Adult Dosing

Genital herpes (HSV), immunocompetent adults

• First episode: 250 mg PO tid for 7-10 days
• Recurrence: 1000 mg PO bid x 1 day
• Suppression: 250 mg PO bid

Genital herpes,immunocompromised adults

• Recurrence: 1000 mg twice daily for 1 day
• Suppressive therapy: 250 mg BID

Orolabial HSV, immunocompetent adults

• Recurrence: 1500 mg PO x 1

Orolabial HSV, immunocompromised adults

• Recurrence: 500 mg PO bid x 7 days

Herpes zoster (shingles)

• 500 mg PO tid x 7 days

Pharyngitis (Acute) [Non-FDA Approved]

• 125 mg PO bid x 5 days, or 1000 mg bid x 1 day

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Acute herpes zoster infections (shingles)
• Treatment/suppression of recurrent genital herpes in immunocompetent patients
• Treatment of recurrent mucocutaneous herpes simplex virus (HSV) infection in HIV-infected patients
• Treatment of recurrent herpes labialis in immunocompetent individuals

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment(Based on CrCl)

Recurrent Genital Herpes

• 60 mL/min: 1000 mg q12 x1 day
• 40-59 mL/min: 500 mg q12 X1 day
• 20-39 mL/min: 500 mg x 1
• < 20 mL/min: 250 mg x 1
• HD: 250 mg single dose following dialysis

Recurrent herpes labialis

• 60 mL/min: 1500 mg X 1
• 40-59 mL/min: 750 mg X 1
• 20-39 mL/min: 500 mg x 1
• < 20 mL/min: 250 mg x 1
• HD: 250 mg single dose following dialysis

Suppression of Recurrent Genital Herpes

• 40 mL/min: 250 mg q12
• 20-39 mL/min: 125 mg q12
• < 20 mL/min: 125 mg Daily
• HD: 250 mg dose following each dialysis

Recurrent orolabial/genital herpes in HIV patients

• 40 mL/min: 500 mg q12
• 20-39 mL/min: 500 mg Daily
• < 20 mL/min: 250 mg Daily
• HD: 250 mg dose following each dialysis

Herpes zoster

• 60 mL/min: 500 mg q8
• 40-59 mL/min: 500 mg q12
• 20-39 mL/min: 500 mg Daily
• < 20 mL/min: 250 mg Daily
• HD: 250 mg dose following each dialysis

Hepatic Dose Adjustment

• Mild-moderate impairment: No Dose adjustments
• Severe impairment: Dose adjustments not defined

• Cases of acute renal failure have been reported in patients receiving high doses and having underlying renal disease. Dosage adjustment is recommended
• For recurrent genital herpes, assess history of frequency of recurrence. Monitor for efficacy of treatment
• Use of famciclovir does not prevent sexual transmission in genital herpes. Sexual intercourse must be avoided when lesions are present

use cautiously in

• Renal impairment
• Geriatric patients
• Pregnancy
• Lactation
• Children < 18 yrs

Pregancy Category: B

Breastfeeding: Safety unknown, other agents might be preferred. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 16 June 2010).

• CNS: Headache, fatigue, migraine, paresthesia; dizziness, somnolence (postmarketing)
• PSYCHIATRIC: Confusion, confusional state, delirium, disorientation
• GI: Nausea, diarrhea, vomiting, abdominal pain, flatulence, elevated ALT, AST, total bilirubin
• DERM: Pruritus, rash; erythema multiforme, Stevens-Johnson syndrome, urticaria, toxic epidermal necrolysis (postmarketing).
• GU: Dysmenorrhea
• HEMA: Anemia, leukopenia, neutropenia, thrombocytopenia (postmarketing)
• HEPA: Jaundice (postmarketing)

• Nucleoside analogue: Inhibits viral DNA synthesis in herpes-infected cells only; selectively inhibits herpes viral DNA synthesis and replication. A prodrug of penciclovir
• Metabolized by liver; famciclovir is a prodrug which is converted to penciclovir
• Excreted in urine (primarily) and feces
• Half-Life: 2-3 hrs (penciclovir)

US Trade Name(s)

• Famvir

US Availability

famciclovir (generic)

• TABS: 125, 250, 500 mg

Famvir

• TABS: 125, 250, 500 mg

Canadian Trade Name(s)

• Famvir

Canadian Availability

famciclovir (generic)

• TABS: 125, 250, 500 mg

Famvir

• TABS: 125, 250, 500 mg

UK Trade Name(s)

• Famvir

UK Availability

famciclovir (generic)

• TABS: 125, 250, 500, 750 mg

Famvir

• TABS: 125, 250, 500, 750 mg

Australian Trade Name(s)

• Famvir

Australian Availability

famvir

• TABS: 125, 250, 500 mg

[Outline]

Antimicrobials

Antiviral Agents

Anti-Herpetics/Anti-CMV Agents

Infectious Disease

Antiviral Agents

Anti-Herpetics/Anti-CMV Agents

Pricing data from www.DrugStore.com in U.S.A.

• Famvir 500 MG TABS [Bottle] (NOVARTIS)
  30 mg = $456.01
  90 mg = $1309.99
• Famciclovir 500 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
  30 mg = $326
  90 mg = $950.02
• Famciclovir 250 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
  30 mg = $169.99
  90 mg = $479.95
• Famciclovir 125 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
  30 mg = $159.99
  90 mg = $455.97
• Famvir 125 MG TABS [Bottle] (NOVARTIS)
  30 mg = $201
  90 mg = $567.97
• Famvir 250 MG TABS [Bottle] (NOVARTIS)
  30 mg = $216.99
  90 mg = $619.99

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• FAMCICLOVIR 500 mg (Physicians Total Care, Inc.)
• Famciclovir 125 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Famciclovir 250 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Famciclovir 500 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Famvir 125 MG Oral Tablet (Novartis Pharmaceuticals Corporation)
• Famvir 250 MG Oral Tablet (Novartis Pharmaceuticals Corporation)
• Famvir 500 MG Oral Tablet (Novartis Pharmaceuticals Corporation)