▶ With oral use in adults For herpes zoster, use normal oral
dose every 8 hours if eGFR 10–25 mL/minute/1.73 m2
(every 12 hours if eGFR less than 10 mL/minute/1.73 m2
For herpes simplex, use normal oral dose every 12 hours if
eGFR less than 10 mL/minute/1.73 m2
▶ With oral use in children For herpes zoster, use normal oral
dose every 8 hours if estimated glomerular filtration rate
10–25 mL/minute/1.73 m2 (every 12 hours if estimated
glomerular filtration rate less than 10 mL/minute/1.73 m2
For herpes simplex, use normal dose every 12 hours if
estimated glomerular filtration rate less than
l DIRECTIONS FOR ADMINISTRATION
▶ With intravenous use in adults For intravenous infusion Zovirax
IV ®, Aciclovir IV (Genus), give intermittently in Sodium
chloride 0.9% or Sodium chloride and glucose; initially
reconstitute to 25 mg/mL in water for injection or sodium
chloride 0.9% then dilute to not more than 5 mg/mL with
the infusion fluid; to be given over 1 hour; alternatively,
may be administered in a concentration of 25 mg/mL using
a suitable infusion pump and given over 1 hour; for
Aciclovir IV (Hospira) dilute to not more than 5 mg/mL with
infusion fluid; give over 1 hour.
l PRESCRIBING AND DISPENSING INFORMATION
▶ With oral use Flavours of oral liquid preparations may
Medicines for Children leaflet: Aciclovir (oral) for viral infections
▶ With oral use www.medicinesforchildren.org.uk/aciclovir-oralviral-infections-0
l PROFESSION SPECIFIC INFORMATION
Dental practitioners’ formulary
▶ With oral use Aciclovir Tablets 200 mg or 800 mg may be
prescribed. Aciclovir Oral Suspension 200 mg/5mL may be
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
CAUTIONARY AND ADVISORY LABELS 9
Aciclovir 200 mg Aciclovir 200mg tablets | 25 tablet P £1.25 DT
Aciclovir 400 mg Aciclovir 400mg tablets | 56 tablet P £3.30 DT
Aciclovir 800 mg Aciclovir 800mg tablets | 35 tablet P £4.35 DT
CAUTIONARY AND ADVISORY LABELS 9
Aciclovir 200 mg Aciclovir 200mg dispersible tablets | 25 tablet P £1.05 DT = £1.01
Aciclovir 400 mg Aciclovir 400mg dispersible tablets | 56 tablet P £11.98 DT = £11.98
Aciclovir 800 mg Aciclovir 800mg dispersible tablets | 35 tablet P £10.98 DT = £10.98
▶ Zovirax (GlaxoSmithKline UK Ltd)
Aciclovir 200 mg Zovirax 200mg dispersible tablets |
Aciclovir 800 mg Zovirax 800mg dispersible tablets | 35 tablet P £10.50 DT = £10.98
CAUTIONARY AND ADVISORY LABELS 9
Aciclovir 40 mg per 1 ml Aciclovir 200mg/5ml oral suspension sugar
free sugar-free | 125 ml P £35.76 DT = £35.76
Aciclovir 80 mg per 1 ml Aciclovir 400mg/5ml oral suspension sugar
free sugar-free | 100 ml P £39.47 DT = £39.47
▶ Zovirax (GlaxoSmithKline UK Ltd)
Aciclovir 40 mg per 1 ml Zovirax 200mg/5ml oral suspension sugarfree | 125 ml P £29.56 DT = £35.76
Aciclovir 80 mg per 1 ml Zovirax Double Strength 400mg/5ml oral
suspension sugar-free | 100 ml P £33.02 DT = £39.47
ELECTROLYTES: May contain Sodium
Aciclovir (as Aciclovir sodium) 25 mg per 1 ml Aciclovir 1g/40ml
solution for infusion vials | 1 vial P £40.00 (Hospital only)
Aciclovir 500mg/20ml concentrate for solution for infusion vials | 5 vial P £40.00 (Hospital only)
Powder for solution for infusion
ELECTROLYTES: May contain Sodium
Aciclovir (as Aciclovir sodium) 250 mg Aciclovir 250mg powder for
solution for Infusion vials | 5 vial P £16.50 (Hospital only)
Aciclovir (as Aciclovir sodium) 500 mg Aciclovir 500mg powder for
solution for infusion vials | 10 vial P £182.00 (Hospital only)
▶ Zovirax I.V. (GlaxoSmithKline UK Ltd)
Aciclovir (as Aciclovir sodium) 250 mg Zovirax I.V. 250mg powder
for solution for infusion vials | 5 vial P £16.70
Aciclovir (as Aciclovir sodium) 500 mg Zovirax I.V. 500mg powder
for solution for infusion vials | 5 vial P £17.00
Herpes zoster infection, treatment
▶ Adult: 500 mg 3 times a day for 7 days, alternatively
750 mg 1–2 times a day for 7 days
Herpes zoster infection, treatment in
▶ Adult: 500 mg 3 times a day for 10 days, continue for
2 days after crusting of lesions
▶ Adult: 250 mg twice daily, therapy to be interrupted
every 6–12 months to reassess recurrence frequency—
consider restarting after two or more recurrences
Genital herpes, suppression in immunocompromised or
▶ Adult: 500 mg twice daily, therapy to be interrupted
every 6–12 months to reassess recurrence frequency—
consider restarting after two or more recurrences
Genital herpes infection, treatment of first episode
▶ Adult: 250 mg 3 times a day for 5 days or longer if new
lesions appear during treatment or if healing
Genital herpes infection, treatment of first episode in
immunocompromised or HIV-positive patients
▶ Adult: 500 mg twice daily for 10 days
Genital herpes infection, treatment of recurrent infection
▶ Adult: 125 mg twice daily for 5 days, alternatively 1 g
Genital herpes infection, treatment of recurrent
infections in immunocompromised or HIV-positive
▶ Adult: 500 mg twice daily for 5–10 days
Herpes simplex infection (non-genital), treatment in
▶ Adult: 500 mg twice daily for 7 days
l UNLICENSED USE Famciclovir doses in BNF may differ
from those in product literature.
▶ Uncommon Angioedema . confusion . drowsiness
▶ Rare or very rare Hallucination . jaundice cholestatic . palpitations .thrombocytopenia
l PREGNANCY Manufacturers advise avoid unless potential
BNF 78 Herpesvirus infections 635
l BREAST FEEDING No information available—present in
l HEPATIC IMPAIRMENT Manufacturer advises efficacy may
be decreased in severe impairment (risk of impaired
conversion to active metabolite, no information available).
Dose adjustments Reduce dose; consult product literature.
l PRESCRIBING AND DISPENSING INFORMATION Famciclovir
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: tablet
CAUTIONARY AND ADVISORY LABELS 9
▶ Famciclovir (Non-proprietary)
Famciclovir 125 mg Famciclovir 125mg tablets | 10 tablet P £53.45 DT = £53.45
▶ Famvir (Novartis Pharmaceuticals UK Ltd)
Famciclovir 125 mg Famvir 125mg tablets | 10 tablet P £53.45
Famciclovir 500 mg Famvir 500mg tablets | 14 tablet P £249.43 DT = £179.83 | 30 tablet P £641.21
Herpes zoster infection, treatment
▶ Adult: 1 g 3 times a day for 7 days
Herpes zoster infection, treatment in
▶ Adult: 1 g 3 times a day for at least 7 days and
continued for 2 days after crusting of lesions
Herpes simplex, treatment of first infective episode
▶ Adult: 500 mg twice daily for 5 days (longer if new
lesions appear during treatment or healing is
Herpes simplex infections treatment of first episode in
immunocompromised or HIV-positive patients
▶ Adult: 1 g twice daily for 10 days
Herpes simplex, treatment of recurrent infections
▶ Adult: 500 mg twice daily for 3–5 days
Treatment of recurrent herpes simplex infections in
immunocompromised or HIV-positive patients
▶ Adult: 1 g twice daily for 5–10 days
▶ Child 12–17 years: Initially 2 g, then 2 g after 12 hours
▶ Adult: Initially 2 g, then 2 g after 12 hours
Herpes simplex, suppression of infections
▶ Adult: 500 mg daily in 1–2 divided doses, therapy to be
interrupted every 6–12 months to reassess recurrence
frequency—consider restarting after two or more
Herpes simplex, suppression of infections in
immunocompromised or HIV-positive patients
▶ Adult: 500 mg twice daily, therapy to be interrupted
every 6–12 months to reassess recurrence frequency—
consider restarting after two or more recurrences
Genital herpes, reduction of transmission (administered
▶ Adult: 500 mg once daily, to be taken by the infected
Prevention of cytomegalovirus disease following solid
organ transplantation when valganciclovir or ganciclovir
▶ Adult: 2 g 4 times a day usually for 90 days, preferably
starting within 72 hours of transplantation
l INTERACTIONS → Appendix 1: valaciclovir
consciousness decreased .renal pain .thrombocytopenia . tremor
▶ Frequency not known Microangiopathic haemolytic
SIDE-EFFECTS, FURTHER INFORMATION Neurological
reactions more frequent with higher doses.
l PREGNANCY Not known to be harmful—manufacturers
advise use only when potential benefit outweighs risk.
l BREAST FEEDING Significant amount in milk after systemic
administration—not known to be harmful but
l HEPATIC IMPAIRMENT Manufacturer advises caution with
doses of 4 g or more per day (no information available).
l RENAL IMPAIRMENT Maintain adequate hydration.
Dose adjustments ▶ In adults For herpes zoster, 1 g every
12 hours if eGFR 30–50 mL/minute/1.73 m2 (1 g every
24 hours if eGFR 10– 30 mL/minute/1.73 m2
24 hours if eGFR less than 10 mL/minute/1.73 m2
treatment of herpes simplex, 500 mg (1 g in
immunocompromised or HIV-positive patients) every
24 hours if eGFR less than 30 mL/minute/1.73 m2
treatment of herpes labialis, if eGFR
, initially 1 g, then 1 g 12 hours
after initial dose (if eGFR 10–30 mL/minute/1.73 m2
initially 500 mg, then 500 mg 12 hours after initial dose; if
eGFR less than 10 mL/minute/1.73 m2
dose). For suppression of herpes simplex, 250 mg (500 mg in
immunocompromised or HIV-positive patients) every
24 hours if eGFR less than 30 mL/minute/1.73 m2
reduction of genital herpes transmission, 250 mg every
24 hours if eGFR less than 15 mL/minute/1.73 m2
dose according to eGFR for cytomegalovirus prophylaxis
following solid organ transplantation (consult product
▶ In children For treatment of herpes labialis, if estimated
glomerular filtration rate 30–50 mL/minute/1.73 m2
initially 1 g, then 1 g 12 hours after initial dose (if
estimated glomerular filtration rate
, initially 500 mg, then 500 mg
12 hours after initial dose; if estimated glomerular
filtration rate less than 10 mL/minute/1.73 m2
l PRESCRIBING AND DISPENSING INFORMATION Valaciclovir
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: oral suspension
CAUTIONARY AND ADVISORY LABELS 9
▶ Valaciclovir (Non-proprietary)
Valaciclovir (as Valaciclovir hydrochloride) 500 mg Valaciclovir
500mg tablets | 10 tablet P £20.59 DT = £2.47 | 42 tablet P £8.99–£86.30
▶ Valtrex (GlaxoSmithKline UK Ltd)
Valaciclovir (as Valaciclovir hydrochloride) 250 mg Valtrex 250mg
tablets | 60 tablet P £123.28 DT = £123.28
Valaciclovir (as Valaciclovir hydrochloride) 500 mg Valtrex
500mg tablets | 10 tablet P £20.59 DT = £2.47 | 42 tablet P £86.30
6.3a Cytomegalovirus infections
ANTIVIRALS › NUCLEOSIDE ANALOGUES
l DRUG ACTION Cidofovir is a selective inhibitor of human
cytomegalovirus (HCMV) DNA polymerase which inhibits
viral DNA synthesis and thereby suppresses HCMV
Cytomegalovirus retinitis in patients with AIDS (in
combination with probenecid) (specialist use only)
▶ Adult: Initially 5 mg/kg once weekly for 2 weeks, then
maintenance 5 mg/kg every 2 weeks, maintenance
treatment to be started 2 weeks after completion of
l CONTRA-INDICATIONS Concomitant administration with
potentially nephrotoxic drugs—discontinue potentially
nephrotoxic drugs at least 7 days before starting cidofovir. patients unable to receive probenecid
l CAUTIONS Diabetes mellitus (increased risk of ocular
hypotony). ensure concomitant use of probenecid and
▶ Probenecid and Sodium Chloride 0.9% Manufacturer advises
oral probenecid and intravenous Sodium Chloride 0.9%
must be administered with each cidofovir dose to prevent
nephrotoxicity (consult cidofovir product literature for
information on probenecid dosing and recommendations
on intravenous hydration); see Prescribing and dispensing
information for details on obtaining probenecid.
l INTERACTIONS → Appendix 1: cidofovir
▶ Uncommon Fanconi syndrome acquired
▶ Frequency not known Hearing impairment. nephrotoxicity . pancreatitis
SIDE-EFFECTS, FURTHER INFORMATION Manufacturer
advises intravenous sodium chloride 0.9% prehydration
and concomitant oral probenecid for prevention of
nephrotoxicity; consider treatment interruption, or
discontinuation if changes in renal function occur—
l CONCEPTION AND CONTRACEPTION Manufacturer advises
ensure effective contraception during and after treatment
in women; men should be advised to use barrier
contraception during and for 3 months after treatment.
Cidofovir may cause impaired fertility in males—reduced
testes weight and hypospermia observed in animal studies.
l PREGNANCY Manufacturer advises avoid—toxicity in
l BREAST FEEDING Manufacturer advises avoid (no
l HEPATIC IMPAIRMENT Manufacturer advises caution (no
l RENAL IMPAIRMENT Manufacturer advises avoid if
creatinine clearance is less than or equal to 55 mL/minute
or if proteinuria is greater than or equal to 100 mg/dL.
▶ Manufacturer advises monitor serum creatinine, urine
protein levels, and white blood cell count before each
▶ Manufacturer advises regular eye examinations (increased
risk of iritis, ocular hypotony, and uveitis).
l DIRECTIONS FOR ADMINISTRATION Manufacturer advises
for intravenous infusion, dilute with 100 mL Sodium
Chloride 0.9% and mix thoroughly; give at a constant rate
over 1 hour via an infusion pump.
l PRESCRIBING AND DISPENSING INFORMATION Probenecid
is available from ‘special-order’ manufacturers or
specialist importing companies—in case of difficulties, the
cidofovir manufacturer (Tillomed) advises contacting their
local representative. See probenecid product literature for
prescribing information for probenecid, including
Caution in handling Manufacturer advises cidofovir should
be considered a potential carcinogen and must be handled
with caution (consult product literature); if contact with
skin or mucous membranes occurs, wash thoroughly with
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
ELECTROLYTES: May contain Sodium
▶ Cidofovir (non-proprietary) A
Cidofovir 75 mg per 1 ml Cidofovir 375mg/5ml concentrate for
solution for infusion vials | 1 vial P s
Prevention of cytomegalovirus disease [pre-emptive
therapy in patients with drug-induced
▶ Adult: Initially 5 mg/kg every 12 hours for 7–14 days,
then maintenance 6 mg/kg once daily, on 5 days of the
week, alternatively maintenance 5 mg/kg once daily
Prevention of cytomegalovirus disease [universal
prophylaxis in patients with drug-induced
▶ Adult: 6 mg/kg once daily, on 5 days of the week,
alternatively 5 mg/kg once daily
Treatment of cytomegalovirus disease [in
▶ Adult: Initially 5 mg/kg every 12 hours for 14–21 days,
then maintenance 6 mg/kg once daily, on 5 days of
the week, alternatively maintenance continued→
BNF 78 Cytomegalovirus infections 637
5 mg/kg once daily, maintenance only for patients at
risk of relapse; if disease progresses initial induction
l CONTRA-INDICATIONS Abnormally low haemoglobin count
(consult product literature) . abnormally low neutrophil
count (consult product literature). abnormally low platelet
count (consult product literature)
l CAUTIONS History of cytopenia . potential carcinogen
(including long-term carcinogenicity). potential teratogen
(including long-term teratogenicity).radiotherapy
l INTERACTIONS → Appendix 1: ganciclovir
▶ Common or very common Anaemia . anxiety . appetite
neuropathy .renal impairment. seizure . sensation
abnormal . sepsis . skin reactions .taste altered .thinking
abnormal .thrombocytopenia . vomiting . weight
▶ Rare or very rare Agranulocytosis . hallucination
l ALLERGY AND CROSS-SENSITIVITY Contra-indicated in
patients hypersensitive to valganciclovir, aciclovir, or
l CONCEPTION AND CONTRACEPTION Manufacturer advises
women of childbearing potential should use effective
contraception during and for at least 30 days after
treatment; men with partners of childbearing potential
should be advised to use barrier contraception during and
for at least 90 days after treatment. Ganciclovir may cause
temporary or permanent inhibition of spermatogenesis—
impaired fertility observed in animal studies.
l PREGNANCY Manufacturer advises avoid unless potential
benefit outweighs risk—teratogenicity in animal studies.
l BREAST FEEDING Manufacturer advises avoid—present in
Dose adjustments Manufacturer advises reduce dose for
patients receiving mg/kg dosing if creatinine clearance less
than 70 mL/minute—consult product literature.
l MONITORING REQUIREMENTS Monitor full blood count
closely (severe deterioration may require correction and
possibly treatment interruption).
l DIRECTIONS FOR ADMINISTRATION Manufacturer advises,
for intravenous infusion, give intermittently in Glucose 5%
or Sodium Chloride 0.9%. Reconstitute with Water for
Injections (500 mg/10 mL) then dilute requisite dose to a
concentration of not more than 10 mg/mL with infusion
fluid; give over 1 hour into a vein with adequate flow,
preferably using a plastic cannula.
Caution in handling Ganciclovir is a potential teratogen and
carcinogen. Manufacturer advises avoid inhalation of the
powder or direct contact of the powder or reconstituted
solution with the skin or mucous membranes; if contact
occurs, wash thoroughly with soap and water; rinse eyes
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Powder for solution for infusion
ELECTROLYTES: May contain Sodium
▶ Ganciclovir (Non-proprietary)
Ganciclovir (as Ganciclovir sodium) 500 mg Ganciclovir 500mg
powder for concentrate for solution for infusion vials | 5 vial P £125.95–£148.83
▶ Cymevene (Cheplapharm Arzneimittel GmbH)
Ganciclovir (as Ganciclovir sodium) 500 mg Cymevene 500mg
powder for solution for infusion vials | 5 vial P £148.83
Cytomegalovirus retinitis [induction and maintenance
treatment in patients with AIDS]
▶ Adult: Initially 900 mg twice daily for 21 days, then
maintenance 900 mg daily, induction regimen may be
repeated if retinitis progresses
Prevention of cytomegalovirus disease [following solid
organ transplantation from a cytomegalovirus positive
▶ Adult: 900 mg daily for 100 days (for 100–200 days
following kidney transplantation), to be started within
DOSE EQUIVALENCE AND CONVERSION
▶ Oral valganciclovir 900 mg twice daily is equivalent to
intravenous ganciclovir 5 mg/kg twice daily.
l CONTRA-INDICATIONS Abnormally low haemoglobin count
(consult product literature). abnormally low neutrophil
count (consult product literature). abnormally low platelet
count (consult product literature)
l CAUTIONS History of cytopenia . potential carcinogen
(including long-term carcinogenicity). potential teratogen
(including long-term teratogenicity).radiotherapy
l INTERACTIONS → Appendix 1: valganciclovir
▶ Common or very common Anaemia . anxiety . appetite
ulceration . pancreatitis . psychotic disorder.tremor. visual impairment
l ALLERGY AND CROSS-SENSITIVITY Contra-indicated in
patients hypersensitive to ganciclovir, aciclovir, or
l CONCEPTION AND CONTRACEPTION Manufacturer advises
women of childbearing potential should use effective
contraception during and for at least 30 days after
treatment; men with partners of childbearing potential
should be advised to use barrier contraception during and
for at least 90 days after treatment. Ganciclovir may cause
temporary or permanent inhibition of spermatogenesis—
impaired fertility observed in animal studies.
l PREGNANCY Manufacturer advises avoid unless potential
benefit outweighs risk—teratogenicity observed with
ganciclovir in animal studies.
l BREAST FEEDING Manufacturer advises avoid— ganciclovir
present in milk in animal studies.
Dose adjustments Manufacturer advises reduce dose if
creatinine clearance less than 60 mL/minute—consult
l MONITORING REQUIREMENTS Monitor full blood count
closely (severe deterioration may require correction and
possibly treatment interruption).
l PRESCRIBING AND DISPENSING INFORMATION
Valganciclovir is a pro-drug of ganciclovir.
Flavours of oral liquid formulations may include tuttifrutti.
l HANDLING AND STORAGE Manufacturer advises
reconstituted powder for oral solution should be stored in
a refrigerator (2–8°C) for up to 49 days.
Caution in handling Valganciclovir is a potential teratogen
and carcinogen. Manufacturer advises caution when
handling the powder, reconstituted solution, or broken
tablets and avoid inhalation of powder; if contact with skin
or mucous membranes occurs, wash thoroughly with soap
and water; rinse eyes thoroughly with plain water.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: oral solution
CAUTIONARY AND ADVISORY LABELS 21
▶ Valcyte (Roche Products Ltd)
Valganciclovir (as Valganciclovir hydrochloride) 50 mg per
1 ml Valcyte 50mg/ml oral solution sugar-free | 100 ml P £230.32
CAUTIONARY AND ADVISORY LABELS 21
▶ Valganciclovir (Non-proprietary)
Valganciclovir (as Valganciclovir hydrochloride)
450 mg Valganciclovir 450mg tablets | 60 tablet P £865.17–
▶ Valcyte (Roche Products Ltd)
Valganciclovir (as Valganciclovir hydrochloride) 450 mg Valcyte
450mg tablets | 60 tablet P £1,081.46 DT = £1,027.39
▶ Adult: Initially 60 mg/kg every 8 hours for 2–3 weeks,
alternatively initially 90 mg/kg every 12 hours for
2–3 weeks, then maintenance 60 mg/kg daily, then
increased if tolerated to 90–120 mg/kg daily, if disease
progresses on maintenance dose, repeat induction
Mucocutaneous herpes simplex virus infections
unresponsive to aciclovir in immunocompromised
▶ Adult: 40 mg/kg every 8 hours for 2–3 weeks or until
l UNLICENSED USE Licensed for CMV retinitis in AIDS
patients only. Foscarnet doses in BNF may differ from
l CAUTIONS Ensure adequate hydration
l INTERACTIONS → Appendix 1: foscarnet
imbalance .fever. gastrointestinal discomfort. genital
urine). haemorrhage . headache . hepatic function
infusion rate). peripheral neuropathy . proteinuria .renal
impairment. seizure . sepsis . skin reactions . thrombocytopenia .thrombophlebitis .tremor. urinary
▶ Uncommon Acidosis . angioedema . glomerulonephritis . nephropathy . pancytopenia
▶ Frequency not known Anaphylactoid reaction . diabetes
insipidus . muscle weakness . myopathy . oesophageal
ulcer. QT interval prolongation .renal pain .renal tubular
acidosis . severe cutaneous adverse reactions (SCARs)
l CONCEPTION AND CONTRACEPTION Men should avoid
fathering a child during and for 6 months after treatment.
l PREGNANCY Manufacturer advises avoid.
l BREAST FEEDING Avoid—present in milk in animal studies.
Dose adjustments Reduce dose; consult product literature.
▶ Monitor electrolytes, particularly calcium and magnesium.
▶ Monitor serum creatinine every second day during
induction and every week during maintenance.
l DIRECTIONS FOR ADMINISTRATION Avoid rapid infusion.
For intravenous infusion (Foscavir ®), give intermittently in
Glucose 5% or Sodium Chloride 0.9%; dilute to a
concentration of 12 mg/mL for infusion into peripheral
vein (undiluted solution via central venous line only);
infuse over at least 1 hour (infuse doses greater than
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
ELECTROLYTES: May contain Sodium
▶ Foscavir (Clinigen Healthcare Ltd)
Foscarnet sodium 24 mg per 1 ml Foscavir 6g/250ml solution for
infusion bottles | 1 bottle P £119.85 (Hospital only)
l DRUG ACTION Letermovir is a cytomegalovirus DNA
terminase complex inhibitor that interferes with
cytomegalovirus genome formation and virion maturation.
Prevention of cytomegalovirus reactivation and disease
[in recipients of an allogeneic haematopoietic stem cell
transplant who are seropositive for the human
cytomegalovirus] (initiated by a specialist)
▶ Adult: 480 mg once daily for 100 days post-transplant,
start within 28 days post-transplant, treatment beyond
100 days may be considered in some patients—consult
DOSE ADJUSTMENTS DUE TO INTERACTIONS
▶ Manufacturer advises reduce dose to 240 mg once daily
with concurrent use of ciclosporin.
l INTERACTIONS → Appendix 1: letermovir
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