Comparative Pharmacology
Head-to-head clinical analysis: FAMCICLOVIR versus HARVONI.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FAMCICLOVIR versus HARVONI.
FAMCICLOVIR vs HARVONI
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Famciclovir is a prodrug of penciclovir, which inhibits viral DNA polymerase by competing with deoxyguanosine triphosphate, thus inhibiting viral DNA replication. It has activity against herpes simplex virus (HSV-1, HSV-2), varicella-zoster virus (VZV), and Epstein-Barr virus (EBV).
Fixed-dose combination of ledipasvir, an HCV NS5A inhibitor, and sofosbuvir, an HCV NS5B nucleotide polymerase inhibitor. Ledipasvir inhibits HCV NS5A protein essential for viral replication and assembly; sofosbuvir is a prodrug that after intracellular metabolism acts as a chain terminator by inhibiting NS5B RNA-dependent RNA polymerase.
500 mg orally three times daily for 7 days for herpes zoster; 125 mg twice daily for 5 days for recurrent genital herpes; 250 mg three times daily for 7 days for first-episode genital herpes; 500 mg twice daily for 7 days for recurrent herpes labialis.
One tablet (90 mg ledipasvir/400 mg sofosbuvir) orally once daily with or without food for 12 weeks. For treatment-naïve patients with genotype 1 and cirrhosis, 24 weeks may be considered. For genotype 4, 12 weeks recommended.
None Documented
Clinical Note
moderateFamciclovir + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Famciclovir."
Clinical Note
moderateFamciclovir + Erythromycin
"The metabolism of Erythromycin can be decreased when combined with Famciclovir."
Clinical Note
moderateFamciclovir + Cyclosporine
"The metabolism of Cyclosporine can be decreased when combined with Famciclovir."
Clinical Note
moderateFamciclovir + Fluconazole
None Documented
Terminal half-life of penciclovir is 2-3 hours in healthy adults, prolonged to 3-6 hours in hepatic impairment and >20 hours in severe renal impairment (CrCl <30 mL/min), requiring dose adjustment.
Ledipasvir: 47 hours; Sofosbuvir: 0.5 hours; GS-331007 (predominant circulating metabolite): 27 hours; clinical context: supports once-daily dosing with no accumulation beyond steady state by day 7
Renal elimination: ~60% as penciclovir (active metabolite) and <10% as unchanged famciclovir; biliary/fecal: <5%; the remainder is metabolized to inactive compounds.
Ledipasvir: 86% fecal, 1% renal; Sofosbuvir: 80% renal (as inactive metabolite GS-331007), 14% fecal; GS-331007: 78% renal
Category A/B
Category C
Antiviral
Antiviral
"The metabolism of Fluconazole can be decreased when combined with Famciclovir."