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Penciclovir


Pronunciation

 (pen SYE kloe veer)


U.S. Brand Names

 Denavir®


Generic Available

 No


Use

 Topical treatment of herpes simplex labialis (cold sores)


Pregnancy Risk Factor

 B


Lactation

 Excretion in breast milk unknown


Contraindications

 Hypersensitivity to the penciclovir or any component of the formulation; previous and significant adverse reactions to famciclovir


Warnings/Precautions

 Penciclovir should only be used on herpes labialis on the lips and face; because no data are available, application to mucous membranes is not recommended. Avoid application in or near eyes since it may cause irritation. The effect of penciclovir has not been established in immunocompromised patients.


Adverse Reactions

>10%: Dermatologic: Mild erythema (50%)

1% to 10%: Central nervous system: Headache (5.3%)

<1%: Local anesthesia (0.9%)

Postmarketing and/or case reports: Application site reaction, local edema, urticaria, pain, pruritus, paresthesia, skin discoloration, erythematous rash, oropharyngeal edema, parosmia


Overdosage/Toxicology

 Penciclovir is poorly absorbed if ingested orally. Adverse reactions related to oral ingestion are unlikely.


Drug Interactions

 No data reported


Stability

 Store at controlled room temperature of 20°C to 25°C (68°F to 77°F).


Mechanism of Action

 In cells infected with HSV-1 or HSV-2, viral thymidine kinase phosphorylates penciclovir to a monophosphate form which, in turn, is converted to penciclovir triphosphate by cellular kinases. Penciclovir triphosphate inhibits HSV polymerase competitively with deoxyguanosine triphosphate. Consequently, herpes viral DNA synthesis and, therefore, replication are selectively inhibited


Pharmacodynamics/Kinetics

 Absorption: Topical: None


Dosage

 Children 12 years and Adults: Topical: Apply cream at the first sign or symptom of cold sore (eg, tingling, swelling); apply every 2 hours during waking hours for 4 days


Monitoring Parameters

 Reduction in virus shedding, negative cultures for herpes virus; resolution of pain and healing of cold sore lesion


Patient Education

 This is not a cure for herpes (recurrences tend to appear within 3 months of original infection), nor will this medication reduce the risk of transmission to others when lesions are present. For external use only. Wash hands before and after application. Apply this film over affected areas at first sign of cold sore. Avoid use of other topical creams, lotions, or ointments unless approved by prescriber. You may experience headache, mild rash, or taste disturbances. Breast-feeding precaution: Consult prescriber if breast-feeding.


Additional Information

 Penciclovir is the active metabolite of the prodrug famciclovir. Penciclovir is an alternative to topical acyclovir for HSV-1 and HSV-2 infections. Neither drug will prevent recurring HSV attacks.


Dental Health: Effects on Dental Treatment

 No significant effects or complications reported


Dental Health: Vasoconstrictor/Local Anesthetic Precautions

 No information available to require special precautions


Mental Health: Effects on Mental Status

 None reported


Mental Health: Effects on Psychiatric Treatment

 None reported


Dosage Forms

 Cream: 1% (1.5 g)


References

Alrabiah FA and Sacks SL, "New Antiherpesvirus Agents. Their Targets and Therapeutic Potential," Drugs , 1996, 52(1):17-32.


International Brand Names

 Famvir® [extern.] (AT); Famvir® [extern.] (BR, CH, NL); Penciclovir Visfarm® (ES); Pentavir® (AR); Vectavir® (BE, BG, DE, DK, ES, FI, GB, HR, HU, IL, IT, NL, NO, PL, RO, RU, SE)


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