Intravenous antiviral therapy for shingles (herpes zoster)

If intravenous antiviral therapy is indicated for shingles, use:

aciclovir intravenously, 8-hourly aciclovir aciclovir aciclovir

adult and child older than 12 years: 10 mg/kg¹. For dosage adjustment in adults with kidney impairment, see aciclovir intravenous dosage adjustment

child younger than 5 years: 20 mg/kg or 500 mg/m²² ³

child 5 years to 12 years: 15 mg/kg or 500 mg/m²² ³.

For ongoing management of patients with shingles complicated by encephalitis, see Varicella zoster encephalitis.

For patients with shingles and ocular involvement, consult an ophthalmologist; see Herpes zoster ophthalmicus for additional information on management.

Switch to oral antiviral therapy after significant clinical improvement, and continue treatment for a minimum of 7 days (intravenous + oral). Longer courses of up to 14 days may be required for patients with significant immune compromise or extensive disease.

¹ Aciclovir dosing in obesity is poorly defined; however, limited data support dosing based on adjusted body weight in adults and ideal body weight in children. For simplicity, some centres recommend a maximum dosing weight of 100 kg (eg 1 g for 10 mg/kg doses, 1.5 g for 15 mg/kg doses).Return

² Use the online calculator determine body surface area.Return

³ Aciclovir dosing in obesity is poorly defined; however, limited data support dosing based on ideal body weight in children.Return