Asyclovir

Neonatal Herpes Simplex Virus Infection

30 mg/kg/day IV divided q8hr for 14-21 days; alternatively, 20 mg/kg IV q8hr for 14-21
days

Herpes Simplex Virus Encephalitis

3 months-12 years: 20 mg/kg IV q8hr for 10 days

>12 years: 10-15 mg/kg IV q8hr for 14-21 days

Mucocutaneous Herpes Simplex Virus Infection

Treatment in immunocompromised patients

<12 years: 10 mg/kg IV q8hr for 7 days

>12 years: 5-10 mg/kg/day IV divided q8hr for 5-7 days

Herpes Zoster (Shingles)

<12 years (immunocompromised): 20 mg/kg IV q8hr for 7 days

>12 years (immunocompetent): 800 mg PO q4hr while awake (5 times daily) for 7-10 days

>12 years (immunocompromised): 30 mg/kg/day IV divided q8hr for 7-10 days

Varicella Zoster (Chickenpox)

2 years and <40 kg: 80 mg/kg/day PO divided q6hr for 5 days

>40 kg: 800 mg PO q6hr for 5 days

Immunocompromised patients (any age): 10 mg/kg IV q8hr for 7-10 days

Dosing Modifications

Renal impairment (IV)

CrCl 25-50 mL/min: Give recommended dose q12hr

CrCl 10-25 mL/min: Give recommended dose q24hr
CrCl <10 mL/min: Give 50% of recommended dose q24hr

Renal impairment (PO)

Normal dosage 200 mg q4hr or 400 mg q12hr and CrCl <10 mL/min: Decrease to 200
mg q12hr
 Normal dosage 800 mg q4hr and CrCl 10-25 mL/min: Decrease to 800 mg q8hr
Normal dosage 800 mg q4hr and CrCl <10 mL/min: Decrease to 800 mg q12hr

Famcyclovir
Genital Herpes (Off-label)

Treatment of initial and recurrent episodes or suppressive therapy

<18 years: Safety and efficacy not established; may be considered in adolescents

Initial episode: 250 mg PO q8hr for 7-10 days

Suppressive therapy: 250 mg PO q12hr for up to 12 months

Recurrent episodes: 125 mg PO q12hr for 3-5 days

Renal impairment: As for adults; see Dosing Modifications