Name: Hovilpri (pritelivir) in Refractory mucocutaneous herpes simplex virus infection in immunocompromised adults: Dosage
Published: 2026-10-11T11:04:25-04:00

Recommended dosage

“Initiate treatment with a loading dose of 400 mg (four 100 mg tablets) on day 1, followed by a maintenance dose of 100 mg (one tablet) daily by mouth with or without food, until HSV lesions have healed” (opens the prescribing information at this quote)
“Recommended dose is 400 mg on the first day, followed by 100 mg once daily with or without food, until HSV lesions have healed.” (opens the prescribing information at this quote)

Co-administration with acid-reducing agents

“While taking HOVILPRI, avoid concomitant use of the following proton pump inhibitors” (opens the prescribing information at this quote)
“Esomeprazole or rabeprazole” (opens the prescribing information at this quote)
“Omeprazole or lansoprazole at daily doses above 20 mg” (opens the prescribing information at this quote)
“Pantoprazole at daily doses above 40 mg” (opens the prescribing information at this quote)
“Take HOVILPRI 2 hours before or 12 hours after taking a H2-receptor antagonist” (opens the prescribing information at this quote)
“Separate any dosing of antacids from HOVILPRI dosing by 2 hours” (opens the prescribing information at this quote)

Missed dose

“If a dose of HOVILPRI is missed, take it as soon as it is remembered. If it is not taken until the scheduled dosing time on the next day, take two tablets at that time.” (opens the prescribing information at this quote)

Dosage in renal and hepatic impairment

“No dose adjustment is recommended for patients with mild, moderate, or severe renal impairment.” (opens the prescribing information at this quote)
“No dose adjustment is recommended for patients with mild (Child-Pugh Class A) or moderate (Child-Pugh Class B) hepatic impairment.” (opens the prescribing information at this quote)

Treatment duration studied in PRIOH-1 Part C

“Participants received HOVILPRI (400 mg loading dose on Day 1 followed by 100 mg once daily) or Investigator’s Choice treatment (IV foscarnet, IV/topical cidofovir, or 5% topical imiquimod) for up to 28 days until all mucocutaneous lesions healed, extended up to 42 days total if lesions were improving but not completely healed after 28 days.” (opens the prescribing information at this quote)
“Across the 51 participants treated with HOVILPRI, the mean duration of treatment was 27.1 days (range 6–43).” (opens the prescribing information at this quote)
“33 % of participant in the HOVILPRI arm extended treatment up to 42 days, whose lesions were improving by Day 28.” (opens the prescribing information at this quote)

Treatment duration as registered for PRIOH-1 Parts C to F

“Duration of treatment: Until all mucocutaneous HSV lesions are healed or up to 28 days, whichever is earlier. A prolongation up to a maximum of 42 days may be possible depending on the clinical progress.” (opens the source at this quote in a new tab)

Treatment duration rule in the phase 2 parts of PRIOH-1

“In both study parts, 100 mg of pritelivir was administered orally, once daily, following an initial 400-mg loading dose administered orally on day 1.” (opens the source at this quote in a new tab)
“Treatment continued until 7 days after complete lesion healing or for a maximum of 28 days, whichever occurred first.” (opens the source at this quote in a new tab)

Rationale for the loading dose

“When a loading dose of 400 mg pritelivir was administered on Day 1 followed by a maintenance dose of 100 mg once daily, steady-state exposures were reached on Day 2.” (opens the prescribing information at this quote)

“treated with pritelivir 100 mg once daily (following a loading dose of 400 mg as first dose to rapidly reach steady-state plasma concentration)” (opens the source at this quote in a new tab)

“After administration of a loading dose of 400 mg of pritelivir followed by maintenance doses of 100 mg once daily onward, plasma levels in the therapeutic range were reached immediately.” (opens the source at this quote in a new tab)

“The oral loading dose was used to reach steady state more quickly as pritelivir is known to have a long half-life (52-83 hours).” (opens the source at this quote in a new tab)

Selection of the 100 mg once daily dose

“Based on these data together with pharmacodynamics and experience from phase 2, a dose of 100 mg once daily with a loading dose of 400 mg on day 1 was selected for the currently ongoing phase 3 trial in immunocompromised patients with acyclovir resistant mucocutaneous HSV infection (PRIOH-1, NCT03073967).” (opens the source at this quote in a new tab)

“Overall, pritelivir showed linear pharmacokinetics within the dose range selected for Phase 2 and 3 clinical trials, which is 100 mg once daily with a loading dose of 400 mg on Day 1.” (opens the source at this quote in a new tab)

Exposure-response at the recommended dose

“No exposure-response relationship was identified between steady-state plasma pritelivir exposures at 100 mg once daily and the occurrence of all lesions healed by Day 28.” (opens the prescribing information at this quote)

Dose range studied in healthy adults

“Pritelivir was safe and well tolerated up to 600 mg following single and up to 200 mg following multiple once-daily doses.” (opens the source at this quote in a new tab)
“Considering a therapeutic dose of 100 mg once-daily, pritelivir demonstrated a favorable safety and tolerability and pharmacokinetic profile in healthy subjects to support further development.” (opens the source at this quote in a new tab)