Indication

Drug and Adult Dose

Drug and Pediatric Dose

Duration

Primary varicella

Acyclovir 10 mg/kg IV Q8h

Acyclovir 10 mg/kg IV q8h

Antivirals are to be given for at least 7 days or until lesions are custed.

In SOT recipients treatment might need to be prolonged as crusting of lesions is usually delayed or for more invasive disease.

Localized Zoster

Acyclovir 800 mg PO 5 times a day

Valacyclovir 1g PO TID

Famciclovir 500 mg PO TID

Acyclovir 20 mg/kg PO 4 times a day

Valacyclovir 20 mg/kg PO TID

Disseminated Zoster Organ invasive disease Zoster ophthalmicus Ramsey-Hunt Syndrome

Acyclovir 10 mg/kg IV Q8h

Acyclovir 10 mg/kg IV Q8h

Indication

Drug

Adult Dose

Duration

Primary prophylaxis

Ganciclovir

(If CMV prophylaxis indicated)

1 g PO three times a day

First 3 months post transplant

Valganciclovir

(If CMV prophylaxis indicated)

900 mg PO once a day

Acyclovir

600-1000 mg/day (over 3-5 doses)

First 6 months post transplant

 (if not on CMV prophylaxis)

Valacyclovir

500 mg PO twice a day

Secondary prophylaxis

VariZIG

125 units/10 kg IM once

(625 units maximum, 125 units minimum)

Within 96 hours of exposure

IVIG

400 mg/kg IV once

After 96 hours of exposure

Acyclovir

800 mg PO Four times a day

For 7 days, starting on day 7-10

post exposure

Valacyclovir

1g PO three times a day