Universal reference book for medicines
Name of the drug: FAMACIVIR (FAMACIVIR)

Active substance: famciclovir

Type: Antiviral drug

Manufacturer: EvoFarm (Russia)
Composition, form of production and packaging
The tablets covered with a film membrane of
white or almost white color, round, biconcave;
the core is white or almost white in cross section.
1 tab.

famciclovir 250 mg

Excipients: giprolose (hydroxypropylcellulose) 9.6 mg, anhydrous lactose 40 mg, silicon dioxide colloid (aerosil) 5.4 mg, microcrystalline cellulose 33.4 mg, carboxymethyl starch sodium (sodium starch glycolate) 18 mg, magnesium stearate 3.6 mg.

Sheath composition: giprolose (hydroxypropylmethylcellulose) - 7 mg, macrogol 6000 (polyethylene glycol 6000) - 2 mg, titanium dioxide - 1 mg.

3 pcs.
- Packings contour mesh (1) - packs cardboard.
3 pcs.
- packings contour mesh (2) - packs cardboard.
3 pcs.
- Packings contour mesh (3) - packs cardboard.
3 pcs.
- packings contour mesh (4) - packs cardboard.
7 pcs.
- Packings contour mesh (1) - packs cardboard.
7 pcs.
- packings contour mesh (2) - packs cardboard.
7 pcs.
- Packings contour mesh (3) - packs cardboard.
7 pcs.
- packings contour mesh (4) - packs cardboard.
10 pieces.
- Packings contour mesh (1) - packs cardboard.
10 pieces.
- packings contour mesh (2) - packs cardboard.
10 pieces.
- Packings contour mesh (3) - packs cardboard.
10 pieces.
- packings contour mesh (4) - packs cardboard.
The tablets covered with a film membrane of white or almost white color, round, biconcave;
the core is white or almost white in cross section.
1 tab.

famciclovir 125 mg

Auxiliary substances: giprolose (hydroxypropyl cellulose) 4.8 mg, anhydrous lactose 20 mg, silicon dioxide colloid (aerosil) 2.7 mg, microcrystalline cellulose 16.7 mg, carboxymethyl starch sodium (sodium starch glycolate) 9 mg, magnesium stearate 1.8 mg.

Sheath composition: giprolose (hydroxypropylmethylcellulose) 3.5 mg, macrogol 6000 (polyethylene glycol 6000) 1 mg, titanium dioxide 0.5 mg.

3 pcs.
- Packings contour mesh (1) - packs cardboard.
3 pcs.
- packings contour mesh (2) - packs cardboard.
3 pcs.
- Packings contour mesh (3) - packs cardboard.
3 pcs.
- packings contour mesh (4) - packs cardboard.
7 pcs.
- Packings contour mesh (1) - packs cardboard.
7 pcs.
- packings contour mesh (2) - packs cardboard.
7 pcs.
- Packings contour mesh (3) - packs cardboard.
7 pcs.
- packings contour mesh (4) - packs cardboard.
10 pieces.
- Packings contour mesh (1) - packs cardboard.
10 pieces.
- packings contour mesh (2) - packs cardboard.
10 pieces.
- Packings contour mesh (3) - packs cardboard.
10 pieces.
- packings contour mesh (4) - packs cardboard.
The tablets covered with a film shell of white or almost white color, oblong with rounded edges, biconvex, with a risk;
the core is white or almost white in cross section.
1 tab.

famciclovir 500 mg

Excipients: giprolose (hydroxypropylcellulose) - 19.2 mg, anhydrous lactose - 80 mg, silicon dioxide colloid (aerosil) - 10.8 mg, microcrystalline cellulose - 66.8 mg, sodium carboxymethyl starch (sodium starch glycolate) 36 mg, magnesium stearate 7.2 mg.

Sheath composition: giprolose (hydroxypropylmethylcellulose) - 14 mg, macrogol 6000 (polyethylene glycol 6000) - 4 mg, titanium dioxide - 2 mg.

3 pcs.
- Packings contour mesh (1) - packs cardboard.
3 pcs.
- packings contour mesh (2) - packs cardboard.
3 pcs.
- Packings contour mesh (3) - packs cardboard.
3 pcs.
- packings contour mesh (4) - packs cardboard.
7 pcs.
- Packings contour mesh (1) - packs cardboard.
7 pcs.
- packings contour mesh (2) - packs cardboard.
7 pcs.
- Packings contour mesh (3) - packs cardboard.
7 pcs.
- packings contour mesh (4) - packs cardboard.
10 pieces.
- Packings contour mesh (1) - packs cardboard.
10 pieces.
- packings contour mesh (2) - packs cardboard.
10 pieces.
- Packings contour mesh (3) - packs cardboard.
10 pieces.
- packings contour mesh (4) - packs cardboard.
INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the printed edition of 2015.

PHARMACHOLOGIC EFFECT

After intake, famciclovir rapidly turns into penciclovir, which has activity against human herpes viruses, including the virus Varicella zoster and Herpes simplex1 and 2 types, as well as the Epstein-Barr virus and cytomegalovirus.

Penzyclovir enters the virus-infected cells, where, under the action of viral thymidine kinase, it rapidly converts to monophosphate, which in turn becomes a triphosphate.

Penciclovir triphosphate inhibits the replication of viral DNA (deoxyribonucleic acid).
The intracellular half-life of penciclovir triphosphate for the culture of cells infected with Herpessimplex 1 is 10 h; Herpes simplex 2 - 20 hours; Varicella zoster - 7 h. The concentration of penciclovir triphosphate in uninfected cells does not exceed the minimum determined, therefore in therapeutic concentrations penciclovir does not affect uninfected cells.
As for acyclovir.
resistance to penciclovir is most often associated with mutations in the gene of viral thymidine kinase, leading to a deficiency or disruption of the substrate specificity of the enzyme. Changes in the DNA polymerase gene are much less common.
The use of famciclovir for the treatment of herpes zoster (caused by the Varicella zoster virus) in immunocompetent patients and patients with reduced immunity is noted to accelerate the healing of the skin and mucous membranes.

Famciclovir is effective in treating various manifestations of ophthalmoherpes caused by the virus Varicella zoster.

Famciclovir significantly reduces the severity and duration of postherpetic neuralgia in patients with herpes zoster.

One-day treatment with famciclovir of immunocompetent patients in the vine 1500 mg once a day or 750 mg twice a day promotes the rapid resolution of manifestations of recurrent labial herpes (caused by the Herpes simplex virus).
The use of famciclovir in immunocompetent patients at a dose of 1000 mg twice a day for 1 day, 125 mg twice a day for 5 days, or 500 mg twice a day for 3 days accelerates the healing of the skin and mucous membranes with recurrence of genital herpes (caused by Herpes simplex virus).
Famciclovir 500 mg twice a day for 7 days is effective in treating various manifestations of herpes zoster in patients with reduced immunity due to infection with the human immunodeficiency virus (HIV).
In HIV-infected patients, famciclovir 500 mg twice a day for 7 days accelerates the healing of the skin and mucous membranes with relapse of genital herpes, and also reduces the number of days of virus isolation of Herpes simplex (both with clinical manifestations and without them). The use of famciclovir in patients with reduced immunity due to other causes has not been studied.
The efficacy of one-day administration of famciclovir 1000 mg twice daily for the treatment of recurrent genital herpes in immunocompetent patients of the Negroid race did not exceed that for placebo.

The safety profile of a one-day administration of famciclovir 1000 mg twice daily for this category of patients was similar to that established earlier.

PHARMACOKINETICS

Absorption

Famciclovir is a prodrug.
After oral administration, famciclovir is rapidly and almost completely absorbed and rapidly converted into a pharmacologically active metabolite, penciclovir. Bioavailability of penciclovir after administration of famciclovir is 77%. An increase in the concentration of penciclovir in the blood plasma occurs in proportion to the increase in a single dose of famciclovir in the range of 125-1000 mg.
According to the study, the maximum concentration (C max ) of penciclovir in the blood plasma after ingestion of 125 mg.
250 mg or 500 mg of famciclovir is achieved on average after 45 minutes and averages 0.8 μg / ml, 1.6 μg / ml and 3.3 μg / ml, respectively.
Another study demonstrates C max of penciclovir after ingestion of 250 mg, 500 mg or 1000 mg of famciclovir in 1.5 μg / ml, 3.2 μg / ml and 5.8 μg / ml, respectively.

Systemic bioavailability (the area under the concentration-time curve (AUC)) of penciclovir does not depend on the time of ingestion.

AUC of penciclovir with a single administration of famciclovir and when dividing the daily dose into two or three doses coincide, which indicates the absence of cumulation of penciclovir with repeated applications of famciclovir.

Metabolism

After oral administration, famciclovir rapidly and completely turns into pharmacologically active metabolite-penciclovir.

Distribution

The binding to plasma proteins of penciclovir and its 6-deoxy precursor is less than 20%.

Excretion

Famciclovir is excreted mainly in the form of penciclovir and its 6-deoxy prodrug, which are excreted through the kidneys unchanged.
Famciclovir in the urine is not found. T 1/2 of penciclovir from the blood plasma in the final phase after taking single and repeated doses is about 2 hours.
Pharmacokinetics in special cases

Patients with infection caused by the virus Varicella zoster

In patients with uncomplicated infection caused by the Varicella zoster virus, no significant changes in the pharmacokinetic parameters of penciclovir (T 1/2 ofpenciclovir from plasma in the final phase after taking single and repeated doses of famciclovir are 2.8 and 2.7 hours, respectively).

Patients with impaired renal function

After taking single and repeated doses of famciclovir, a linear relationship is observed between a decrease in plasma clearance, renal clearance, the rate of excretion of penciclovir from the blood plasma, and the degree of impaired renal function.

Pharmacokinetic features of famciclovir in patients with severe (uncompensated) impairment of renal function have not been studied.

Patients with hepatic impairment

In patients with impaired liver function of mild and moderate severity, there is no increase in the AUC value of penciclovir.
The pharmacokinetics of penciclovir in patients with severe impairment of liver function has not been studied. The conversion of famciclovir into an active metabolite of penciclovir in this group of patients may be impaired, which leads to a decrease in the concentration of penciclovir in the plasma and, consequently, a decrease in the effectiveness of famciclovir.
Patients over the age of 65 years

In patients aged 65 to 70 years, an average increase in the AUC of penciclovir is approximately 40% and a decrease in its renal clearance by approximately 20% compared to persons younger than 65 years.
These pharmacokinetic features of penciclovir may be partly due to age-related changes in renal function in patients over 65 years of age.
Floor

The sex of the patient has no significant effect on the pharmacokinetic parameters of famciclovir (insignificant differences in the clearance of penciclovir in men and women).

Race

When applied to famciclovir (single or multiple administration at a dose of 500 mg 1, 2 or 3 times a day) pharmacokinetics parameters of famciclovir in healthy volunteers of the Negroid race and patients of the Negroid race with impaired renal or hepatic function did not differ from those of Caucasians of the Caucasoid race.

INDICATIONS

- infections caused by Varicella zoster (herpes zoster), including ophthalmoherpes;
to reduce the risk of occurrence and duration of postherpetic neuralgia;
- infections caused by Herpes simplex 1 and 2 types: treatment of primary infection, treatment and prevention of exacerbations of chronic infection;

- infections caused by viruses Varicella zoster and Herpes simplex 1 and 2 types (labial and genital) in patients with reduced immunity.

DOSING MODE

Inside, regardless of food intake, without chewing, washing with water.
Treatment should be started as soon as possible, immediately after the appearance of the first symptoms of the disease (tingling, itching and burning).
Infection caused by the Varicella zoster virus (herpes zoster), in patients with normal immunity

The recommended dose is 500 mg 3 times a day for 7 days.
This method of application allows to reduce the duration of postherpetic neuralgia. In the acute phase of the disease for the resolution of skin manifestations, the recommended dose is 250 mg 3 times a day or 500 mg twice a day or 750 mg once a day for 7 days.
Ophthalmoherpes, caused by the virus Varicella zoster, in patients with normal immunity

The recommended dose is 500 mg 3 times a day for 7 days.

Infection caused by the virus Varicella zoster (herpes zoster), in patients with reduced immunity

The recommended dose is 500 mg 3 times a day for 10 days.

Infection caused by the Herpes simplex virus (labial or genital herpes), in patients with normal immunity:

- with the primary infection of genital herpes, the recommended dose is 250 mg 3 times a day for 5 days:

- with relapses of genital herpes, 1000 mg twice a day for 1 day or 125 mg twice a day for 5 days or 500 mg once, followed by the use of 3 doses of 250 mg every 12 hours;

- with relapses of labial herpes, the recommended dose is 1500 mg once for 1 day or 750 mg twice a day for 1 day.

Infection caused by the Herpes simplex virus (labial or genital herpes), in patients with reduced immunity

The recommended dose is 500 mg twice a day for 7 days.

To prevent exacerbations of recurrent infection caused by the Herpes simplex virus (suppressive therapy), 250 mg 2 times a day are prescribed.
The duration of therapy depends on the severity of the disease. It is recommended to periodically evaluate possible changes in the course of the disease after 12 months.
In HIV-infected patients, the effective dose is 500 mg twice a day.

Patients over the age of 65 years

In elderly patients with normal renal function, correction of the dosing regimen of famciclovir is not required.

Patients with impaired renal function

In patients with impaired renal function, a decrease in the clearance of pecyclovir is observed.
The following correction of the dosing regimen is recommended, depending on the creatinine clearance
Infection caused by the Varicella zoster virus (herpes zoster), in patients with normal immunity

Dosing regimen Creatinine clearance, ml / min Adjusted dosing regimen

500 mg 3 times daily for 7 days> 60 500 mg 3 times a day for 7 days

40-59 500 mg twice a day for 7 days

20-39 500 mg once a day for 7 days

<20 250 mg once a day for 7 days

Patients on hemodialysis 250 mg after each dialysis session for 7 days

250 mg 3 times daily for 7 days> 40 250 mg 3 times a day for 7 days

20-39 500 mg once a day for 7 days

<20 250 mg once a day for 7 days

Patients on hemodialysis 250 mg after each dialysis session for 7 days

500 mg twice a day for 7 days> 40 500 mg twice a day for 7 days

20-39 500 mg once a day for 7 days

<20 250 mg once a day for 7 days

Patients on hemodialysis 250 mg after each dialysis session for 7 days

750 mg once a day for 7 days> 40 750 mg twice a day for 7 days

20-39 500 mg once a day for 7 days

<20 250 mg once a day for 7 days

Patients on hemodialysis 250 mg after each dialysis session for 7 days

Infection caused by the virus Varicella zoster (herpes zoster), in patients with reduced immunity

Dosing regimen Creatinine clearance, ml / min Adjusted dosing regimen

500 mg 3 times a day for 10 days> 60 500 mg 3 times a day for 10 days

40-59 500 mg twice a day for 10 days

20-39 500 mg once a day for 10 days

<20 250 mg once a day for 10 days

Patients on hemodialysis 250 mg after each dialysis session for 10 days

Infection caused by the Herpes simplex virus, in patients with normal immunity

Dosing regimen Creatinine clearance, ml / min Adjusted dosing regimen

The first episode > 40 250 mg 3 times a day for 5 days

250 mg 3 times a day for 5 days 20-39 250 mg twice a day for 5 days

<20 250 mg once a day for 5 days

Patients on hemodialysis 250 mg after each dialysis session for 5 days

With recurrence of genital herpes

1000 mg twice a day for 1 day> 60 1000 mg 2 times a day for 1 day

40-59 500 mg 2 times a day for 1 day

20-39 500 mg once

<20 250 mg once

Patients on hemodialysis 250 mg once after a dialysis session

125 mg twice a day for 5 days> 20 125 mg twice a day for 5 days

<20 125 mg once

Patients on hemodialysis 125 mg after each dialysis session for 5 days

500 mg once, followed by 3 doses of 250 mg every 12 hours> 40,500 mg once, followed by 3 doses but 250 mg every 12 hours

20-39 250 mg once, followed by 3 doses of 250 mg every 12 hours

<20 250 mg once with subsequent application of 250 mg every other day

Patients on hemodialysis 250 mg once after a dialysis session

With recurrence of labial herpes

1500 mg single-dose> 60 1500 mg single-dose

40-59 750 mg once

20-39 500 mg once

<20 250 mg once

Patients on hemodialysis 250 mg once after a dialysis session

750 mg twice a day> 60 750 mg twice a day for 1 day

40-59 750 mg once

20-39 500 mg once

<20 250 mg once

Patients on hemodialysis 250 mg once after a dialysis session

To prevent exacerbations of recurrent infection caused by the Herpes simplex virus (suppressive therapy )

Dosing regimen Creatinine clearance, ml / min Adjusted dosing regimen

250 mg 2 times a day?
40 250 mg twice a day
20-39 125 mg 2 times a day

<20 125 mg once daily

Patients on hemodialysis 125 mg after each dialysis session for 10 days

Infection caused by the Herpes simplex virus (labial or genital herpes), in patients with reduced immunity

Dosing regimen Creatinine clearance, ml / min Adjusted dosing regimen

500 mg 2 times a day for 7 days?
40 500 mg twice a day for 7 days
20-39 500 mg once a day for 7 days

<20 250 mg once a day for 7 days

Patients on hemodialysis 250 mg after each dialysis session for 10 days

Patients with renal insufficiency who are on hemodialysis

Since after a 4-hour hemodialysis, the concentration of penciclovir in the plasma is reduced by 75%, famciclovir should be taken immediately after the procedure of hemodialysis.
The recommended dose is 250 mg (for patients with herpes zoster) and 125 mg (for patients with genital herpes).
Patients with hepatic impairment

For patients with impaired liver function of mild to moderate severity, dosage adjustment is not required.

Patients of the Negroid race

The efficacy of a one-day administration of famciclovir 1000 ml-2 times a day for the treatment of recurrence of genital herpes in immunocompetent patients of the Negroid race did not exceed that for placebo.
The clinical significance of famciclovir dosing regimens for the treatment of both recurrences of genital herpes (within 2 or 5 days) and other infectious lesions caused by the viruses Varicella zoster and Herpes simplex is unknown.
SIDE EFFECT

The frequency of adverse reactions is presented according to the WHO classification: very common (> 1/10 cases), common (> 1/100 and <1/10 cases), rarely (> 1/1 000 and <1/100 cases), rarely ( > 1/10 000 and <1/1 000) and very rare (<1/10000 cases).
Adverse reactions that have been observed in post-marketing period of application famciclovir and frequency of which can be calculated from the data available will have the designation "unknown frequency".
From the blood and lymphatic system: rarely - thrombocytopenia.
Mental disorders: rarely - confusion (especially in elderly patients): rarely - hallucinations.
From the nervous system: very often - headache;
often - dizziness: rarely - somnolence (predominantly in elderly patients).
Of the heart: rarely - palpitations.
Gastro-intestinal tract: often - nausea, vomiting, abdominal pain, diarrhea.
Of the liver and biliary tract: often - increasing the concentration of bilirubin and "liver" transamipaz;
rarely - cholestatic jaundice.
Skin and subcutaneous tissue disorders: often - a rash, itching; infrequently - angioneurotic edema (swelling of the face, eyelids, periorbital area, pharynx), urticaria;frequency is unknown -heavy skin reactions (including erythema multiforme, Stevens-Johnson syndrome, Lyell syndrome (toxic epidermal necrolysis) lekotsitoklastichesky vasculitis (allergic)..
Other: often - increased sweating;
very rarely - a fever.
If any of these instructions are exacerbated by adverse reactions or you notice other side effects not mentioned in the instructions, tell your doctor.
CONTRAINDICATIONS

- hypersensitivity to famciclovir or other components of the formulation;
- Hypersensitivity to penciclovir;
- lactose intolerance, lactase deficiency, glucose-galactose malabsorption.
Carefully

Care should be taken when treating patients with renal dysfunction, which may require correction dosing regimen.
Special precautions in elderly patients and in patients with impaired liver function and mild to moderate severity is not required. Experience of famciclovir in patients with severe (decompensated) impaired liver function is missing.
The efficacy and safety of famciclovir in children has not been studied, therefore its use in these patients is not recommended unless the potential benefit of treatment does not exceed the potential risk of complications.
PREGNANCY AND LACTATION

Experimental studies have shown no embryotoxicity or teratogenicity famciclovir and penciclovir. However, since the data on the safety of famciclovir in pregnant and lactating women is not enough to use the drug Famatsivir during pregnancy and breastfeeding period is possible only if the benefit of treatment to the mother outweighs the potential risk to the fetus and child.
In experimental studies, the application of famciclovir (inside) mentioned selection penciclovir in breast milk. It is not known whether penciclovir is excreted in breast milk in humans.
APPLICATION FOR FUNCTIONS OF THE LIVER

Care should be taken when treating patients with renal dysfunction, which may require correction dosing regimen.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS

Special precautions in patients with impaired liver function and mild to moderate severity is not required. Experience of famciclovir in patients with severe (decompensated) impaired liver function is missing.
APPLICATION FOR CHILDREN

The efficacy and safety of famciclovir in children has not been studied, therefore its use in these patients is not recommended unless the potential benefit of treatment does not exceed the potential risk of complications.
APPLICATION IN ELDERLY PATIENTS

Special precautions in elderly patients is not required.
SPECIAL INSTRUCTIONS

Treatment should be started immediately after diagnosis.
Care should be taken when treating patients with renal dysfunction, which may require correction dosing regimen.
Special precautions in elderly patients and in patients with impaired liver function and mild to moderate severity is not required.
Genital herpes - a disease transmitted through sexual contact. During recurrence risk of infection increases. In the presence of clinical manifestations of the disease, even in the event of an antiviral treatment, patients should avoid sexual intercourse. During suppressive therapy antiviral agents frequency spread of viral infection significantly decreased, however, the risk of transmission exists theoretically. Therefore, patients should take appropriate protective measures during sexual intercourse.
The composition of the tablets of the drug Famatsivir includes lactose, so it should not be used in patients with lactose intolerance, lactase deficiency, glucose-galactose malabsorption.
Famciclovir has no marked effect on the semen analysis, morphology or motility of human sperm. Reduced fertility was observed in an experimental model in rats male Iola- receiving famciclovir at a dose of 500 mg / kg body weight: not observed in female rats were expressed decrease in fertility.
Tolerable dose famciclovir and duration of treatment
Famciclovir was well tolerated in the treatment of herpes zoster when used at a dose of 750 mg three times a day for 7 days; in patients with genital herpes when used at a dose of 750 mg three times a day for 5 days in the dose of 500 mg three times a day for 10 days. It was also shown that famciclovir is well tolerated at suppressive therapy in a dose of 250 mg three times a day for 12 months for the treatment of genital herpes.
Famciclovir was well tolerated in patients with reduced immunity in treating Varicella zoster when receiving 500 mg 3 times a day for 10 days, and also Herpes simplex, when receiving up to 500 mg 2 times a day for 7 days or 500 mg 2 times a day for 8 weeks.
Effects on ability to drive vehicles, mechanisms and engage in other activities that require high concentration
is not expected to influence Famatsivir drug on the ability to drive and use machines. However, patients who have a background in the use of the drug occurs dizziness, drowsiness, confusion, or other disorders of the central nervous system, should refrain from driving and classes of potentially hazardous activities that require high concentration and speed of psychomotor reactions


OVERDOSE

There are limited data on overdose famciclovir.
Treatment: symptomatic and supportive.
Failure to comply with the recommendations to reduce the dose of famciclovir in view of kidney function in patients with diseases nochek rarely been cases of acute renal failure.
Penciclovir, which is the active metabolite of famciclovir, appear in hemodialysis. Penciclovir concentrations in plasma are reduced by 75% after dialysis for 4 hours.
DRUG INTERACTION

The simultaneous use of probenecid may increase penciclovir concentrations in the blood plasma. For the prevention of toxic reactions and the possible reduction in the dose necessary to monitor patients receiving penciclovir 500mg concurrently with probenecid. There were no clinically significant changes in the pharmacokinetic parameters of penciclovir when a single application (500 mg) immediately after receiving antacids (magnesium or aluminum hydroxide) or patients treated before treatment (multiple dose) allopurinol, cimetidine, theophylline, zidovudine, promethazine . In single dose of famciclovir (500 mg) with emtricitabine or AZT showed no changes in the pharmacokinetic parameters of penciclovir, AZT,metabolite of zidovudine (AZT glucuronide) and emtricitabine.
In single or multiple dose of famciclovir (500 mg 3 times daily) with digoxin no change pharmacokinetic parameters penciclovir and digoxin.
Given that the conversion of the inactive metabolite 6-dezoksipentsiklovira (formed by deacetylation of famciclovir) to penciclovir is catalysed by the enzyme aldehyde oxidase may develop drug interaction when used together with famciclovir drugs metabolized with the participation of the enzyme or its inhibitory activity. In applying famciclovir with cimetidine and promethazine. are inhibitors of aldehyde oxidase in vitro, there was no evidence of reducing the formation of penciclovir famciclovir. However, while taking famciclovir and potent inhibitor of aldehyde invitro, raloxifene, may reduce the formation of penciclovir famciclovir, and as a result, the efficiency of famciclovir.It is necessary to evaluate the clinical efficacy of the antiviral therapy in simultaneous application with raloxifene.
Given that famciclovir is a weak inhibitor of aldehyde oxidase in vitro, possibly its effect on the pharmacokinetic parameters of the drugs metabolized with the participation of the enzyme.
In experimental studies, famciclovir had no effect on inducing cytochrome P450 and does not inhibit the isoenzyme CYP3A4.
It is necessary to consider the possibility of interaction with drugs which are excreted by active tubular secretion (e.g., acetylsalicylic acid, ibuprofen).
TERMS OF RELEASE FROM PHARMACY

On prescription.

TERMS AND CONDITIONS OF STORAGE

In dry, dark place at a temperature of no higher than 25 ° C.
Keep out of the reach of children.
Shelf life - 2 years.
Do not use after the expiry date printed on the package.
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