← Search & browse all drugs
ANTIINFECTIVES FOR SYSTEMIC USE › ANTIVIRALS FOR SYSTEMIC USE › DIRECT ACTING ANTIVIRALS › Nucleosides and nucleotides excl. reverse transcriptase inhibitors
brivudine
J05AB15
Adult Dosing
- Herpes zoster (shingles) acute infection: 125 mg orally once daily for 7 days
- Treatment should be initiated as soon as possible, ideally within 72 hours of rash onset
Pediatric Dosing
- Safety and efficacy in pediatric patients under 18 years of age have not been established; not recommended
Indications
- Early treatment of acute herpes zoster (shingles) in immunocompetent adults
Mechanism of Action
- Nucleoside analogue with potent and selective activity against varicella-zoster virus (VZV)
- Phosphorylated by VZV thymidine kinase to brivudine triphosphate, which inhibits viral DNA polymerase
Contraindications
- Hypersensitivity to brivudine
- Concomitant administration with 5-fluorouracil (5-FU) and other topical/systemic fluoropyrimidines (e.g., capecitabine, tegafur) due to fatal drug-drug interaction
- Immunocompromised patients (e.g., receiving chemotherapy or immunosuppressants)
- Pregnancy and lactation
Adverse Reactions
- Nausea
- Fatigue
- Headache
- Elevated liver transaminases
- Dizziness
- Gastrointestinal discomfort
Drug Interactions
- 5-Fluorouracil (5-FU), capecitabine, tegafur, and other fluoropyrimidines: Absolute contraindication; brivudine metabolite (BVDU) irreversibly inhibits dihydropyrimidine dehydrogenase (DPD), causing severe and potentially fatal 5-FU toxicity
- Must allow at least a 4-week washout period between brivudine cessation and initiation of any fluoropyrimidine-containing therapy
Curated Content: Needs Vetting Before Put to Clinical Use