Acyclovir

What is Acyclovir?

• Acyclovir (Sitavig ; Zovirax) is a synthetic nucleoside analogue and antiviral agent used in therapy of herpes and varicella-zoster virus infections.

Acyclovir

Acyclovir 3D

What are the uses of this medicine?

Acyclovir (Sitavig ; Zovirax) used for the treatment of:

• The acute treatment of herpes zoster (shingles)
• Genital Herpes
• Chickenpox (varicella)

How does this medicine work?

• Acyclovir (ay sye' kloe vir) is an acyclic purine nucleoside analogue (acycloguanosine) which has antiviral activity against many herpes viruses, including herpes simplex 1 and 2, cytomegalovirus, Ebstein-Barr virus and varicella-zoster.
• Acyclovir is phosphorylated intracellularly by viral kinases, and the resultant triphosphate competes with guanosine for incorporation into viral DNA blocking viral DNA polymerase activity.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• hypersensitivity to acyclovir or valacyclovir.

What drug interactions can this medicine cause?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Be sure to mention if you are taking any of the following:

• amphotericin B (Fungizone)
• aminoglycoside antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Nes-RX, Neo-Fradin), paramomycin (Humatin), streptomycin, and tobramycin (Tobi, Nebcin)
• aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn)
• cyclosporine (Gengraf, Neoral, Sandimmune)
• medications to treat HIV or AIDS such as zidovudine (Retrovir, AZT)
• pentamidine (NebuPent)
• probenecid (Benemid)
• sulfonamides such as sulfamethoxazole and trimethoprim (Bactrim)
• tacrolimus (Prograf)
• vancomycin

Is this medicine FDA approved?

• Acyclovir was approved for use in herpes virus infections in the United States in 1982, and is still widely used in treatment and prophylaxis of genital and mucocutaneous herpes simplex infection with almost 5 million prescriptions filled yearly.

How should this medicine be used?

Recommended dosage:

• Acute Treatment of Herpes Zoster: 800 mg every 4 hours orally, 5 times daily for 7 to 10 days.
• Genital Herpes: Treatment of Initial Genital Herpes: 200 mg every 4 hours, 5 times daily for 10 days.
• Chronic Suppressive Therapy for Recurrent Disease: 400 mg 2 times daily for up to 12 months, followed by re-evaluation. Alternative regimens have included doses ranging from 200 mg 3 times daily to 200 mg 5 times daily.
• Intermittent Therapy: 200 mg every 4 hours, 5 times daily for 5 days. Therapy should be initiated at the earliest sign or symptom (prodrome) of recurrence.

Treatment of Chickenpox:

• Children (2 years of age and older): 20 mg/kg per dose orally 4 times daily (80 mg/kg/day) for 5 days. Children over 40 kg should receive the adult dose for chickenpox.
• Adults and children over 40 kg: 800 mg 4 times daily for 5 days.

• Dosage adjustment is recommended when administering acyclovir to patients with renal impairment.

Administration:

• Acyclovir comes as a tablet, a capsule, and a suspension (liquid) to take by mouth.
• It also comes as a delayed-release buccal tablet to apply to the upper gum of the mouth.
• The tablets, capsules, and suspension are usually taken with or without food two to five times a day for 5 to 10 days, starting as soon as possible after your symptoms begin.
• When acyclovir is used to prevent outbreaks of genital herpes, it is usually taken two to five times a day for up to 12 months. T
• he delayed-release buccal tablet is usually applied with a dry finger as a one-time dose within 1 hour after itching, redness, burning or tingling cold sore symptoms begin but before the cold sore appears.
• Do not chew, crush, suck, or swallow the delayed-release buccal tablets.
• Drink plenty of liquids, if you have a dry mouth while using the delayed-release buccal tablets.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As capsules of 200 mg, tablets of 400 and 800 mg, oral suspensions, creams, ointments, delayed-release buccal tablet

This medicine is available in fallowing brand namesː

• Sitavig ; Zovirax

What side effects can this medication cause?

The most common side effects of this medicine include: In Herpes Simplex:

• nausea and/or vomiting

In Long-Term Administration:

• diarrhea, nausea, and headache

In Herpes Zoster:

• malaise

In Chickenpox:

• diarrhea

Side effects are uncommon with oral formulations, but can include:

• upset stomach
• vomiting
• diarrhea
• dizziness
• tiredness
• agitation
• pain, especially in the joints
• hair loss
• changes in vision
• Rare side effects include bone marrow toxicity and Stevens Johnson syndrome.

What special precautions should I follow?

• Renal failure, in some cases resulting in death, has been observed with acyclovir therapy.
• Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS), which has resulted in death, has occurred in immunocompromised patients receiving acyclovir therapy.
• Patients should be advised to maintain adequate hydration.
• Patients should be advised to initiate treatment as soon as possible after a diagnosis of herpes zoster.
• Patients should be informed that acyclovir is not a cure for genital herpes. Because genital herpes is a sexually transmitted disease, patients should avoid contact with lesions or intercourse when lesions and/or symptoms are present to avoid infecting partners. If medical management of a genital herpes recurrence is indicated, patients should be advised to initiate therapy at the first sign or symptom of an episode.
• Acyclovir has not been associated with clinically apparent liver injury.

What to do in case of emergency/overdose?

Symptoms of overdose may include:

• agitation
• coma
• seizures
• lethargy
• acute renal failure
• anuria

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• The patient may benefit from hemodialysis until renal function is restored.

Can this medicine be used in pregnancy?

• Pregnancy Category B.
• There are no adequate and well-controlled studies in pregnant women.
• Acyclovir should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Can this medicine be used in children?

• Safety and effectiveness of oral formulations of acyclovir in pediatric patients less than 2 years of age have not been established.

What are the active and inactive ingredients in this medicine?

Active ingredients:

• ACYCLOVIR

Inactive ingredient:

• LACTOSE MONOHYDRATE
• MAGNESIUM STEARATE
• STARCH, CORN
• GELATIN
• TITANIUM DIOXIDE
• FERROSOFERRIC OXIDE
• PROPYLENE GLYCOL

Who manufactures and distributes this medicine?

Manufactured for:

• Ranbaxy Pharmaceuticals Inc.
• Jacksonville, FL USA

Manufactured by:

• Ohm Laboratories Inc.
• North Brunswick, NJ USA

ZOVIRAX Cream: Distributed by:

• Bausch Health US, LLC
• Bridgewater, NJ 08807 USA

Manufactured by:

• Bausch Health Companies Inc.
• Laval, Quebec, Canada

What should I know about storage and disposal of this medication?

• Store at 20 - 25° C (68 - 77° F).

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Drugs for Herpes Virus

• infections (HSV), CMV, others

Acyclovir, Cidofovir, Famciclovir, Foscarnet, Ganciclovir, Valacyclovir, Valganciclovir

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• Dailymed label info on Acyclovir
• FDA Acyclovir

Acyclovir Resources
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