Neonatal Herpes Simplex Virus Infection

30 mg/kg/day IV divided q8hr for 14-21 days; alternatively, 20 mg/kg IV q8hr for 14-21 days

Herpes Simplex Virus Encephalitis

3 months-12 years: 20 mg/kg IV q8hr for 10 days >12 years: 10-15 mg/kg IV q8hr for 14-21 days

Mucocutaneous Herpes Simplex Virus Infection

Treatment in immunocompromised patients <12 years: 10 mg/kg IV q8hr for 7 days >12 years: 5-10 mg/kg/day IV divided q8hr for 5-7 days

Herpes Zoster (Shingles)

<12 years (immunocompromised): 20 mg/kg IV q8hr for 7 days >12 years (immunocompetent): 800 mg PO q4hr while awake (5 times daily) for 7-10 days >12 years (immunocompromised): 30 mg/kg/day IV divided q8hr for 7-10 days

Varicella Zoster (Chickenpox)

2 years and <40 kg: 80 mg/kg/day PO divided q6hr for 5 days >40 kg: 800 mg PO q6hr for 5 days Immunocompromised patients (any age): 10 mg/kg IV q8hr for 7-10 days

Dosing Modifications
Renal impairment (IV)

CrCl 25-50 mL/min: Give recommended dose q12hr CrCl 10-25 mL/min: Give recommended dose q24hr CrCl <10 mL/min: Give 50% of recommended dose q24hr

Renal impairment (PO)

Normal dosage 200 mg q4hr or 400 mg q12hr and CrCl <10 mL/min: Decrease to 200 mg q12hr Normal dosage 800 mg q4hr and CrCl 10-25 mL/min: Decrease to 800 mg q8hr Normal dosage 800 mg q4hr and CrCl <10 mL/min: Decrease to 800 mg q12hr