Indicated for the following conditions: The treatment of initial episodes of herpes genitalis. The suppression of unusually frequent recurrences of herpes genitalis (6 or more episodes per year). The acute treatment of herpes zoster (shingles) and varicella (chickenpox).
Purine Nucleoside Analogue; Antiviral
Acyclovir is an antiviral drug active against herpes simplex virus. Acyclovir is a synthetic purine nucleoside analogue with cell culture and in vivo inhibitory activity against HSV types 1 (HSV-1) and 2 (HSV-2). The inhibitory activity of acyclovir is highly selective due to its affinity for the enzyme thymidine kinase (TK) encoded by HSV. This viral enzyme converts acyclovir into acyclovir monophosphate, a nucleotide analogue. The monophosphate is further converted into diphosphate by cellular guanylate kinase and into triphosphate by a number of cellular enzymes. In cell culture, acyclovir triphosphate stops replication of herpes viral DNA. This inhibition is accomplished in 3 ways: 1) competitive inhibition of viral DNA polymerase, 2) incorporation into and termination of the growing viral DNA chain, and 3) inactivation of the viral DNA polymerase.
ORAL Primary herpes simplex infectIons: Adult: 200 mg 5 times daily every 4 hr for 5-10 days; for severely immunocompromised patients & those w/ impaired absorption: 400 mg 5 times daily for 5 days. Suppression of recurrent herpes simplex: Adult: 800 mg daily in 2-4 divided doses. May reduce to 400-600 mg daily if necessary. Reassess the condition every 6-12 mth. For mild or infrequent recurrences: Episodic treatment may be used: 200 mg 5 times daily for 5 days, preferably begun during the prodromal period. Prophylaxis of herpes simplex In Immunocompromised patients: Adult: 200-400 mg 4 times daily. Child: 2 yr: 200-400 mg 4 times daily; <2 yr: 100-200 mg 4 times daily. Varicella zoster: Adult: >40 kg: 800 mg 4 times daily for 5 days. Child: 2yr& 40 kg: 20 mg/kg (up to 800 mg) 4 times daily for 5 days. Herpes zoster (shingles): Adult: 800 mg 5 times daily for 7-10 days. Child: 6 yr: 800 mg 4 times daily; 2-5 yr: 400 mg 4 times daily; <2 yr: 200 mg 4 times daily. INTRAVENOUS Mucocutaneous herpes simplex in immunocompromised patients: Adult: 5 mg/kg every 8 hr for 7 days. Dose to be given as IV infusion over 1 hr. Child: 10 mg/ kg every 8 hr for 7 days. Herpes simplex encephalitis: Adult: 10 mg/kg every 8 hr for 10 days. Child: 3 mth: 20 mg/kg every 8 hr for 10 days. Genital herpes: Adult: 5 mg/kg every 8 hr for 5-7 days. Neonatal HSV infections: Child: Birth -3 mth: 10 mg/kg every 8 hr for 10 days. Herpes zoster in immunocompromised patients: Adult: 12 yr: 10 mg/kg every 8 hr for 7 days. Child: 20 mg/kg every 8 hr for 7 days.
Clinical experience has identified no interactions resulting from topical or systemic administration of other drugs concomitantly with Acyclovir cream. Due to minimal systemic absorption of Acyclovir cream, systemic drug interactions are unlikely.
Hypersensitivity. Renal impairment. Pregnancy, lactation. Neurological abnormalities w/ significant hypoxia, serious hepatic or electrolyte abnormalities. Maintain adequate hydration.
Nausea, vomiting, headache, diarrhoea, rash, haematological changes (occasional), increase in liver enzymes, burning, itching or erythema (topical use). Eye application may produce stinging, superficial punctate keratopathy, blepharitis or conjunctivitis. IV administration; Local reaction, pain, inflammation, phlebitis, extravasation leads to ulceration. Increase in BUN and/or creatinine. Rarely, renal failure. Occasionally neurotoxicity after IV use: Lethargy, confusion, agitation, tremors, seizures, coma.
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.Benefit should outweigh risk. Adverse effects in breast-feeding infants associated with exposure to this drug via breast milk have not been reported in the literature. With the highest maternal dosage, the expected infant dose is about 1% of a typical infant dose. Use caution.
Store Acyclovir cream at room temperature between 20°C to 25°C
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