FAMCICLOVIR

By Dr. Sujata Maurya

FAMCICLOVIR
• Anti-viral
drug, a nucleoside analogue
•oral prodrug of Penciclovir

•Other nucleoside analogue-

1. Acyclovir
2. Valacyclovir
3. Famciclovir
MECHANISM OF ACTION
MECHANISM OF ACTION
PHARMACOKINETICS
•Famciclovir is converted to Penciclovir(PCV) by first-pass
metabolism

•PCV triphosphate has a much longer intracellular half-life (10–20

hours in HSV-infected cells and 7 hours in VZV-infected cells)

•77% bioavailability

•No hepatic metabolism

•Excretion by urine
CLINICAL USE
HERPES SIMPLEX INFECTION
1.Orofacial HSV infection
•use in primary infection
•episodic treatment for recurrent orofacial HSV

2.Genital HSV infection

•primary infection
•episodic treatment of recurrent infections
•continuous suppressive therapy
OROFACIAL HERPES SIMPLEX
INFECTION
•Primary infection- Famciclovir, 250 mg orally 3 times a day-7-
10 days

•Recurrent infection:episodic treatment-

Famciclovir, 500 mg orally 2 or 3 times a day
Famciclovir, 1500 mg single dose or
750 mg twice a day for 1 day
 GENITAL HERPES SIMPLEX
INFECTION
•Primary infection- Famciclovir, 250 mg orally 3 times a day-7–10 days

•Recurrent infection- Famciclovir, 500 mg, 250 mg, 125 mg orally twice a day
Famciclovir, 1 g orally twice a day for 1 day (patient
initiated)
Famciclovir, 500 mg, then 250 mg twice daily for 2
days

•Suppression of recurrences- Famciclovir, 250 mg orally twice a day

Famciclovir, 125 mg, 250 mg orally 3 times a day
HERPES ZOSTER INFECTION
•In immunocompetent patients dose is 500 mg orally TID for
7days

•During the acute phase, FCV significantly

1.accelerates lesion healing
2.reduces the duration of viral shedding
3.Reduces duration of acute pain.

•Importantly, FCV was found to decrease the duration of PHN

HERPES ZOSTER INFECTION
•In immunocompromised patient

•Dose of FCV is 500 mg TID for 10 days

OFF LABEL DERMATOLOGICAL
USES
•Primary gingivostomatitis

• Herpes gladiatorum

•Eczema herpeticum

• Herpetic whitlow

•Herpetic keratoconjunctivitis
CONTRAINDICATION
Hypersensitivity to Famciclovir
WARNINGS AND PRECAUTIONS
•For varicella start therapy within 24 hours of rash onset

•Maintain adequate hydration during therapy

•Famciclovir may contain lactose (caution patients with lactose

intolerance)
WARNINGS AND PRECAUTIONS
•Renal failure from rapid IV administration

•Thrombotic microangiopathy in immunocompromised

patients

•Neurotoxicity with higher doses and reduced renal

function

• Reduce dosage in patients with renal impairment

PREGNANCY CATEGORY
•Pregnancy Category B

•Lactating mothers-should be avoided

•Patients <18 years of age

FORMULATION
Tablets: 125 mg, 250 mg, 500 mg
Suspension: 125mg/ml
FAMCIMAC Rs. 94/Tablet
MICROVIR-250 Rs. 50/Tablet
HERPINIL-F 250 Rs.55.0/Tablet
ADVERSE EFFECTS
•Headache

•Nausea

•Diarrhea
DRUG INTERACTION
1. Digoxin- FCV may increase serum digoxin level by 20%.

2. Varicella vaccine- Avoid vaccine 1 day before FCV and

atleast 2 weeks after the antiviral therapy.

3. Chemotherapy agent- combination may decrease

efficacy of this melanoma intralesional therapy.

4. Probenecid: May increase penciclovir levels. Monitor for

evidence of penciclovir toxicity
THANK YOU