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ACICLOVIR
Generic Name: ACICLOVIR
ABSTRACT -
Aciclovir, also spelled acyclovir, is an antiviral nucleoside analogue used for infections caused by herpes simplex virus and varicella-zoster virus. After activation by viral thymidine kinase and cellular enzymes, it inhibits viral DNA polymerase and viral DNA replication. It is available in oral, intravenous, and topical formulations in many countries. Dosing depends on the indication, route, immune status, kidney function, age, and local prescribing information.
DOSAGE -
Aciclovir dosage should be individualized by a qualified healthcare professional according to indication, severity, route, age, weight, and renal function.
- Oral regimens are commonly used for genital herpes, herpes labialis, shingles, and chickenpox when appropriate.
- Intravenous aciclovir is used for severe disease, immunocompromised patients, neonatal herpes, or suspected herpes encephalitis.
- Renal dose adjustment is important because aciclovir is primarily eliminated by the kidneys.
- Adequate hydration is recommended, especially with intravenous therapy or high doses.
- Treatment is most effective when started early in the course of infection.
- Complete the prescribed course and do not change the dose without medical advice.
SIDE EFFECTS –
Reported or potential side effects may include:
- Nausea, vomiting, diarrhea, or abdominal pain
- Headache or dizziness
- Fatigue
- Rash or itching
- Injection-site inflammation with intravenous use
- Kidney function changes or crystalluria, especially with dehydration or rapid IV infusion
- Confusion, tremor, hallucinations, or seizures, especially with renal impairment or high levels
- Elevated liver enzymes
- Blood count changes, rarely
- Severe skin reactions, rarely
ALLRGIC REACTIONS–
(These symptoms may indicate an allergic reaction to the medicine.)
- Skin rash
- Itching
- Hives
- Swelling of the face, lips, tongue, or throat
- Difficulty breathing or wheezing
- Chest tightness
- Severe dizziness or fainting
- Rapid heartbeat
- Anaphylaxis or severe hypersensitivity reaction
DRUG INTERACTIONS–
Caution should be exercised when aciclovir is used with:
- Nephrotoxic medicines such as aminoglycosides, amphotericin B, ciclosporin, tacrolimus, or high-dose NSAIDs
- Probenecid, which may increase aciclovir exposure
- Cimetidine, which may affect renal clearance
- Mycophenolate mofetil, where levels of both medicines may change
- Other antivirals or medicines requiring renal dose adjustment
- Dehydrating medicines or conditions that increase kidney risk
Patients should inform healthcare providers about all prescription medicines, non-prescription medicines, vitamins, herbal products, vaccines, and supplements being used.
PRECAUTIONS –
- Assess kidney function before and during treatment when clinically indicated.
- Maintain hydration and avoid rapid intravenous infusion.
- Use caution in older adults, patients with kidney disease, and immunocompromised patients.
- Neurologic symptoms during therapy require prompt evaluation, particularly in renal impairment.
- Topical formulations are for external use only and should not be placed in the eye unless specifically formulated for ophthalmic use.
- Pregnancy and breastfeeding use should be discussed with a healthcare professional.
- Patients should seek care for worsening lesions, eye involvement, neurologic symptoms, or signs of dissemination.
WARNINGS –
- Serious kidney injury and neurotoxicity can occur, especially with high doses, dehydration, or renal impairment.
- Herpes encephalitis, neonatal herpes, disseminated infection, or eye involvement require urgent medical evaluation.
- Aciclovir does not eradicate latent herpes virus and recurrences may still occur.
- Do not use someone else's antiviral medicine or share prescribed medicine.
- Keep out of reach of children.
- In case of severe adverse reaction or suspected overdose, seek medical attention.
- Patients should report unusual symptoms or side effects to their healthcare provider promptly.
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