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Varicella

Updated : September 17, 2022





Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

immune globulin IM (IGIM) 

For Prophylaxis:

0.6 - 1.2

mL/kg

Intramuscular (IM)

within six days of exposure


Note: take only the varicella-zoster IG (Human) is unavailable 



varicella zoster immune globulin, human 

Indicated for the reduction of infection severity after exposure
625 units intramuscularly within 10 days post-exposure (within 96 hours)
Administer the total dose 3 weeks later the initial dose in patients who are additionally exposed to this virus



acyclovir 

For those over 40 kg (immunocompetent), take 800 mg orally every 6 hours for a period of 5 days.
Patients with impaired immune systems: 10–15 mg/kg IV every 8 hours for 7–10 days
Use ideal body weight while treating obese individuals (IBW)



Dose Adjustments

Renal dose adjustments
dose modification in accordance with standard dosage guidelines and renal clearance
200 milligrams every four hours:
200 mg every 12 hours; 0–10 mL/min/1.73 m²
More than 10 mL/min/1.73 m²: 200 mg five times a day every four hours
400 mg every 12 hours :
200 mg every 12 hours for 0–10 mL/min/1.73 m²
Exceeding 10 mL/min/1.73 m²: 400 mg per 12-hour period
800 mg every 4 hours :
0–10 mL/min/1.73 m²: 800 mg every 12 hours
800 mg every 8 hours at 10–25 mL/min/1.73 m²
More than 25 mL/min/1.73 m²: 800 mg five times a day every four hours
Changing the dosage according to the dosage form:
Renal impairment (IV)
Administer prescribed dose every 12 hours when CrCl is 25–50 mL/min/1.73 m²
10–25 mL/min/1.73 m² of CrCl: Administer the prescribed dosage once every 24 hours
Give 50% of the recommended dose every 24 hours if the CrCl is less than 10 mL/min/1.73 m²
Renal impairment (Oral)
When the CrCl is less than 10 mL/min/1.73 m², the normal dosage of 200 mg every 4 hours or 400 mg every 12 hours should be reduced to 200 mg every 12 hours
CrCl 10–25 mL/min/1.73 m² and the usual dosage of 800 mg every 4 hours: Reduce to 800 mg every 8 hours
If the CrCl is less than 10 mL/min/1.73 m², reduce the normal dosage to 800 mg every 12 hours

 

immune globulin IM (IGIM) 

For Prophylaxis: the dose of 0.6-1.2 mL/kg IM within six days of exposure   
Note: take only the varicella-zoster IG (Human) is unavailable  



varicella zoster immune globulin, human 

Indicated for the reduction of infection severity after exposure
125 IU/10 kg intramuscularly
Do not exceed more than 625 IU/dose
Administer the dose within 4-10 days post-exposure
For <2kg: 62.5 IU intramuscularly
2.1-10 kg: 125 IU intramuscularly
10.1-20 kg: 250 IU intramuscularly
20.1-30 kg: 375 IU intramuscularly
30.1-40 kg: 500 IU intramuscularly
More than 40 kg: 625 IU intramuscularly
Administer the second dose 3 weeks later the initial dose in patients who are additionally exposed to this virus



acyclovir 

Children under 40 kg and 2 years old: 20 mg/kg/dose taken orally every 6 hours for 5 days, with a maximum dose of 800 mg
Use ideal body weight while treating obese individuals (IBW):
Over 40 kg: 800 mg taken orally every 6 hours for 5 days
In patients with impaired immune systems:
Less than 12 years old: intravenously (IV) administer 20 mg/kg/dose every 8 hours for 7 days
Elderly adults: 10 mg/kg/dose IV given every 8 hours for a period of 7 days



 

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References

Varicella

Updated : September 17, 2022




immune globulin IM (IGIM) 

For Prophylaxis:

0.6 - 1.2

mL/kg

Intramuscular (IM)

within six days of exposure


Note: take only the varicella-zoster IG (Human) is unavailable 



varicella zoster immune globulin, human 

Indicated for the reduction of infection severity after exposure
625 units intramuscularly within 10 days post-exposure (within 96 hours)
Administer the total dose 3 weeks later the initial dose in patients who are additionally exposed to this virus



acyclovir 

For those over 40 kg (immunocompetent), take 800 mg orally every 6 hours for a period of 5 days.
Patients with impaired immune systems: 10–15 mg/kg IV every 8 hours for 7–10 days
Use ideal body weight while treating obese individuals (IBW)



Dose Adjustments

Renal dose adjustments
dose modification in accordance with standard dosage guidelines and renal clearance
200 milligrams every four hours:
200 mg every 12 hours; 0–10 mL/min/1.73 m²
More than 10 mL/min/1.73 m²: 200 mg five times a day every four hours
400 mg every 12 hours :
200 mg every 12 hours for 0–10 mL/min/1.73 m²
Exceeding 10 mL/min/1.73 m²: 400 mg per 12-hour period
800 mg every 4 hours :
0–10 mL/min/1.73 m²: 800 mg every 12 hours
800 mg every 8 hours at 10–25 mL/min/1.73 m²
More than 25 mL/min/1.73 m²: 800 mg five times a day every four hours
Changing the dosage according to the dosage form:
Renal impairment (IV)
Administer prescribed dose every 12 hours when CrCl is 25–50 mL/min/1.73 m²
10–25 mL/min/1.73 m² of CrCl: Administer the prescribed dosage once every 24 hours
Give 50% of the recommended dose every 24 hours if the CrCl is less than 10 mL/min/1.73 m²
Renal impairment (Oral)
When the CrCl is less than 10 mL/min/1.73 m², the normal dosage of 200 mg every 4 hours or 400 mg every 12 hours should be reduced to 200 mg every 12 hours
CrCl 10–25 mL/min/1.73 m² and the usual dosage of 800 mg every 4 hours: Reduce to 800 mg every 8 hours
If the CrCl is less than 10 mL/min/1.73 m², reduce the normal dosage to 800 mg every 12 hours

immune globulin IM (IGIM) 

For Prophylaxis: the dose of 0.6-1.2 mL/kg IM within six days of exposure   
Note: take only the varicella-zoster IG (Human) is unavailable  



varicella zoster immune globulin, human 

Indicated for the reduction of infection severity after exposure
125 IU/10 kg intramuscularly
Do not exceed more than 625 IU/dose
Administer the dose within 4-10 days post-exposure
For <2kg: 62.5 IU intramuscularly
2.1-10 kg: 125 IU intramuscularly
10.1-20 kg: 250 IU intramuscularly
20.1-30 kg: 375 IU intramuscularly
30.1-40 kg: 500 IU intramuscularly
More than 40 kg: 625 IU intramuscularly
Administer the second dose 3 weeks later the initial dose in patients who are additionally exposed to this virus



acyclovir 

Children under 40 kg and 2 years old: 20 mg/kg/dose taken orally every 6 hours for 5 days, with a maximum dose of 800 mg
Use ideal body weight while treating obese individuals (IBW):
Over 40 kg: 800 mg taken orally every 6 hours for 5 days
In patients with impaired immune systems:
Less than 12 years old: intravenously (IV) administer 20 mg/kg/dose every 8 hours for 7 days
Elderly adults: 10 mg/kg/dose IV given every 8 hours for a period of 7 days