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41. Chickenpox in Pregnancy

that there is no increase in the risk of major fetal malformation with aciclovir exposure in pregnancy. 42–44 A Danish registry-based cohort study of 837 795 live births between 1996 and 2008 43 reported the pregnancy outcome in 1804 pregnancies exposed to aciclovir, valciclovir or famciclovir in the first trimester. The rate of major birth defects in the exposed group was 2.2% compared to 2.4% in the unexposed (adjusted prevalence odds ratio 0.89, 95% CI 0.65–1.22). The most common antiviral drug used was aciclovir (...) systemic prenatal acyclovir exposure: Conclusions from the international acyclovir pregnancy registry, 1984–99. Birth Defects Res A Clin Mol Teratol 2004;70:201–7. 43. Pasternak B, Hviid A. Use of acyclovir, valacyclovir and famciclovir in the first trimester of pregnancy and the risk of birth defects. JAMA 2010;304:859–66. 44. Mills JL, Carter TC. Acyclovir exposure and birth defects: an important advance, but more are needed. JAMA 2010;304:905–6. 45. Daley AJ, Thorpe S, Garland SM. Varicella

2015 Royal College of Obstetricians and Gynaecologists

42. Shingles

neuralgia [Chen, 2014]. The review found insufficient evidence from RCTs to ascertain whether this is also the case for other antiviral drugs. Previous changes Previous changes May 2018 — minor update. Eligible ages for the shingles vaccination has been updated in line with Public Health England (PHE) guidance. See the section on for more information. October 2017 — minor update. Seizure has been included as a possible adverse effect of famciclovir. January 2017 — minor update. Correction made to advice (...) in immunocompromised people, and recurrences are more likely to be associated with aciclovir-resistant strains [ ]. Pain inadequately controlled or considering a strong opioid This recommendation is based on what CKS considers to be good clinical practice. Antiviral treatment When should I prescribe oral antiviral treatment? If admission or immediate specialist advice is not , c onsider the need for oral antiviral treatment (aciclovir, valaciclovir, or famciclovir). Prescribe an oral antiviral treatment within 72

2018 NICE Clinical Knowledge Summaries

44. WHO guidelines for the treatment of Genital Herpes Simplex Virus

. Strong recommendation, moderate quality evidence For adults and adolescents with a first clinical episode of genital HSV infection, the WHO STI guideline suggests a standard dose of aciclovir over valaciclovir or famciclovir. Dosages: • aciclovir 400 mg orally thrice daily for 10 days (standard dose) • aciclovir 200 mg orally five times daily for 10 days • valaciclovir 500 mg orally twice daily for 10 days • famciclovir 250 mg orally thrice daily for 10 days Remarks: Given that follow-up visits may (...) not be possible during the course of treatment and symptoms of the first clinical episode may be prolonged, therapy is provided for 10 days. Although the benefits of the medicines are probably similar, the costs of valaciclovir and famciclovir are higher than aciclovir, and therefore aciclovir is preferred. The choice of medicine may also depend on compliance considerations. This recommendation also applies to people living with HIV, people who are immunocompromised, people with a severe episode and pregnant

2016 World Health Organisation Guidelines

46. Management of Genital Herpes in Pregnancy

effects have been reported. Aciclovir is well tolerated in pregnancy. For treatment courses no dose adjustment is necessary. 23,24 There is no evidence of an increased risk of birth defects with aciclovir, famciclovir or valaciclovir if used in the first trimester. 22 Safety data for aciclovir may be extrapolated to valaciclovir in late pregnancy, as it is the valine ester, but as there is less experience with the use of valaciclovir or famciclovir, they are not recommended as a first- line treatment (...) , Sørensen HT. Adverse pregnancy outcome in women exposed to acyclovir during pregnancy: a population-based observational study. Scand J Infect Dis 2003;35:255–9. 22. Pasternak B, Hviid A. Use of acyclovir, valacyclovir, and famciclovir in the first trimester of pregnancy and the risk of birth defects. JAMA 2010;304:859–66. 23. Frenkel LM, Brown ZA, Bryson YJ, Corey L, Unadkat JD, Hensleigh PA, et al. Pharmacokinetics of acyclovir in the term human pregnancy and neonate. Am J Obstet Gynecol 1991;164:569

2014 Royal College of Obstetricians and Gynaecologists

47. UK National Guideline for the Management of Anogenital Herpes

with the probability of this over HSV-2 being greater at younger age, (females 500) although there is very limited trial evidence to support this approach. One trial with famciclovir has reported this effect. 85 Dosage of antivirals • Providing there is no evidence of immune failure standard doses of antivirals should suffice (Ib,A). In those with advanced disease it may be necessary to double the standard dose and to continue therapy beyond 5 days (Ib,B). Currently there is no evidence to support the use (...) be substituted. In others, where the pre-treatment pattern of recurrences resumes, suppressive treatment may need to restart (Evidence level IV, C) • Recommended drug regimens for daily suppressive treatment 23,86,87 o Aciclovir 400 mg orally twice to three times a day o Valaciclovir 500 mg orally twice a day • If these options do not adequately control disease then the first option should be to double the dose. If control is still not achieved then famciclovir 500 mg orally twice a day can be tried. (IIa,B

2015 British Association for Sexual Health and HIV

48. Herpes zoster involving the abducens and vagus nerves without typical skin rash: A case report and literature review. Full Text available with Trip Pro

for VZV DNA was positive at the skin lesion. The patient was diagnosed as having herpes zoster associated with vagus and sixth nerve palsy.She received famciclovir at a dose of 500 mg 3 times daily for 7 days and coadministered methylprednisolone. At the 4-month follow-up, her diplopia and eye movement had resolved completely.In patients with abducens nerve palsy without typical vesicular lesion, herpes zoster may not be detected early. In that case, systemic examination is very important

2019 Medicine

49. Herpes simplex - genital

five times a day for 5–10 days, or alternatively: Valaciclovir 500 mg orally twice a day for 5–10 days. Famciclovir 250 mg orally three times a day for 5–10 days. Advise all people about appropriate to help relieve symptoms. Topical antiviral drugs are not recommended, as they offer minimal clinical benefit. Basis for recommendation Basis for recommendation These recommendations are based on the British Association for Sexual Health and HIV (BASHH) UK national guideline for the management (...) recommends using clinical judgement when determining the dose of antivirals and the duration of treatment. Topical antivirals Topical agents are less effective than oral agents, and combining oral and topical treatment is of no additional benefit over oral treatment alone [ ]. Choice of oral antiviral There is no evidence of a difference in efficacy, tolerability, or toxicity between aciclovir, valaciclovir, or famciclovir in the management of primary genital herpes [ ]. UK guidelines recommend aciclovir

2017 NICE Clinical Knowledge Summaries

51. [Shallow Fire-needle Acupuncture Stimulation Plus Cupping Relieves Neuralgia and Down-regulates Serum Substance P Level in Patients with Acute Herpes Zoster]. (Abstract)

in each). Patients of both groups were ordered to take Famciclovir (0.25 g/time, three times a day) and Mecobalamin (0.5 g/time, three times a day) orally for 7 days. In addition, patients of the treatment group were also treated by repeated shallow fire-needle stimulation and cupping, once a day for 7 days. Before and after the treatment, the patient's pain severity was assessed using visual analogue scale (VAS) and serum SP concentration was measured using ELISA.After the treatment, the VAS scores

2018 Zhen ci yan jiu = Acupuncture research Controlled trial quality: uncertain

52. Trial of C134 in Patients With Recurrent GBM

within 2 weeks of scheduled IRS1-chimeric HSV1 administration. Active oral herpes lesion. Concurrent therapy with any drug active against HSV (acyclovir, valaciclovir, penciclovir, famciclovir, ganciclovir, foscarnet, cidofovir). Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or any other medical condition that precludes surgery . Also, psychiatric illness/social

2018 Clinical Trials

53. Clinical Trial of Herbal Treatment Gene-Eden-VIR/Novirin in Oral Herpes Full Text available with Trip Pro

Clinical Trial of Herbal Treatment Gene-Eden-VIR/Novirin in Oral Herpes Our previous articles showed that suppressive or preventive treatment with the herbal Gene-Eden-VIR/Novirin reduced the number and duration of genital herpes outbreaks with no adverse effects. These studies also revealed that the herbal Gene-Eden-VIR/Novirin is mostly superior to acyclovir, valacyclovir, and famciclovir drugs in genital herpes. This study tested the effect of Gene-Eden-VIR/Novirin in oral herpes (also

2018 Journal of Evidence-based Integrative Medicine Controlled trial quality: uncertain

54. Volatile Acid-Solvent Evaporation (VASE): Molecularly Homogeneous Distribution of Acyclovir in a Bioerodable Polymer Matrix for Long-Term Treatment of Herpes Simplex Virus-1 Infections Full Text available with Trip Pro

Volatile Acid-Solvent Evaporation (VASE): Molecularly Homogeneous Distribution of Acyclovir in a Bioerodable Polymer Matrix for Long-Term Treatment of Herpes Simplex Virus-1 Infections Treatment for herpes simplex virus-1 and -2 (HSV-1 and -2) patients who suffer from recurrent outbreaks consists of multiple daily doses of the antiviral drugs acyclovir (ACV), penciclovir, or their more orally bioavailable derivatives valacyclovir or famciclovir. Drug troughs caused by missed doses may result

2018 Journal of drug delivery

55. Variation in the Reported Management of Canine Prolapsed Nictitans Gland and Feline Herpetic Keratitis Full Text available with Trip Pro

FHV-1 keratitis with topical antibiotics (76.4%), with a minority suggesting topical antivirals (32.2%). GPs favoured topical acyclovir whilst PGs more frequently recommended topical trifluorothymidine. A significantly larger proportion of PGs nominated systemic famciclovir and lysine supplement for FHV-1 keratitis. This survey revealed moderate treatment variation for these conditions, both between and within practitioner groups. Additional research is needed to assess the reasons

2018 Veterinary Sciences

56. A Phase 2 Trial to Evaluate the Safety and Efficacy of UB-621 in Adults With Recurrent Genital HSV-2 Infection.

, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Subject must be HSV-2 seropositive Subjects have a history of recurrent genital herpes in the past year Subjects have a negative result on the HIV Ab/Ag assay Subjects must agree to use contraception during study participation Exclusion Criteria: Documented HSV resistance to acyclovir, valacyclovir, famciclovir, or penciclovir History or current evidence of malignancy except for a localized non

2018 Clinical Trials

57. Letermovir Versus Valganciclovir to Prevent Human Cytomegalovirus Disease in Kidney Transplant Recipients (MK-8228-002)

to receive during the study any of the following anti-CMV IgG antibody treatment or anti-CMV drug therapy including the following: Cidofovir, CMV hyper-immune globulin, Any investigational CMV antiviral agent/biologic therapy. Has received within 7 days prior to randomization or plans to receive during the study any of the following anti-CMV drug therapy: LET, GCV, VGCV, Foscarnet, ACV, Valacyclovir, Famciclovir. Is a user of recreational or illicit drugs or has had a recent history (within the last year

2018 Clinical Trials

58. Pharmacologic Interventions for Bell's Palsy

% confidence intervals [CI], -18% to 17.6%). However, the analysis lacked the statistical precision to exclude an important beneficial effect (or harm) from the addition of valacyclovir. A Class IV study observed a significant improvement in recovery (RD 26.6%) between patients with severe Bell palsy treated with prednisone alone and patients with severe Bell palsy treated with prednisone plus famciclovir (House-Brackmann Scale score of 5 or 6). This study had a high risk of bias because

2014 National Guideline Clearinghouse (partial archive)

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