Clinical Pharmacology Details


Aciclovir


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Indications & Dose:

INDICATIONS AND DOSE: 


Herpes zoster in immunocompetent adults; initial episode and episodic treatment of recurrent genital herpes in immunocompefent adults; suppression of recurrent episodes of genital herpes in immunocompetent adults



Adults:


Herpes zoster:


200mg (400mg in immunocompromised or if absorption impaired) 5 times daily at 4 hourly intervals for 7 days ( longer if new lision appears during treatment or if heal;ing incomplete , increase dose 800mg 5 times daily for genital herpes in the immunocompromised . Herpes simplex treatment: 200mg -400mg 5 times daily at 4 hourly intervals for 5 days butmay need to be extended in severe initial infections.. Prophylaxis or suppression: 200mg 4 times daily at 6 hourly intervals. Chicken pox: 800mg 5 times a day for 7-10 days. Vericella and Herpes Zoster: 800mg 5 times a day for 7days


Children:


Herpes zoster –


not applicable.


Herpes simplex treatment –


under 2 years: 100mg 5 times daily at 4 hourly intervals for 5 days. Over 2 years: Same as adult. Prophylaxis: Under 2 years – 100mg 4 times daily at 6 hourly intervals. Over 2 years: Same as adult. Chicken pox: 20mg/kg body wt. (max. 800mg) 4 times daily for 5 days. Varicella; Under 2 years 200mg 4 times daily for 5 days, 2-5 years 400mg 4 times daily for 5 days, over 6 years; 800mg five times daily for 7 days. By intravenous infusion over 1 hour, herpes simplex or recurrent varicella zoster 5mg/kg every 9 hours; doubled in primary and recurrent varicella zoster in the immunocompromised, and in simplex encephalitis; child up to 3 months 10mg/kg every 8 hours; 3 months-12 years, 250mg/m2 every 8 hours, dose doubled in the immunocompromised and in simplex encephalitis.



Herpes simplex (cream or eye ointment as appropriate) every 4 hours (5 times daily).for 5 days if healing not complete.


Note: cream should not be used on mucous membranes

Contraindications:

Side Effects:

Cautions:

Precautions:

Renal insufficiency, hepatic insufficiency, elderly, children

Interaction:

Drugs


Probenecid: Increases efficacy by decreasing urinary excretion and increasing half-life.


Zidovudine: Causes severe drowsiness and lethargy

Warnings:

Adverse Effects:

Lactations:

Pregnancy category B; acyclovir excreted into breast milk, safety not established but should be compatible with breast feeding

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Dizziness, headache


GI: Abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting


GU: Renal dysfunction


NEME: Anemia, thrombocytopenia

Patient And Carer Advice: