenous infusion, 250 mg (base) per square meter of body surface area every eight hours for five days. Administer at a constant rate over at least a one-hour period.
Children 12 years of age and over: See Usual adult and adolescent dose .
Herpes simplex (HSV-1 and HSV-2) infections, mucocutaneous, in immunocompromised patients-Infants and children up to 12 years of age: Intravenous infusion, 10 mg (base) per kg of body weight every eight hours for seven days. Administer at a constant rate over at least a one-hour period.
Children 12 years of age and over: See Usual adult and adolescent dose .
Herpes simplex infections, neonatal -Infants from birth to 3 months of age: Intravenous infusion, 10 mg (base) per kg of body weight every eight hours for ten days. Administer at a constant rate over at least a one-hour period.
Note: Intravenous doses of 15 or 20 mg (base) per kg of body weight every eight hours, administered at a constant rate over at least a one-hour period, have been used; however, the safety and efficacy of these doses have not been established.
Herpes simplex encephalitis -Infants 3 months and older and children up to 12 years of age: Intravenous infusion, 20 mg (base) per kg of body weight every eight hours for ten days. Administer at a constant rate over at least a one-hour period.
Children 12 years of age and older: See Usual adult and adolescent dose .
Herpes zoster, caused by varicella zoster virus, in immunocompromised patients-Children up to 12 years of age: Intravenous infusion, 20 mg (base) per kg of body weight every eight hours for seven days. Administer at a constant rate over at least a one-hour period.
Children 12 years of age and older: See Usual adult and adolescent dose .
Note: Patients with acute or chronic renal impairment require a reduction in dose and/or dosing interval as follows :
Creatinine clearance (mL/min)/(mL/sec) Dose (base) Dosing interval (hr)
> 50/0.83 100% 8
25-50/0.42-0.83 100% 12
10-25/0.17-0.42 100% 24
0-10/0-0.17 50% 24
Hemodialysis patients require administration of an additional dose following each hemodialysis session .
No additional dosing is required for peritoneal dialysis patients . |
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MAXIMUM PEDIATRIC
DOSE:
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ELDERLY DOSE:
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