Qiang Ni indications
Oral
Primary herpes simplex infections
Adult: 200 mg 5 times daily, usually 4 hrly while awake for 5-10 days. Severely immunocompromised patients: 400 mg 5 times daily for 5 days.
Child: Renal impairment: Suppression of recurrent herpes simplex Adult: 800 mg daily in 2-4 divided doses, may reduce to 400-600 mg daily. Treatment is interrupted every 6-12 mth to re-assess condition. Episodic treatment for mild or infrequent recurrences: 200 mg 5 times daily for 5 days, preferably begun during the prodromal period. Renal impairment: Prophylaxis of herpes simplex in immunocompromised patients Adult: 200-400 mg 4 times daily. Child: Renal impairment: Varicella zoster Adult: 800 mg 4 or 5 times daily for 5-7 days. Child: Renal impairment: Herpes zoster (shingles) Adult: 800 mg 5 times daily for 7-10 days. Renal impairment: Buccal Recurrent herpes labialis Adult: Apply 1 tab (50 mg) as a single dose to the upper gum region w/in 1 hr of onset of prodromal symptoms. Allow the tab to gradually dissolve; do not crush, suck, chew or swallow. Herpes simplex encephalitis Adult: 10 mg/kg 8 hrly for 10 days. Dose to be given as IV infusion over 1 hr. Child: Renal impairment: Reconstitution: Add 10 mL or 20 mL of sterile water for inj to a vial labeled as containing 500 mg or 1,000 mg of Qiang Ni, respectively, to provide a soln containing 50 mg/mL. The appropriate dose of reconstituted soln should then be withdrawn from the vial and diluted w/ 50-125 mL of a compatible IV infusion soln. Incompatibility: Blood products and protein-containing soln. Y-site: Amifostine, amsacrine, aztreonam, caffeine citrate, cefepime, ciclosporin, dobutamine, dopamine, fludarabine, foscarnet, gemcitabine, idarubicin, levofloxacin, ondansetron, pantoprazole, piperacillin/tazobactam, sargramostim, TrophAmine®, vinorelbine. Neonatal herpes simplex virus infections Child: 0-3 mth 10 mg/kg every 8 hr for 10 days. Dose to be given as IV infusion over 1 hr. Renal impairment: Reconstitution: Add 10 mL or 20 mL of sterile water for inj to a vial labeled as containing 500 mg or 1,000 mg of Qiang Ni, respectively, to provide a soln containing 50 mg/mL. The appropriate dose of reconstituted soln should then be withdrawn from the vial and diluted w/ 50-125 mL of a compatible IV infusion soln. Incompatibility: Blood products and protein-containing soln. Y-site: Amifostine, amsacrine, aztreonam, caffeine citrate, cefepime, ciclosporin, dobutamine, dopamine, fludarabine, foscarnet, gemcitabine, idarubicin, levofloxacin, ondansetron, pantoprazole, piperacillin/tazobactam, sargramostim, TrophAmine®, vinorelbine. Varicella zoster Adult: 5 mg/kg 8 hrly. Immunocompromised patients: 10 mg/kg 8 hrly. Dose to be given as IV infusion over 1 hr. Child: Renal impairment: Reconstitution: Add 10 mL or 20 mL of sterile water for inj to a vial labeled as containing 500 mg or 1,000 mg of Qiang Ni, respectively, to provide a soln containing 50 mg/mL. The appropriate dose of reconstituted soln should then be withdrawn from the vial and diluted w/ 50-125 mL of a compatible IV infusion soln. Incompatibility: Blood products and protein-containing soln. Y-site: Amifostine, amsacrine, aztreonam, caffeine citrate, cefepime, ciclosporin, dobutamine, dopamine, fludarabine, foscarnet, gemcitabine, idarubicin, levofloxacin, ondansetron, pantoprazole, piperacillin/tazobactam, sargramostim, TrophAmine®, vinorelbine. 1st episodes of genital herpes Adult: 5 mg/kg 8 hrly for 5-7 days. Dose to be given as IV infusion over 1 hr. Renal impairment: Reconstitution: Add 10 mL or 20 mL of sterile water for inj to a vial labeled as containing 500 mg or 1,000 mg of Qiang Ni, respectively, to provide a soln containing 50 mg/mL. The appropriate dose of reconstituted soln should then be withdrawn from the vial and diluted w/ 50-125 mL of a compatible IV infusion soln. Incompatibility: Blood products and protein-containing soln. Y-site: Amifostine, amsacrine, aztreonam, caffeine citrate, cefepime, ciclosporin, dobutamine, dopamine, fludarabine, foscarnet, gemcitabine, idarubicin, levofloxacin, ondansetron, pantoprazole, piperacillin/tazobactam, sargramostim, TrophAmine®, vinorelbine. Prophylaxis of herpes simplex in immunocompromised patients Adult: 5 mg/kg 8 hrly for 5-7 days. Dose to be given as IV infusion over 1 hr. Child: Renal impairment: Reconstitution: Add 10 mL or 20 mL of sterile water for inj to a vial labeled as containing 500 mg or 1,000 mg of Qiang Ni, respectively, to provide a soln containing 50 mg/mL. The appropriate dose of reconstituted soln should then be withdrawn from the vial and diluted w/ 50-125 mL of a compatible IV infusion soln. Incompatibility: Blood products and protein-containing soln. Y-site: Amifostine, amsacrine, aztreonam, caffeine citrate, cefepime, ciclosporin, dobutamine, dopamine, fludarabine, foscarnet, gemcitabine, idarubicin, levofloxacin, ondansetron, pantoprazole, piperacillin/tazobactam, sargramostim, TrophAmine®, vinorelbine. Herpes simplex keratitis Adult: As 3% oint: Apply inside the lower conjunctival sac 5 times daily at approx 4 hrly intervals. Continue treatment for at least 3 days after healing is complete. Herpes simplex infections of skin Adult: As 5% oint/cream: Apply 5 or 6 times daily for 5-10 days, preferably beginning in the prodromal period. Special Populations: Critically ill patients receiving renal replacement therapy: Continuous venovenous haemofiltration (CVVH): 5-10 mg/kg 24 hrly. Continuous venovenous haemodialysis (CVVHD) or haemodiafiltration (CVVHDF): 5-10 mg/kg 12-24 hrly. A guanosine analog antiviral drug that acts as an antimetabolite. Qiang Ni is used for the treatment of herpes simplex virus infections, varicella zoster (chickenpox) and herpes zoster (shingles). Qiang Ni has also been investigated for the treatment of herpes labialis applied using an iontophoretic device. Currently approved drugs for the treatment of herpes labialis (cold sores) exhibit low levels of efficacy due to the limited ability of the drugs to penetrate the skin to the site where the herpes virus is replicating. Iontophoresis uses electric current to enhance the delivery of drugs through the skin. Adults: Treatment of Herpes Simplex Infections: 200 mg should be taken 5 times daily at approximately 4-hr intervals omitting the night time dose. Treatment should continue for 5 days, but in severe initial infections this may have to be extended. In severely immunocompromised patients (eg, after marrow transplant) or in patients with impaired absorption from the gut, the dose can be doubled to 400 mg or alternatively IV dosing could be considered. Dosing should begin as early as possible after the start of an infection. For recurrent episodes, this should preferably be during the prodromal period when lesions first appear. Suppression of Herpes Simplex Infections in Immunocompetent Patients: 200 mg should be taken 4 times daily at approximately 6-hr intervals. Many patients may be conveniently managed on a regimen of 400 mg twice daily at approximately 12-hr intervals. Dosage titration down to 200 mg taken thrice daily at approximately 8-hr intervals or even twice daily at approximately 12-hr intervals, may prove effective. Therapy should be interrupted periodically at intervals of 6-12 months in order to observe possible changes in the natural history of the disease. Prophylaxis of Herpes Simplex Infections in Immunocompromised Patients: 200 mg should be taken 4 times daily at approximately 6-hr intervals. In severely immunocompromised patients (eg, after marrow transplant) or in patients with impaired absorption from the gut, the dose can be doubled to 400 mg or alternatively IV dosing could be considered. The duration of prophylactic administration is determined by the duration of the period at risk. Treatment of Herpes Zoster Infections: 800 mg tablets should be taken 5 times daily at approximately 4-hr intervals omitting the night time dose. Treatment should continue for 7 days. In severely immunocompromised patients or in patients with impaired absorption from the gut, consideration should be given to IV dosing. Dosing should begin as early as possible after the start of an infection; treatment yields better results if initiated as a soon as possible after rash onset. Children >2 years: Treatment of Herpes Simplex Infections and Prophylaxis of Herpes Simplex Infections: Should be given adult dosages, <2 years should be given ½ the adult dose of Qiang Ni tablet. Treatment of Chicken Pox in Children up to 2 years: Qiang Ni tablet is administered 20 mg/kg on the basis of body weight 4 times daily for 5 days. Dosing should begin as early as possible after the start of a chicken pox rash, treatment yields better results if initiated within 24 hrs after rash onset. Patients with Renal Impairment: Treatment of Herpes Simplex Infections: In the management of herpes simplex infections in patients with impaired renal function, the recommended oral doses will not lead to accumulation of Qiang Ni tablets above levels that have been established by IV infusion. For patients with severe renal impairment (CrCl <10 mL/min) of an adjustment of dosage to Qiang Ni 200 mg tablets twice daily at approximately 12-hr intervals is recommended. Treatment of Herpes Zoster Infections: For patients with severe renal impairment (CrCl <10 mL/min) an adjustment of dosage to Qiang Ni 800 mg tab 3-4 times daily at approximately 6-8 hrs intervals is recommended. Elderly: In elderly, total Qiang Ni body clearance declines in parallel with CrCl. Adequate hydration of elderly patients taking high oral doses of Qiang Ni tablets should be maintained. Special attention should be given to dosage reduction in elderly patients with impaired renal function. Probenecid increases the Qiang Ni mean t½ and area under the plasma concentration curve. Other drugs affecting renal physiology could potentially influence the pharmacokinetics of Qiang Ni. Herpes simplex: Short term administration: the most frequent adverse events reported with Qiang Ni 200 mg administered orally 5 times daily every 4 hours for 10 days were nausea and/or vomiting. Long term administration: the most frequent adverse events reported in a clinical trial for the prevention of recurrences with continuous administration of 400 mg 2 times daily for 1 year were nausea (4.8%) and diarrhea (2.4%). Herpes zoster: the most frequent adverse event reported with 800 mg of oral Qiang Ni 5 times daily for 7 to 10 days in 323 patients was malaise (11.5%). Chickenpox: the most frequent adverse event reported with oral Qiang Ni at doses of 10 to 20 mg/kg 4 times daily for 5 to 7 days was diarrhea (3.2%). Observed during clinical practice: in addition to adverse events reported from clinical trials, the following events have been identified during post-approval use of Qiang Ni. General: anaphylaxis, angioedema, fever, headache, pain, peripheral edema. Nervous: aggressive behavior, agitation, ataxia, coma, confusion, decreased consciousness, delirium, dizziness, encephalopathy, hallucinations, paresthesia, psychosis, seizure, somnolence, tremors. These symptoms may be marked, particularly in older adults or in patients with renal impairment. Digestive: diarrhea, gastrointestinal distress, nausea. Hematologic and lymphatic: anemia, leukocytoclastic vasculitis, leukopenia, lymphadenopathy, thrombocytopenia. Hepatobiliary tract and pancreas: elevated liver function tests, hepatitis, hyperbilirubinemia, jaundice. Musculoskeletal: myalgia. Skin: alopecia, erythema multiforme, photosensitive rash, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria. Skin: alopecia, erythema multiforme, photosensitive rash, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria. Urogenital: renal failure, elevated blood urea nitrogen, elevated creatinine, hematuria. Qiang Ni Lotion is contraindicated for premature neonates because their skin may be more permeable than full term infants and their liver enzymes may not be sufficiently developed. It is also contraindicated for patients with Norwegian (crusted) scabies due to possible increased absorption. It is also contraindicated for patients with known seizure disorders and for individuals with a known sensitivity to the product or any of its components. Aciclovir in China. Information checked by Dr. Sachin Kumar, MD PharmacologyCrCl (ml/min) Dosage Recommendation <10 200 mg 12 hrly. Oral
CrCl (ml/min) Dosage Recommendation <10 200 mg 12 hrly. Oral
CrCl (ml/min) Dosage Recommendation <10 200 mg 12 hrly. Oral
CrCl (ml/min) Dosage Recommendation <10 800 mg 12 hrly. 10-25 800 mg 8 hrly. Oral
CrCl (ml/min) Dosage Recommendation <10 800 mg 12 hrly. 10-25 800 mg 8 hrly. Intravenous
CrCl (ml/min) Dosage Recommendation <10 and patient on peritoneal dialysis Half the usual dose once daily. <10 and patient on haemodialysis Half the usual dose once daily then, additional half-dose after haemodialysis. 10-24 Increase dose interval to 24 hr. 25-50 Increase dose interval to 12 hr. Intravenous
CrCl (ml/min) Dosage Recommendation <10 and patient on peritoneal dialysis Half the usual dose once daily. <10 and patient on haemodialysis Half the usual dose once daily then, additional half-dose after haemodialysis. 10-24 Increase dose interval to 24 hr. 25-50 Increase dose interval to 12 hr. Intravenous
CrCl (ml/min) Dosage Recommendation <10 and patient on peritoneal dialysis Half the usual dose once daily. <10 and patient on haemodialysis Half the usual dose once daily then, additional half-dose after haemodialysis. 10-24 Increase dose interval to 24 hr. 25-50 Increase dose interval to 12 hr. Intravenous
CrCl (ml/min) Dosage Recommendation <10 and patient on peritoneal dialysis Half the usual dose once daily. <10 and patient on haemodialysis Half the usual dose once daily then, additional half-dose after haemodialysis. 10-24 Increase dose interval to 24 hr. 25-50 Increase dose interval to 12 hr. Intravenous
CrCl (ml/min) Dosage Recommendation <10 and patient on peritoneal dialysis Half the usual dose once daily. <10 and patient on haemodialysis Half the usual dose once daily then, additional half-dose after haemodialysis. 10-24 Increase dose interval to 24 hr. 25-50 Increase dose interval to 12 hr. Ophthalmic
Topical/Cutaneous
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List of Qiang Ni substitutes (brand and generic names)
Sort by popularity Unit description / dosage (Manufacturer) Price, USD Pulibex (Greece) Qing Lin (China) Qualiclovir (Hong Kong) Qualiclovir 200 mg x 1, 000's (Quality) $ 580.00 Qualiclovir 400 mg x 1, 000's (Quality) $ 1080.00 Qualiclovir Cream (Hongkong) Qualiclovir Cream 5 % x 500 g $ 360.00 Quilabir (Peru) Ranvir (Thailand) Ranvir 200 mg x 10 x 5's (Ranbaxy) Ranvir 800 mg x 10 x 5's (Ranbaxy) Ranvir tab 200 mg 10 x 5's (Ranbaxy) Ranvir tab 800 mg 10 x 5's (Ranbaxy) ratio-Acyclovir (Canada) Tablet; Oral; Acyclovir 200 mg
Tablet; Oral; Acyclovir 400 mg Tablet; Oral; Acyclovir 800 mg Tablets; Oral; Acyclovir 200 mg Tablets; Oral; Acyclovir 400 mg Tablets; Oral; Acyclovir 800 mg Ratio-acyclovir tablet 800 mg (Teva Canada Limited (Canada)) Ratio-acyclovir tablet 400 mg (Teva Canada Limited (Canada)) Ratio-acyclovir tablet 200 mg (Teva Canada Limited (Canada)) Reclovax (Thailand) Reclovax 200 mg x 3 x 10's Reclovax 800 mg x 10's Remex (France) Cream; Topical; Acyclovir 5% Remex 5% (France) Rexan (Italy) Ridoherp (India) Ridoherp 200mg TAB / 5gm (RPG LS) $ 0.72 200 mg x 10's (RPG LS) $ 0.72 Ridoherp 200mg TAB / 10 (RPG LS) $ 0.72 RIDOHERP tab 200 mg x 10's (RPG LS) $ 0.72 Riduvir (Italy) RiteMED Aciclovir (Philippines) RiteMED Aciclovir tab 400 mg 30's (RiteMED) RiteMED Aciclovir tab 800 mg 30's (RiteMED) Rodoherp CRM Rodoherp CRM 5 % CRM / 5g $ 0.30 Ruz-AciclovirВ® 200 Ruz-AciclovirВ® 400 RXT aciclovir (Netherlands) Sanavir (Italy) Scanovir (Indonesia) Scanovir 200 mg x 3 x 10's (Tempo scan pacific) $ 8.25 Scanovir 400 mg x 3 x 10's (Tempo scan pacific) $ 14.32 Seracic (Mexico) Sha Wei Luo (China) Sheng Nuo Wei (China) Simplex (Norway) See 1971 substitutes for Qiang Ni
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