Herpevex Dosage/Direction for Use

Ensure that patients on high doses of aciclovir are adequately hydrated.
Dosage in adults: Treatment of herpes simplex infections: 200 mg Herpevex should be taken five times daily at approximately four hourly intervals omitting the night time dose. Treatment should continue for 5 days, but in severe initial infections this may have to be extended.
In severe immunocompromised patients (e.g. after marrow transplant) or in patients with impaired absorption from the gut the dose can be doubled to 400 mg Herpevex or alternatively intravenous dosing could be considered.
Dosing should begin as early as possible after the start of an infection: for recurrent episodes this should preferably be during the prodromal period or when lesions first appear.
Suppression of herpes infections in immunocompetent patients: 200 mg Herpevex should be taken four times daily at approximately six- hourly intervals.
Many patients may be conveniently managed on a regimen of 400 mg Herpevex twice daily at approximately twelve-hourly intervals.
Dosage titration down to 200 mg Herpevex taken thrice daily at approximately eight-hourly intervals or even twice daily at approximately twelve-hourly intervals may prove, effective.
Some patients may experience break-through infection on total daily doses of 800 mg Herpevex.
Therapy should be interrupted periodically at intervals of six to twelve months, in order to observe possible chances in the natural history of the disease.
Prophylaxis of herpes simplex infections in immunocompromised patients: 200 mg Herpevex should be taken four times daily at approximately sixhourly intervals.
In severely immunocompromised patients (e.g. after marrow transplant) or in patients with impaired absorption from the gut, the dose can be doubled to 400 mg Herpevex or alternatively, intravenous dosing could be considered.
The duration of prophylactic administration is determined by the duration of the period at risk.
Treatment of varicella and herpes zoster infections 800 mg Herpevex should be taken five times daily at approximately four-hourly intervals, omitting the night time dose. Treatment should continue for seven days.
In severely, immunocompromised patients (e.g. after marrow transplant) or in patients with impaired absorption from the gut, consideration should be given to intravenous dosing.
Dosing should begin as early as possible after the start of an infection: Treatment of herpes zoster yields better results if initiated as soon as possible after the onset of the rash. Treatment of chickenpox in immunocompetent patients should begin within 24 hours after onset of the rash.
Dosage in the elderly: In the elderly, total aciclovir body clearance declines along with creatinine clearance. Adequate hydration of elderly patients taking high oral doses of Herpevex should be maintained. Special attention should be given to dosage reduction in elderly patients with impaired renal function.
Dosage in renal impairment: In the management of herpes simplex infections in patients with impaired renal function, the recommended oral doses will not lead to accumulation of aciclovir above levels that have been established by intravenous infusion. However for patients with severe renal impairment (creatinine clearance less than 10 ml/ minute) an adjustment of dosage to 200 mg aciclovir twice daily at approximately twelve-hourly intervals is recommended.
In the treatment of herpes zoster infections it is recommended to adjust the dosage to 800 mg aciclovir twice daily at approximately twelve - hourly intervals for patients with severe renal impairment (creatinine clearance less than 10 ml/ minute), and to 800 mg aciclovir three times daily at intervals of approximately eight hours for patients with moderate renal impairment (creatinine clearance in the range 10 - 25 ml/ minute).
Route of administration: Oral.