- See: Herpes Simplex Finger Infection
- Discussion:
- adult w/ initial Herpes simplex infecction infection:
- 200mg PO q4h while awake (5 caps/day) for 10 days;
- or 5mg/kg IV over 1hr q8hr x 5days, or 1gm/day in 5 divided doses PO for 10 days;
- or 5% topical ointment 4-6 times/day for 7-14 days;
- peds: 30 mg/kg/day q 8hr;
- will increase rate of lesion healing, but does do not prevent recurrence;
- chronic suppresive therapy for recurrent disease:
- 200 mgPO tid for up to 6 months;
- or better 1gm/day in 5 divided doses PO for 5 days;
- daily rx for 4 months decreases but does not prevent recurrences;
- may apply ointment for up to 6 times a day for 7 days;
- Side Effects:
- may cause Renal Impairment; adequate hydration essential to prevent renal tubular crystallization;
- encephalopathic reactions have been reported;
- side effects include transient burning, N, V, D, HA;
- not for use in the eye;
- interactions: w/ probenecid and sulfinpyrazone and zidovudine: to increase toxicity of acyclovoir, marked lethargy;
- IV Use:
- for mucocutaneous lesions in immunocomprimised host: 6.2mg/kg or 250mg/Msq IV over 1hr q8hr for 7 days;
- herpes zoster (normal host): 5-10mg/kg IV over 1hr q8hr for 5 days;
- IV use for Herpes in the immunocomprimised patient:
- 5mg/kg IV infused slowly over 1 hr q8hr (15mg/kg each day) for 7 days;
- for severe initial episodes of genital herpes for 5 days;
- Renal Dosing:
- decrease dosage in Renal patients and contraindicated with hypersensitivity;
- renal (5%): increase creatinine, hematuria;
- with high doses, crystalizes in renal collecting tubules leading to obstructive uropathy; Hepatic: Inc SGOT, SGPT;
- Alternative Medications:
- valacyclovir: 1000 mg every eight hours
- famciclovir: 500 mg every eight hours