Adapted from: Basic & Clinical Pharmacology, 11e

Bertram G. Katzung, Susan B. Masters, Anthony J. Trevor (ed.); available through McGraw Hills Access
Medicine; Tables 49-1; 49-2
Agents to Treat or Prevent Herpes Simplex Virus (HSV) and Varicella-Zoster Virus (VZV)
Infections.

Route of Administration Use

Adverse events

Acyclovir
Oral

First episode genital herpes headache, diarrhea & nausea may occur
Recurrent genital herpes
Genital herpes suppression
Herpes proctitis
Orolabial herpes
Orolabial or genital herpes suppression
Mucocutaneous herpes in the immunocompromised host
Varicella
Zoster
Intravenous Severe HSV infection reversible renal or neurologic toxicity

Mucocutaneous herpes in the immunocompromised host

Herpes encephalitis
Neonatal HSV infection
Varicella or zoster in the immunosuppressed host
Topical Herpes labialis
Topical (5% cream) Recurrent herpes labialis
Famciclovir
Oral
First episode genital herpes headache, diarrhea & nausea may occur
Recurrent genital herpes
Genital herpes suppression
Orolabial herpes
Orolabial or genital herpes in the immunosuppressed host
Orolabial or genital herpes suppression
Zoster
Valacyclovir
Oral
First episode genital herpes nausea, vomiting, or rash occasionally occur
high doses: confusion, hallucinations & seizures
chronic high-dosage: gastrointestinal intolerance, thrombotic thrombocytopenic purpura &hemolytic-uremic syndrome
Recurrent genital herpes
Genital herpes suppression
Orolabial herpes
Orolabial or genital herpes in the immunosuppressed host
Orolabial or genital herpes suppression
Zoster
Foscarnet
Intravenous Acyclovir-resistant HSV & VZV infections (see next table)

Agents to Treat Cytomegalovirus (CMV) Infection.

Agent
Route of Administration Use Adverse events
Valganciclovir
Oral CMV retinitis
(same as ganciclovir)
CMV prophylaxis (transplant patients)
Ganciclovir IntravenousCMV retinitis, colitis, esophagitis, & pneumonitis
Myelosuppression most
common (after IV)
IV or oral: nausea, diarrhea, fever, rash, headache, insomnia, & peripheral neuropathy
rare: confusion, seizures, psychiatric disturbance & hepatotoxicity
Oral CMV prophylaxis
CMV retinitis
Intraocular implant
CMV retinitis
Foscarnet IntravenousCMV retinitis
Nausea, vomiting, anemia, elevation of liver enzymes & fatigue
CNS toxicities: headache, hallucinations & seizures
Potential adverse effects: renal impairment, hypo- or hypercalcemia, hypo- or hyperphosphatemia,
hypokalemia & hypomagnesemia
Cidofovir
IntravenousCMV retinitis
proximal tubular nephrotoxicity
possible effects: Proteinuria, azotemia, metabolic acidosis, and Fanconi's syndrome, uveitis, ocular
hypotony, and neutropenia