PAEDIATRIC ACYCLOVIR DOSING

Indicatons
Genital HSV
infection

Dose
Infants and Children <12 years: Immunocompetent (off-label use):
Initial episode : PO 40-80 mg/kg/day divided into 3-4 doses for 5-10 days (maximum: 1000
mg daily)
Chronic suppression: PO 40-80 mg/kg/day in 3 divided doses for 12 months; (maximum:
1000 mg daily)
Recurrent infection: PO 20-25 mg/kg/dose twice daily; maximum dose: 400 mg
Children 12 years and Adolescents: Immunocompetent (off-label use):
Initial episode: PO 200 mg q4h while awake (5 times daily) or 400 mg tds for 7-10 days;
treatment can be extended beyond 10 days if healing is not complete
Chronic suppression: PO 800 mg daily in 2 divided doses for 12 continuous months

Herpes Zoster
HSV, Herpes
Labialis

Recurrent infection: PO 200 mg every 4 hours while awake (5 times daily) for 5 days or 800
mg twice daily for 5 days or 800 mg 3 times daily for 2 days
Children 12 years and Adolescents: Immunocompetent (off-label use): PO 800 mg 5 times
daily for 5-7 days
PO 30 mg/kg/day in 3 divided doses for up to 12 months (maximum: 1000 mg
daily). Note: Re-evaluate after 12 months

Varicella Zoster
Begin treatment within the first 24 hours of rash onset:
Children 2 years and 40 kg: Immunocompetent: 20 mg/kg/dose (maximum: 800 mg per
dose) 4 times daily for 5 days
Children >40 kg: Immunocompetent: 800 mg 4 times daily for 5 days
Note: The CDC HIV guidelines recommended duration of therapy is 7-10 days or until no new
lesions for 48 hours (for patients with mild varicella and no or moderate immune
suppression) (CDC, 2009).