Composition
IV Infusion 250 mg/500 mg/1 gm: Acyclovir 250mg/500 mg/1 gm, powder in vial. Tab/Cap 200 mg/400 mg/800 mg: Acyclovir 200 mg/400 mg/800 mg. Susp 200 mg/400 mg: Per 5 ml: Acyclovir 200 mg/400 m
Indications & Dosage
Herpes simplex, Genital herpes simplex, suppression & treatment: Adult & Children above 12 yrs: suppression: 400 mg twice daily, alternatively 200 mg 4 times a day; increased to 400 mg 3 times a day, dose may be increased if recurrences occur on standard suppressive therapy or for suppression of genital herpes during late pregnancy (from 36 weeks gestation), therapy interrupted every 6-12 months to reassess recurrence frequency; consider restarting after two or more recurrences. Treatment: Adult: 200 mg 5 times a day, alternatively 400 mg 3 times a day both courses usually for 5 days or longer if needed. Herpes simplex, Genital herpes simplex, prophylaxis & treatment in the immune-compromised, Severe genital herpes simplex: Prophylaxis: ORAL: Adult: 200-400 mg 4 times a day. Children 1-23 months: 100-200 mg 4 times a day; 2-17 years: 200-400 mg 4 times a day. BY IV INF: Adult: 5 mg/kg every 8 hours Treatment: Adult: 400 mg 5 times a day or longer if needed. Children 1-23 months: 200 mg 4 times a day; 2-17 years: 200-400 mg 4 times a day or longer if needed. Genital herpes simplex, treatment of recurrent infection: Adult: 800 mg 3 times a day for 2 days, alternatively200 mg 5 times a day for 5 days, alternatively 400 mg3 times a day for 3-5 days. Genital herpes simplex, treatment of recurrent infection in immune-compromised or HIV-positive patients: Adult: 400 mg 3 times a day for 5-10 days. Varicella zoster (chickenpox), treatment, Herpes zoster (shingles), treatment: ORAL: Adult & Children above 12 yrs: 800 mg 5 times a day for 7 days Children 1-23 months: 200 mg 4 times a day for 5 days; 2-5 yrs: 400 mg 4 times a day for 5 days; 6-11 yrs: 800 mg 4 times a day for 5 days BY IV INF: Adult: 5 mg/kg every 8 hours usually for 5 days; in immune-compromised patients: Adult: 10 mg/kg every 8 hours usually for 5 days. Herpes zoster, treatment in encephalitis, Varicella zoster, treatment in encephalitis: BY IV INF: Adult: 10 mg/kg every 8 hours given for 10-14 days in encephalitis, possibly or longer if needed. Varicella zoster (chickenpox), attenuation of infection if Varicella-zoster immunoglobulin not indicated: Adult: 10 mg/kg 4 times a day for 7 days, to be started 1 week after exposure. Children: 10 mg/kg 4 times a day for 7 days, to be started 1 week after exposure.
Administration
Avoid rapid infusion; infuse over 1 hour to prevent renal damage; maintain adequate hydration; check for phlebitis and rotate infusion sites. Reconstitute 500 mg with SWFI 10 ml. Do not use bacteriostatic water containing benzyl alcohol or parabens. For IV infusion dilute in D5W, D5NS, D5 1/4 NS, D5 1/2 NS, LR, NS to a final concentration = 7 mg /ml.
Compatibility
Stable in D5W, D5NS, D51/4 NS, D5 NS, LR, NS
Stability
Store at controlled room temperature 15o-25C. Reconstituted solution remains stable for 12 hours at room temperature. Do not refrigerate.
Precautions
Hepatic and renal impairment, maintain adequate hydration, elderly (risk of neurological reactions).To avoid excessive dosage in obese patients, parenteral dose should be calculated on the basis of ideal weight for height.
Interactions
Probenecid, cimetidine,
Pregnancy
Caution advised, use only when potential benefit outweighs risk.
Lactation
Caution advised
Side Effects
: Abdominal pain, diarrhoea, fatigue, headache, nausea, photosensitivity, pruritus, rash, urticaria, vomiting, anaemia, ataxia, confusion, convulsions, dizziness, drowsiness, dysarthria, dyspnea, hallucinations, hepatitis, jaundice, leucopenia, neurological reactions, thrombocytopenia. With intravenous use: Agitation, fever, psychosis, severe local inflammation, tremors. Rare: Acute renal failure