Bell's Palsy

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Patients with Bell's palsy should be treated within three days of the onset of symptoms with a seven-day course of oral aciclovir or valaciclovir, plus a tapering course of oral prednisone

Medication  Dose

Renal 

adjustments

Hepatic adjustment

 

Aciclovir

Adults

400 mg five times daily for 7 days

Children >2 yrs

80 mg per kg daily divided every six hours for 5 days, with a maximal dose of 3,200 mg daily

Adults

eGFR < 10 mL/minute: 400mg twice daily

eGFR: 10 - 25 mL/minute: 400mgevery 8 hours hours

Children

eGFR < 10 mL/minute: normal dose every 12 hours 

eGFR: 10 - 25 mL/minute: normal dose every 8 hours 

 Undefined

Valciclovir

 

Adults and children >12 yrs

1 g three times daily for 7 days 

 

eGFR < 10 mL/minute: 500 mg daily

eGFR: 10 - 29 mL/minute: 1 g daily

eGFR: 30 - 49 mL/minute: 1 g twice daily

None 

 

Prednisolone 

 

Adults

60 mg daily for 5 days, then 40 mg daily for 5 days

Children

2 mg per kg daily for seven to 10 days

 None  Undefined

Patients with complete paralysis who do not improve in two weeks on medication should be referred to an otolaryngologist for evaluation for other causes of facial nerve palsy

Patients should be monitored for eye irritation and be prescribed eye lubrication. Patients with corneal abrasions should be referred to an ophthalmologist

https://www.aafp.org/afp/2007/1001/p997.html#:~:text=Oral%20corticosteroids%20have%20traditionally%20been,at%2060%20mg%20per%20day.

BNF

 

 

Aciclovir prednisolone Valciclovir

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