Zevin

Aciclovir

HSV infections of skin & mucous membrane including initial & recurrent genital herpes. Varicella (chickenpox) infection. Acute treatment of herpes zoster (shingles). Prophylaxis of herpes simplex infection in immunocompromised patients.

Adult Genital herpes simplex Immunocompetent patient Treatment: Initially 400 mg tid, or 200 mg 5 times daily for 7-10 days. Extend duration if lesions have not healed completely. Recurrence: 400 mg tid for 5 days, or 800 mg bid for 5 days, or 800 mg tid for 2 days. Immunocompromised patient including HIV-infected Treatment (initial) or recurrence: 400 mg tid for 5-10 days. Extend duration if lesions have not healed completely. Orolabial herpes simplex Immunocompetent & immunocompromised patient including HIV-infected Treatment (initial) or recurrence: 400 mg tid for 5-10 days & until completion of lesion resolution. Varicella (chickenpox) Initiate therapy w/in 24 hr of symptom onset. Immunocompetent patient 800 mg 5 times daily for ≥5-7 days until all lesions have crusted. Uncomplicated infection 800 mg 5 times daily for 5-7 days until all lesions have crusted. Herpes zoster Immunocompetent patient 800 mg 5 times daily for 7 days. Initiate therapy at earliest sign or symptom ≤72 hr after rash onset. Immunocompromised patient 800 mg 5 times daily for 7-10 days. Prophylaxis of herpes simplex in immunocompromised 200-400 mg qid. Paed Genital herpes simplex Immunocompetent patient ≥12 yr 1,000-1,200 mg daily in 3-5 divided doses for 7-10 days, <12 yr 40-80 mg/kg daily in 3-4 divided doses for 5-10 days. Orolabial herpes simplex Immunocompetent childn 1-6 yr 15 mg/kg (up to 200 mg) 5 times daily for 7 days. Varicella zoster Childn weighing >40 kg 800 mg qid for 5 days, ≥2 yr weighing ≤40 kg 20 mg/kg qid (max daily dose: 80 mg/kg) for 5 days. Herpes zoster Immunocompetent childn ≥12 yr 800 every 4 hr 5 times daily for 5-10 days. Initiate therapy w/in 48 hr of rash onset. Renal impairment Adult w/ normal dose regimen of 200 mg every 4 hr & CrCl >10 mL/min/1.73 m² 200 mg every 4 hr 5 times daily, CrCl 0-10 mL/min/1.73 m² 200 mg every 12 hr. Adult w/ normal dose regimen of 400 mg every 12 hr & CrCl >10 mL/min/1.73 m² 400 mg every 12 hr, CrCl 0-10 mL/min/1.73 m² 200 mg every 12 hr. Adult w/ normal dose regimen of 800 mg every 4 hr & CrCl >25 mL/min/1.73 m² 800 mg every 4 hr 5 times daily, CrCl 10-25 mL/min/1.73 m² 800 mg every 8 hr, CrCl 0-10 mL/min/1.73 m² 800 mg every 12 hr.

May be taken with or without food.

Hypersensitivity to aciclovir or valaciclovir.

TTP/hemolytic uremic syndrome in immunocompromised patients. Increased neurotoxicity (eg, tremor/myoclonus, confusion, agitation, lethargy, hallucination & impaired consciousness) w/ higher doses & in patients w/ renal failure. Monitor patients for signs & symptoms of neurotoxicity. Initiate treatment as soon as possible after diagnosis of herpes zoster; at 1st sign or symptom of genital herpes episode. Avoid contact w/ lesions or intercourse when lesions &/or symptoms are present. Renal failure. Increased risk of renal dysfunction in patients receiving potentially nephrotoxic agents. Pregnancy & lactation. Not recommended for routine use in healthy childn w/ varicella. Elderly.

Headache, malaise; pruritus, skin rash, urticaria; diarrhea, nausea, vomiting; decreased ANC & Hb, thrombocytopenia; increased serum bilirubin & transaminases; increased BUN & serum creatinine. Erythema multiforme, SJS, TEN.

Enhanced nephrotoxic effect w/ foscarnet. Increased serum conc of & w/ mycophenolate; tenofovir products. May diminish therapeutic effect of talimogene laherparepvec; varicella virus & zoster vaccine. Potentiated antiviral effect w/ amphotericin B. Increased mean plasma t_½ & AUC, & decreased urinary excretion & renal clearance w/ probenecid. Concomitant use w/ intrathecal MTX; zidovudine.

Antivirals

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

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