. Author manuscript; available in PMC: 2016 Mar 13.

Published in final edited form as: N Engl J Med. 2013 Jul 18;369(3):255–263. doi: 10.1056/NEJMcp1302674

Table 3.

Antiviral Therapy for Herpes Zoster^*

Medication	Dose	Effects Observed in Controlled Trials	Side Effects
Nonimmunocompromised persons
Acyclovir (oral)	800 mg po 5 times daily for 7–10 days	Reduced time to last new lesion formation, loss of vesicles, full crusting, cessation of viral shedding; reduced severity of acute pain^10–12	malaise
Famiclovir (oral)	500 mg po 3 times daily × 7 days	Reduced time to last new lesion formation, loss of vesicles, full crusting, cessation of viral shedding, cessation of pain^13,14	headache, nausea
Valacyclovir (oral)	1 gm po 3 times daily × 7 days	Reduced time to last new lesion formation, loss of vesicles, full crusting, cessation of pain^15,16	headache, nausea
Immunocompromised persons requiring hospitalization or severe neurologic complications
Acyclovir (intravenous)	10 mg/kg iv every 8 hrs × 7–10 days	Reduced time to last new lesion formation, full crusting, cessation of virus shedding, cessation of pain; reduced cutaneous dissemination, reduced visceral zoser^17,18	renal insufficiency
Foscarnet⁺ (for acyclovir-resistant VZV)	40 mg/kg every 8 hr until healed	not reported	renal insufficiency, hypokalemia, hypocalcemia, hypomagnesemia, hypophosphatemia, nausea, diarrhea, vomiting, anemia, granulocytopenia, headache

All drugsin this table are available as generics

⁺

Not approved for this use by FDA