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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

Other Antiviral drugs

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Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-10 · House clinical team