MOUTH - Herpes, Oral (Herpes simplex virus)
Acyclovir (Zovirax^®) Generics available Pregnancy: C; Lactation: Safe Caps: 200 mg Tabs: 400 mg, 800 mg Suspension: 200 mg/5 mL	Children: (>2 years and <40 kg) 20 mg/kg/day (max of 800 mg/day) in divided doses 4 times daily for 5 days. (>2 years and >40 kg) 200 mg 4 times daily for 5 days. 200 mg/ 5 mL @ 20 mg/kg/day 10 kg (22 lb) = 1.2 mL Q6H 15 kg (33 lb) = 1.8 mL Q6H 20 kg (44 lb) = 2.5 mL Q6H Adults: 200 mg 4 to 5 times daily for 5-10 days.	Food: May take without regard to food. Maintain good hydration. Important side effects: Headache, dizziness, nausea, seizures, bone-marrow suppression, nephrotoxicity. Reduce dose in severe renal disease (CrCl <10 mL/min).
Famciclovir (Famvir^®) Pregnancy: B; Lactation: Unsafe Tabs: 125 mg, 250 mg, 500 mg	Adult: 500 mg PO 3 times daily for 5 days.	Food: May be taken without regard to food. Important side effects: Nausea, diarrhea, headache, dizziness, insomnia, fatigue, rash. Reduce dose in renal disease (CrCl <60 mL/min).
Valacyclovir (Valtrex^®) Pregnancy: B; Lactation: Unk Tabs: 500 mg, 1,000 mg	Adult: First episode 1,000 mg PO twice daily for 3-7 days. Recurrent: 500 mg PO twice daily for 3-7 days.	Food: May be taken without regard to food. Maintain good hydration. Important side effects: Nausea, headache, diarrhea, dizziness, renal dysfunction, Hemolytic-Uremic Syndromes/Thrombocytopenia Purpura. Reduce dose in renal disease (CrCl <30 mL/min).
MOUTH - Oral Herpes, Pregnancy (Herpes simplex virus) Use of acyclovir and valacyclovir in pregnancy are under investigation but preliminary evidence has not found them to be detrimental to the fetus.
Acyclovir (Zovirax^®) Pregnancy: C; Lactation: Safe	Adult: 200 mg 4 to 5 times daily for 5-10 days.	Food: May take without regard to food.
Caps: 200 mg Tabs: 400, 800 mg		Important side effects: Headache, dizziness, nausea, seizures, bone-marrow suppression, nephrotoxicity. Reduce dose in severe renal disease (CrCl <10 mL/min)..
Valacyclovir (Valtrex^®) Pregnancy: B; Lactation: Unk Tabs: 500 mg, 1,000 mg	Adult: First episode 1,000 mg PO twice daily for 3-7 days. Recurrent: 500 mg PO twice daily for 3-7 days.	Food: May be taken without regard to food. Maintain good hydration. Important side effects: Nausea, headache, diarrhea, dizziness, renal dysfunction, HUS/TTP. Reduce dose in severe renal disease (CrCl <30 mL/min).
Acyclovir Topical 5% Pregnancy: C; Lactation Unk Topical 5%	Adult: Apply to lesions on lips 6 times daily for 7 days.

Section contributor: Jill Shelton Wagers, DMD, Boise, ID