Medovir Dosage/Direction for Use

Adults: Treatment of Herpes Simplex: 200 mg should be taken 5 times daily at approximately 4-hourly intervals omitting the nighttime dose. Treatment should continue for 5 days, but in severe initial infections, may have to be extended. In severely immunocompromised patients (eg, after marrow transplant) or in patients with impaired absorption from the gut, the dose can be doubled to 400 mg.
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 1st appear.
Suppression of Herpes Simplex: In immunocompetent patients, 200 mg should be taken 4 times daily at approximately 6-hourly intervals.
Many patients may be conveniently managed on a regimen of 400 mg taken twice daily at approximately 12-hourly intervals.
Dosage titration down to 200 mg taken 3 times daily at approximately 8-hourly intervals or even twice daily at approximately 12-hourly intervals, may prove effective.
Some patients may experience breakthrough infections on total daily doses of 800 mg.
Therapy should be interrupted periodically at intervals of 6-12 months, in order to observe possible changes in the natural history of the disease.
Prophylaxis of Herpes Simplex: In immunocompromised patients, 200 mg should be taken 4 times daily at approximately 6-hourly intervals. In severely immunocompromised patients (eg, after marrow transplant) or in patients with impaired absorption from the gut, the dose can be doubled to 400 mg or alternatively, IV dosing could be considered.
The duration of prophylactic administration is determined by the duration of the period at risk.
Treatment of Herpes Zoster: 800 mg should be taken 5 times daily at approximately 4-hourly intervals, omitting the nighttime dose. Treatment should continue for 7 days.
In severely immunocompromised patients (eg, after marrow transplant) or in patients with impaired absorption from the gut, consideration should be given to IV dosing.
Dosing should begin as early as possible after the start of an infection; treatment yields better results if initiated as soon as possible after onset of the rash.
Children: For treatment and prophylaxis of herpes simplex infections in the immunocompromised, children >2 years should be given adult dosages and children <2 years should be given ½ the adult dose.
No specific data are available on the suppression of herpes simplex infections or the treatment of herpes zoster infections in immunocompetent children.
Elderly: In the elderly, total acyclovir body clearance declines in parallel with creatinine clearance. Adequate hydration of elderly patients taking high oral doses of acyclovir should be maintained. Special attention should be given to dosage reduction in elderly patients with impaired renal function.
Renal Impairment: In the management of herpes simplex infections in patients with impaired renal function, the recommended oral dose will not lead to accumulation of acyclovir above levels that have been established safe by IV infusion. However, for patients with severe renal impairment (creatinine clearance <10 mL/min), an adjustment of dosage to 200 mg twice daily at approximately 12-hourly intervals is recommended.
In the treatment of herpes zoster infections, it is recommended to adjust the dosage to 800 mg twice daily at approximately 12-hourly intervals for patients with severe renal impairment (creatinine clearance <10 mL/min) and to 800 mg 3 or 4 times daily at intervals of approximately 6-8 hrs for patients with moderate renal impairment (creatinine clearance in the range 10-25 mL/min).