FAMVIR Film-coated tablets Ref.[7810] Active ingredients: Famciclovir

Source: Medicines & Healthcare Products Regulatory Agency (GB)  Revision Year: 2018  Publisher: Novartis Pharmaceuticals UK Ltd, Frimley Business Park, Frimley, Camberley, Surrey, GU16 7SR, United Kingdom

Therapeutic indications

Varicella zoster virus (VZV) infections – herpes zoster

Famvir is indicated for:

  • the treatment of herpes zoster and ophthalmic zoster in immunocompetent adults (see section 4.4)
  • the treatment of herpes zoster in immunocompromised adults (see section 4.4)

Herpes simplex virus (HSV) infections – genital herpes

Famvir is indicated for:

  • the treatment of first and recurrent episodes of genital herpes in immunocompetent adults
  • the treatment of recurrent episodes of genital herpes in immunocompromised adults
  • the suppression of recurrent genital herpes in immunocompetent and immunocompromised adults

Clinical studies have not been conducted in HSV-infected patients immunocompromised for other causes than HIV-infection (see section 5.1).

Posology and method of administration

Herpes zoster and ophthalmic zoster in immunocompetent adults

500 mg three times daily for seven days.

Treatment should be initiated as soon as possible after a diagnosis of herpes zoster or ophthalmic zoster.

Herpes zoster in immunocompromised adults

500 mg three times daily for ten days.

Treatment should be initiated as soon as possible after a diagnosis of herpes zoster.

Genital herpes in immunocompetent adults

First episode of genital herpes: 250 mg three times daily for five days. Initiation of treatment is recommended as soon as possible after a diagnosis of first episode of genital herpes.

Episodic treatment of recurrent genital herpes: 125 mg twice daily for five days. Initiation of treatment is recommended as soon as possible after onset of prodromal symptoms (e.g. tingling, itching, burning, pain) or lesions.

Recurrent genital herpes in immunocompromised adults

Episodic treatment of recurrent genital herpes: 500 mg twice daily for seven days. Initiation of treatment is recommended as soon as possible after onset of prodromal symptoms (e.g. tingling, itching, burning, pain) or lesions.

Suppression of recurrent genital herpes in immunocompetent adults

250 mg twice daily. Suppressive therapy should be discontinued after a maximum of 12 months of continuous antiviral therapy to reassess recurrence frequency and severity. The minimum period of reassessment should include two recurrences. Patients who continue to have significant disease may restart suppressive therapy.

Suppression of recurrent genital herpes in immunocompromised adults

500 mg twice daily.

Patients with renal impairment

Because reduced clearance of penciclovir is related to reduced renal function, as measured by creatinine clearance, special attention should be given to doses in patients with impaired renal function. Dose recommendations for adult patients with renal impairment are provided in Table 1.

Table 1. Dose recommendations for adult patients with renal impairment:

Indication and nominal dose regimenCreatinine clearance [ml/min] Adjusted dose regimen
Herpes zoster in immunocompetent adults
500 mg three times daily for 7 days≥60500 mg three times daily for 7 days
40 to 59500 mg twice daily for 7 days
20 to 39500 mg once daily for 7 days
<20250 mg once daily for 7 days
Haemodialysis patients250 mg following each dialysis during 7 days
Herpes zoster in immunocompromised adults
500 mg three times daily for 10 days≥60500 mg three times daily for 10 days
40 to 59500 mg twice daily for 10 days
20 to 39500 mg once daily for 10 days
<20250 mg once daily for 10 days
Haemodialysis patients250 mg following each dialysis during 10 days
Genital herpes in immunocompetent adults – first episode of genital herpes
250 mg three times daily for 5 days≥40250 mg three times daily for 5 days
20 to 39250 mg twice daily for 5 days
<20250 mg once daily for 5 days
Haemodialysis patients250 mg following each dialysis during 5 days
Genital herpes in immunocompetent adults – episodic treatment of recurrent genital herpes
125 mg twice daily for 5 days≥20125 mg twice daily for 5 days
<20125 mg once daily for 5 days
Haemodialysis patients125 mg following each dialysis during 5 days
Genital herpes in immunocompromised adults – episodic treatment of recurrent genital herpes
500 mg twice daily for 7 days≥40500 mg twice daily for 7 days
20 to 39500 mg once daily for 7 days
<20250 mg once daily for 7 days
Haemodialysis patients250 mg following each dialysis during 7 days
Suppression of recurrent genital herpes in immunocompetent adults
250 mg twice daily≥40250 mg twice daily
20 to 39125 mg twice daily
<20125 mg once daily
Haemodialysis patients125 mg following each dialysis
Suppression of recurrent genital herpes in immunocompromised adults
500 mg twice daily≥40500 mg twice daily
20 to 39500 mg once daily
<20250 mg once daily
Haemodialysis patients250 mg following each dialysis

Patients with renal impairment on haemodialysis

Since 4 h haemodialysis resulted in up to 75% reduction in plasma penciclovir concentrations, famciclovir should be administered immediately following dialysis. The recommended dose regimens for haemodialysis patients are included in Table 1.

Patients with hepatic impairment

No dose adjustment is required in patients with mild or moderate hepatic impairment. No data are available for patients with severe hepatic impairment (see sections 4.4 and 5.2).

Elderly (≥65 years)

Dose modification is not required unless renal function is impaired.

Paediatric population

The safety and efficacy of famciclovir in children and adolescents aged less than 18 years have not been established. Currently available data are described in sections 5.1 and 5.2.

Method of administration

Famvir can be taken without regard to meals (see section 5.2).

Overdose

Overdose experience with famciclovir is limited. In the event of an overdose supportive and symptomatic therapy should be given as appropriate. Acute renal failure has been reported rarely in patients with underlying renal disease where the famciclovir dose has not been appropriately reduced for the level of renal function. Penciclovir is dialysable; plasma concentrations are reduced by approximately 75% following 4 h haemodialysis.

Shelf life

Shelf life: 3 years.

Special precautions for storage

Do not store above 25°C. Store in the original package in order to protect from moisture.

Nature and contents of container

Famvir is supplied in PVC/PCTFE/Aluminium blister packs containing 10 tablets.

Special precautions for disposal and other handling

Any unused product or waste material should be disposed of in accordance with local requirements.

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