Mucocutaneous (oral/genital) Herpes Simplex Virus (HSV), initial outbreak (same protocol as immunocompromised or immunocompetent)
- Adults
12 yrs: 200 mg PO, every 4 hours (5x day) for 10 days - In severe cases, consider IV treatment (review IV monograph)
Mucocutaneous (oral/genital) HSV, episodic or recurrent episodes (same protocol for immunocompetent or immunocompromised)
- 200 mg PO, 5 times daily, or 400 mg PO tid, or 800 mg PO bid x 5 days
Genital HSV; chronic suppressive therapy (same protocol for immunocompetent or immunocompromised)
- Adults and adolescents: 200 mg PO tid or 400 mg PO bid (some sources recommend up to 800 mg tid for immunocompromised)
Varicella (chickenpox)
- 800 mg PO qid x 5 days
Herpes zoster (shingles)
- Adults 12 yrs (Immunocompetent): 800 mg PO, every 4 hours (5x daily) for 7-10 days
Herpes zoster ophthalmicus (not FDA approved)
- Adults (Immunocompetent): 800 mg PO, 5 times daily for 7-10 days (in combination with ophthalmic topical antiviral treatment); if immunocompromised, IV acyclovir often recommended
HSV keratitis treatment, with HIV (not FDA approved)
- 400 mg PO 5 times daily
HSV keratitis prevention, in immunocompromised (not FDA approved)
- Adults 12 yrs: 400 mg bid for 12 mo
HSV proctitis
- 400 mg PO tid for 10 days or resolution; or 800 mg PO tid for 7-10 days
Pharyngitis (Acute) [Non-FDA Approved]
- 800 mg PO bid x 5 days, or 400 mg tid x 5 days, or 800 mg tid daily x 2 days
- Note: Safety and effectiveness in pediatric patients < 2 years of age have not been established
- Child 2 years: 20 mg/kg/dose PO qid (80 mg/kg/day)
- Max: 3200 mg/day
- Children over 40kg give adult dose
- Child (Immunocompetent): 80 mg/kg/day PO divided 5 times daily
- Max: 4000 mg/day
Mucocutaneous (oral/genital) Herpes Simplex Virus (HSV), initial outbreak (same protocol immunocompromised or immunocompetent)
- 40-80 mg/kg/day PO, divided 3-5 times/day x 7-14 days
- Max 1600 mg/day
- In severe cases, consider IV treatment (review IV monograph)
Mucocutaneous (oral/genital) HSV, episodic or recurrent episodes (same protocol for immunocompetent or immunocompromised)
- 40-80 mg/kg/day divided bid/tid x 5 days
- Max: 1200 mg/day if tid, 1600 mg/day if bid
Genital HSV; chronic suppressive therapy (same protocol for immunocompetent or immunocompromised) (not FDA approved)
- 40-80 mg/kg/day PO, divided tid/qid
- Max: 1000 mg/day
Pharyngitis (Acute) [Non-FDA Approved]
- 15 mg/kg PO, 5 times daily x 7 days
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