ACYCLOVIR

Indications & Dose:

Herpes zoster in immunocompetent adults; initial episode and episodic treatment of recurrent genital herpes in immunocompefent adults;
suppression of recurrent episodes of genital herpes in immunocompetent adults

BY MOUTH

Adults: Herpes zoster: 200mg (400mg in immunocompromised or if absorption impaired) 5 times daily at 4 hourly intervals for 7 days ( longer if new lision appears during treatment or if heal;ing incomplete , increase dose 800mg 5 times daily for genital herpes in the immunocompromised . Herpes simplex treatment: 200mg -400mg 5 times daily at 4 hourly intervals for 5 days butmay need to be extended in severe initial infections.. Prophylaxisor suppression: 200mg 4 times daily at 6 hourly intervals.
Chicken pox: 800mg 5 times a day for 7-10 days. Vericella and Herpes Zoster: 800mg 5 times a day for 7days.
Children: Herpes zoster – not applicable. Herpes simplex treatment – under 2 years: 100mg 5 times daily at 4 hourly intervals for 5 days. Over 2 years: Same as adult. Prophylaxis: Under 2 years – 100mg 4 times daily at 6 hourly intervals. Over 2 years: Same as adult.
Chicken pox: 20mg/kg body wt. (max. 800mg) 4 times daily for 5 days. Varicella; Under 2 years 200mg 4 times daily for 5 days, 2-5 years 400mg 4 times daily for 5 days,over 6 years; 800mg five times daily for 7 days. By intravenous infusion over 1 hour, herpes  simplex or recurrent varicella zoster 5mg/kg every 9 hours; doubled in primary and recurrent varicella zoster in the immunocompromised, and in simplex encephalitis; child up to 3 months 10mg/kg every 8 hours; 3 months-12 years, 250mg/m2 every 8 hours, dose doubled in the immunocompromised and in simplex encephalitis. BY TOPICAL APPLICATION; Herpes simplex (cream or eye ointment as appropriate) every 4 hours (5 times daily).for 5 days if healing not complete.

Note: cream should not be used on mucous membranes 

Contraindications:

Side Effects:

Cautions:

Precautions:

 Renal insufficiency, hepatic insufficiency, elderly, children 

Interaction:

Drugs
Probenecid: Increases efficacy by decreasing urinary excretion and increasing half-life.
Zidovudine: Causes severe drowsiness and lethargy

Warnings:

Adverse Effects:

Lactations:

Pregnancy category B; acyclovir excreted into breast milk, safety not established but should be compatible with breast feeding 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Dizziness, headache

GI: Abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting

GU: Renal dysfunction

NEME: Anemia, thrombocytopenia 

Patient And Carer Advice: