• Clinical Info

Uses

Genital Herpes

Treatment of initial episodes of genital herpes† in immunocompetent or HIV-infected adults and adolescents.

Episodic treatment of recurrent episodes of genital herpes in immunocompetent or HIV-infected adults and adolescents.

Chronic suppressive therapy of recurrent episodes of genital herpes in immunocompetent or HIV-infected adults and adolescents.

CDC and others recommend oral acyclovir, oral famciclovir, or oral valacyclovir as drugs of choice for treatment of initial episodes of genital herpes and for episodic treatment or chronic suppressive therapy of recurrent genital herpes.

Herpes Labialis

Episodic treatment of herpes labialis (perioral herpes, cold sores, fever blisters) in immunocompetent adults or HIV-infected adults and adolescents.

Mucocutaneous Herpes Simplex Virus (HSV) Infections

Treatment of recurrent mucocutaneous HSV infections in HIV-infected adults and adolescents.

Chronic suppressive or maintenance therapy (secondary prophylaxis) against recurrence of HSV infections† in HIV-infected adults or adolescents who have frequent or severe recurrences.

Herpes Zoster

Treatment of acute, localized herpes zoster (shingles, zoster) in immunocompetent adults and adolescents.

Treatment of localized dermatomal herpes zoster in HIV-infected adults or adolescents†. If cutaneous lesions are extensive or there is clinical evidence of visceral involvement, IV acyclovir should be used for initial treatment.

Hepatitis B Virus Infection

Has been used for management of chronic hepatitis B virus (HBV) infection†, including control of HBV recurrence in organ or bone marrow transplant recipients†. Safety and efficacy for HBV infection not established.

CDC, National Institutes of Health (NIH), and IDSA state that famciclovir is not recommended for treatment of HBV infection in HIV-infected individuals since the drug is less active than lamivudine against HBV and is not active against lamivudine-resistant HBV.

Dosage and Administration

Administration

Oral Administration

Administer orally without regard to meals.

Dosage

Pediatric Patients

Genital Herpes

Oral

Adolescents should receive dosage recommended for adults with genital herpes. (See Adults under Dosage and Administration.)

Mucocutaneous Herpes Simplex Virus (HSV) Infections

Chronic Suppression of Recurrent Episodes

Oral

HIV-infected adolescents: 250 mg twice daily for chronic suppressive or maintenance therapy (secondary prophylaxis) of HSV† infections in those with frequent or severe recurrences.

Herpes Zoster

Oral

Local dermatomal herpes zoster in HIV-infected adolescents†: 500 mg three times daily for 7–10 days recommended by CDC and other experts.

Adults

Genital Herpes

Treatment of First Episodes

Oral

Immunocompetent adults: 250 mg 3 times daily for 7–10 days recommended by CDC and others; duration of treatment may be extended if healing is incomplete after 10 days.†

HIV-infected adults: 500 mg twice daily for 7–14 days recommended by CDC and others.†

Episodic Treatment of Recurrent Episodes

Oral

Immunocompetent adults: 1 g twice daily for 1 day or 125 mg twice daily for 5 days.

HIV-infected adults: 500 mg twice daily for 5–10 days recommended by CDC and others; alternatively, continue for 7–14 days.

Initiate therapy at first sign or symptom of an episode; efficacy not established if initiated >6 hours after onset of signs or symptoms.

Suppressive Therapy of Recurrent Episodes

Oral

Immunocompetent adults: 250 mg twice daily.

HIV-infected adults: 500 mg twice daily recommended by CDC.

Manufacturer states chronic suppressive therapy may be given for up to 1 year.

Because frequency of recurrent episodes diminishes over time in many patients, CDC and others recommend that suppressive antiviral therapy be discontinued periodically (e.g., once yearly) to assess the need for continued therapy.

Herpes Labialis

Oral

Immunocompetent adults: 1.5 g as a single dose.

Initiate therapy at first prodromal symptom (e.g., tingling, itching, burning).

Mucocutaneous Herpes Simplex Virus (HSV) Infections

Episodic Treatment of Recurrent Episodes

Oral

HIV-infected adults: 500 mg every 12 hours for 7 days for treatment of recurrent infections (orolabial or genital herpes). Some experts recommend 7–14 days.

Suppressive Therapy of Recurrent Episodes

Oral

HIV-infected adults: 250 mg twice daily for chronic suppressive or maintenance therapy (secondary prophylaxis) of HSV† in those with frequent or severe recurrences.

Herpes Zoster

Oral

Immunocompetent adults: 500 mg every 8 hours for 7 days.

Local dermatomal herpes zoster in HIV-infected adults†: 500 mg three times daily for 7–10 days recommended by CDC and other experts.

Initiate therapy promptly as soon as diagnosed; efficacy not established if initiated >72 hours after rash onset.

Special Populations

Renal Impairment

Genital Herpes

Herpes Labialis

Mucocutaneous Herpes Simplex Virus (HSV) Infections

Herpes Zoster