RiteMED Aciclovir

Aciclovir

HSV infections of skin & mucous membranes including initial & recurrent genital herpes. Suppression of recurrent herpes simplex infections in immunocompetent patients. Varicella infections (chickenpox) & acute herpes zoster (shingles); reduction of duration & severity of acute symptoms & rash, & reduction of all zoster-associated pain (post-herpetic neuralgia). Management of certain severely immunocompromised patients eg, those w/ advanced HIV disease (CD4+ counts <200/mm³, including patients w/ AIDS or severe ARC) or following bone marrow transplantation. Prophylaxis of herpes simplex infections in immunocompromised patients.

Adult Herpes simplex infections (including genital herpes) 200 mg 5 times daily every 4 hr (omitting night-time dose) for 5-10 days. Immunocompromised patient (eg, after marrow transplants) or those w/ impaired absorption from gut 400 mg 5 times daily every 4 hr (omitting night-time dose) for 5 days or may be extended in severe initial infection. Suppression of herpes simplex infections in immunocompetent patients (including chronic suppressive therapy for recurrent disease) 200 mg every 6 hr or 400 mg every 12 hr, may be titrated down to 200 mg every 8 hr or 12 hr, for 12 mth. Periodically interrupt treatment at intervals of 6-12 mth in order to observe possible changes in natural history of the disease. Prophylaxis of herpes simplex infections 200 mg every 6 hr, may be increased to 400 mg if needed. Duration: Determined by duration of the period at risk. Varicella & herpes zoster 800 mg 5 times daily every 4 hr (omitting night-time dose) for 7 days. Management of severely immunocompromised patients 800 mg every 6 hr for 6-12 mth. Acute treatment of herpes zoster 800 mg 5 times daily every 4 hr for 7-10 days. Childn Dose may be more accurately calculated as 20 mg/kg (not to exceed 800 mg) every 6 hr. Treatment of herpes simplex infections, & prophylaxis of herpes simplex infections in the immunocompromised ≥2 yr Adult dose, <2 yr ½ adult dose. Varicella infections Childn ≥6 yr 800 mg every 6 hr for 5 days, 2-5 yr 400 mg every 6 hr for 5 days, <2 yr 200 mg every 6 hr for 5 days. Renal impairment Treatment & prophylaxis of herpes simplex infections CrCl <10 mL/min 200 mg every 12 hr. Varicella & herpes zoster infections & management of severely immunocompromised patients CrCl 10-25 mL/min 800 mg every 8 hr, <10 mL/min 800 mg every 12 hr.

May be taken with or without food.

Hypersensitivity to aciclovir or valaciclovir.

Not a cure for genital herpes & therefore patients w/ genital herpes should avoid sexual contact while visible lesions are present. Maintain adequate hydration in patients receiving high doses. May increase risk of renal dysfunction &/or reversible CNS symptoms w/ potentially nephrotoxic agents. Renal impairment. Pregnancy & lactation. Childn <2 yr. Elderly.

Fatigue, fever, headache, pain, peripheral edema; aggressive behavior, agitation, ataxia, coma, confusion, decreased consciousness, delirium, dizziness, dysarthria, encephalopathy, hallucinations, convulsions, malaise, obtundation, paresthesia, psychosis, seizures, somnolence, tremors; abdominal pain, diarrhea, GI distress, nausea, vomiting; anemia, leukocytoclastic vasculitis, leukopenia, lymphadenopathy, thrombocytopenia; elevated LFTs, hepatitis, hyperbilirubinemia, jaundice, reversible rises in liver related enzymes; increased blood urea & creatinine, acute renal failure, renal pain; myalgia; alopecia, erythema multiforme, photosensitivity rash, pruritus, rash, SJS, TEN, urticaria; visual abnormalities; dyspnea; accelerated diffuse hair loss; anaphylaxis, angioedema; hypotension, thirst.

Potentiated antiviral effect against pseudorabies virus w/ amphotericin B. Dose-dependent, synergistic, antiviral activity against HSV-1 & -2 w/ ketoconazole. Increased mean plasma t_½ & AUC & decreased urinary excretion & renal clearance w/ probenecid & cimetidine. Additive or synergistic antiviral effect against HSV-1 w/ interferon. Neurotoxicity characterized by profound drowsiness & lethargy w/ zidovudine in 1 AIDS patient. May result in inhibition of metabolism of theophylline.

Antivirals

J05AB01 - aciclovir ; Belongs to the class of nucleosides and nucleotides excluding reverse transcriptase inhibitors. Used in the systemic treatment of viral infections.

Rx