Drug reference
Famciclovir
Antiviral
Also known as FCV, FAMVIR
AntiviralATC J05AB09
CDSCO approvedSchedule HATC J05AB09
EXCRETION
—
not curated
INTERACTIONS
—
none in our sources
PREGNANCY
Manufacturers advise avoid unless potential benefit outweighs risk.
FDA category + note
Mechanism
Famciclovir is a prodrug that is rapidly converted to its active metabolite, penciclovir. Penciclovir is an antiherpesvirus agent that interferes with herpesvirus replication. Similar to other agents in its class, it likely inhibits viral DNA synthesis by targeting viral enzymes involved in genome replication.
Indications
Herpes zosterGenital herpesHSV infectionsVZV infectionsfirst-episode genital herpesrecurrent genital HSVsuppression of recurrent genital HSVchronic HBV hepatitis (reduces HBV DNA and transaminase levels, but less effective than lamivudine)herpes simplex keratitis (off-label)herpes zoster ophthalmicusgenital herpes simplex (first episode)genital herpes simplex (recurrent episode)genital herpes simplex (suppressive treatment)orolabial herpesherpes zoster (reduces duration of post herpetic neuralgia)chronic hepatitis B (less active alternative to lamivudine, but not for resistant cases)ZosterSuppression of genital herpesRecurrent mucocutaneous herpes in patients with HIV infection
Dosing
- Adult
- For Herpes zoster infection, treatment: 500 mg 3 times a day for 10 days, continue for 2 days after crusting of lesions; alternatively, 250 mg 3 times a day for 5 days.
- Renal adjustment
- Reduce dose; consult product literature.
- Hepatic adjustment
- Efficacy may be decreased in severe impairment (risk of impaired conversion to active metabolite, no information available).
Pharmacokinetics
Half-life
9.9 h (plasma elimination in renal insufficiency [Clcr <30 mL/min]); 7 to 20 h (intracellular penciclovir triphosphate)
Bioavailability
~75% (oral)
Metabolism
Prodrug of penciclovir, converted to its active metabolite.
Excretion
Penciclovir (60% of dose) and its 6-deoxy precursor (<10% of dose) eliminated primarily in the urine
Side effects
Common
Abdominal paindiarrhoeadizzinessheadachenauseaskin reactionsvomitingdiarrhealoose motionsitchingrashesmental confusion
Serious
- Angioedema
- confusion
- drowsiness
- Hallucination
- jaundice cholestatic
- palpitations
- thrombocytopenia
- urticaria
- rash
- hallucinations
- confusional states (predominantly in the elderly)
Pregnancy & lactation
Pregnancy
Manufacturers advise avoid unless potential benefit outweighs risk.
Lactation
No information available—present in milk in animal studies.
Related guidelines
Hepatitis B — chronic infection
EASL · Gastroenterology · 2025
Hepatitis B — chronic infection
INASL · Gastroenterology · 2023
Skin and soft tissue infections
IDSA · Infectious Diseases · 2010
Hepatitis B — chronic infection
WHO · Hepatology · 2025
Hepatitis C — chronic infection
EASL · Gastroenterology · 2020
Other Antiviral drugs
Ask House about Famciclovir
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Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-10 · House clinical team