Oral Famciclovir for Suppression of Recurrent Genital Herpes Simplex Virus Infection in Women

Abstract

Oral famciclovir, 250 mg, given twice daily for 4 months is an effective, well-tolerated treatment for the suppression of genital herpes in women with frequent recurrences, but single daily doses produced less complete suppression of genital herpes.

A review of famciclovir in the management of genital herpes

“…Women (n = 375) with a history of six or more episodes of recurrent genital herpes per year were treated with famciclovir (125 mg, once or twice daily; 250 mg, once or twice daily; or 500 mg, once daily) or placebo for four months. 29 All doses of famciclovir were effective in suppressing HSV recurrences; however, famciclovir in doses of 250 mg, twice daily, was clearly the most effective. 29 In addition, the proportion of patients who remained free of HSV recurrences during the 120-day study increased from 48% in the placebo-treated group to 90% in patients receiving famciclovir in doses of 250 mg, twice daily (P < 0.001).…”

“…29 All doses of famciclovir were effective in suppressing HSV recurrences; however, famciclovir in doses of 250 mg, twice daily, was clearly the most effective. 29 In addition, the proportion of patients who remained free of HSV recurrences during the 120-day study increased from 48% in the placebo-treated group to 90% in patients receiving famciclovir in doses of 250 mg, twice daily (P < 0.001). 29 The meta-analysis of two year-long clinical trials, in which 369 patients were enrolled (236 receiving famciclovir, 250 mg, twice daily; 133 receiving placebo), showed that 80% fewer genital herpes outbreaks occurred in famciclovir-treated patients (median number of recurrences was 1) than in placebo-recipients (median number of recurrences was 4.9) (Data on file, SmithKline Beecham Pharmaceuticals).…”

“…These and other studies show that once-daily dosing is less effective at preventing outbreaks than is multidosing. [29][30][31] The efficacy of famciclovir for the treatment of first-episode genital herpes was evaluated in three studies, which enrolled a total of 951 patients. In two of these studies, famciclovir, 250 mg, 500 mg, and 750 mg, three times for a day for five days, was compared with acyclovir, 200 mg, five times a day for five days; in the third study, famciclovir, 125 mg, 250 mg, and 500 mg, three times a day for 10 days, was compared with acyclovir, 200 mg, five times a day for 10 days.…”

Sexually Transmitted Diseases of the Vulva

“…Shorter courses of treatment have also been shown to be effective (Leone et al 2002, Strand et al 2002, Aoki et al 2006. Studies of individuals with six or more recurrences a year have shown benefit with continuous daily suppressive treatment with one of the three antivirals named above (Kaplowitz et al 1991, Mertz et al 1997, Corey et al 2004. Such individuals suffer fewer or no recurrences.…”

Famciclovir treatment options for patients with frequent outbreaks of recurrent genital herpes: The RELIEF trial

“…Suppressive therapy can reduce the frequency of symptomatic recurrences and asymptomatic viral shedding. 1,7 Famciclovir (Famvir ® , Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA), a prodrug of the antiviral agent penciclovir, has been shown to be effective as both episodic [8][9][10] and suppressive [11][12][13] treatment of recurrent genital herpes.…”