Aciclovir

May be taken with or without food. May be taken w/ meals to reduce GI discomfort.

Hypersensitivity to aciclovir and valaciclovir.

Patients receiving high doses; those with underlying neurological abnormalities, significant hypoxia, and serious electrolyte or hepatic abnormalities (IV); volume depletion. Maintain adequate hydration during therapy, particularly with high doses or IV infusion. Avoid extravasation during IV infusion. Topical cream or ointment is not recommended to be applied to the mucous membranes (e.g. eyes, vagina, mouth). Immunocompromised and obese patients. Renal impairment. Neonates, children, and elderly. Pregnancy and lactation. Patient Counselling Oral/IV: Ensure to maintain adequate hydration (especially when taking high doses). Ophthalmic: This drug may interfere with visual ability, if affected, do not drive or operate machinery. Avoid wearing contact lenses when using the eye ointment. Monitoring Parameters Monitor CBC, urinalysis, BUN, serum creatinine, urine output, hydration status, and liver enzymes. Obtain neutrophil count at least twice weekly in neonates receiving 60 mg/kg daily via IV. Closely assess for signs of neurotoxicity and nephrotoxicity (particularly in children receiving high doses, elderly and patients with renal impairment).

Significant: Acute kidney injury, neurotoxicity (e.g. confusion, agitation, lethargy, hallucination, impaired consciousness); skin irritation and contact sensitisation (topical cream). Blood and lymphatic system disorders: Thrombocytopenia, anaemia, leucopenia. Eye disorders: Superficial punctate keratopathy, conjunctivitis, transient mild burning or stinging in the eye after ophthalmic application. Rarely, blepharitis. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain; gingival pain, aphthous stomatitis (buccal tab). General disorders and administration site conditions: Malaise, fatigue, fever, peripheral oedema; inj site inflammation and phlebitis (IV). Hepatobiliary disorders: Rarely, jaundice, hepatitis. Immune system disorders: Rarely, anaphylaxis, angioedema. Investigations: Increased serum transaminases, serum bilirubin, BUN, and serum creatinine. Musculoskeletal and connective tissue disorders: Myalgia. Nervous system disorders: Headache, dizziness, dysarthria, somnolence. Skin and subcutaneous tissue disorders: Pruritus, rash, photosensitivity reaction, urticaria; mild local pain (including transient burning or stinging sensation), mild drying or flaking of the skin, erythema (topical). Vascular disorders: Hypotension.
Potentially Fatal: Thrombotic thrombocytopenic purpura and haemolytic uraemic syndrome (particularly in immunocompromised patients); renal failure.

Increased risk of renal dysfunction with other nephrotoxic agents. May increase the serum concentration of theophylline. Probenecid and cimetidine may increase the plasma exposure and reduce the renal clearance of aciclovir. Increases in plasma concentrations of both aciclovir and inactive metabolite of mycophenolate mofetil when the drugs are administered concurrently. Concomitant use of high-dose IV aciclovir and lithium may increase the risk of lithium toxicity.

Antivirals / Eye Anti-Infectives & Antiseptics / Topical Antivirals

S01AD03 - aciclovir ; Belongs to the class of antiinfectives, antivirals. Used in the treatment of eye infections.
D06BB03 - aciclovir ; Belongs to the class of topical antivirals used in the treatment of dermatological diseases.
J05AB01 - aciclovir ; Belongs to the class of nucleosides and nucleotides excluding reverse transcriptase inhibitors. Used in the systemic treatment of viral infections.