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Frequently Asked Questions(FAQS)
 
 
Mechanism of Action
Activity against HSV types I and II and varicella-zoster virus is due to intracellular conversion of aciclovir to the monophosphate by viral thymidine kinase with subsequent conversion to the diphosphate and active triphosphate by cellular enzymes. This active form inhibits viral DNA synthesis and replication by interfering with viral DNA polymerase enzyme and being incorporated into viral DNA.



Indication & Dosage
 
 
Oral
HERPES ZOSTER (SHINGLES)
Adult: 800 mg 5 times daily for 7-10 days.
 
Oral
HERPES ZOSTER (SHINGLES)
Child: ≥6 yr: 800 mg 4 times daily; 2-5 yr: 400 mg 4 times daily; <2 yr: 200 mg 4 times daily.
 
Oral
CHICKEN POX
Child:  ≥2 yr and ≤40 kg: 20 mg/kg (up to 800 mg) 4 times daily for 5 days.
 
Oral
CHICKEN POX
Adult: 800 mg 4-5 times daily for 5-7 days.
 
Oral
PROPHYLAXIS OF HERPES SIMPLEX IN IMMUNOCOMPROMISED PATIENTS
Child:  ≥2 yr: 200-400 mg 4 times daily; <2 yr: 100-200 mg 4 times daily.
 
Oral
PROPHYLAXIS OF HERPES SIMPLEX IN IMMUNOCOMPROMISED PATIENTS
Adult: 200-400 mg 4 times daily.
 
Oral
SUPPRESSION OF RECURRENT HERPES SIMPLEX
Adult: 800 mg daily in 2-4 divided doses. Reduce to 400-600 mg daily if necessary.
 
Oral
PRIMARY HERPES SIMPLEX INFECTIONS INCLUDING GENITAL HERPES
Adult:  200 mg 5 times daily every 4 hr for 5-10 days or 400 mg 5 times daily for 5 days in severely immunocompromised patients and those with impaired absorption.
 
Intravenous
MUCOCUTANEOUS HERPES SIMPLEX IN IMMUNOCOMPROMISED PATIENTS
Adult: 5 mg/kg every 8 hr for 7 days. Dose to be given as IV infusion over 1 hr.
 
Intravenous
MUCOCUTANEOUS HERPES SIMPLEX IN IMMUNOCOMPROMISED PATIENTS
Child: 10 mg/kg every 8 hr for 7 days.
 
Intravenous
HERPES SIMPLEX ENCEPHALITIS
Adult: 10 mg/kg every 8 hr for 10 days.
 
Intravenous
HERPES SIMPLEX ENCEPHALITIS
Child: ≥3 mth: 20 mg/kg every 8 hr for 10 days.
 
Intravenous
HERPES GENITALIS
Adult: ≥12 yr: 5 mg/kg every 8 hr for 5-7 days.
 
Intravenous
NEONATAL HERPES SIMPLEX VIRUS INFECTIONS
Child: Birth - 3 mth: 10 mg/kg every 8 hr for 10 days.
 
Intravenous
HERPES ZOSTER IN IMMUNOCOMPROMISED PATIENTS
Adult:  ≥12 yr: 10 mg/kg every 8 hr for 7 days.
 
Intravenous
HERPES ZOSTER IN IMMUNOCOMPROMISED PATIENTS
Child: 20 mg/kg every 8 hr for 7 days.
 
Ophthalmic
HERPES SIMPLEX KERATITIS
Adult: Apply a 3% ointment 5 times daily until the 3rd day of complete healing.
 
Topical/Cutaneous
HERPES SIMPLEX INFECTIONS OF THE SKIN
Adult: Apply a 5% ointment/cream 5-6 times daily every 3-4 hr for 5-10 days.
  
AdministrationMay be taken with or without food. (May be taken w/ meals to reduce GI discomfort.)
  
PrecautionsRenal impairment. Pregnancy, lactation. Neurological abnormalities with significant hypoxia, serious hepatic or electrolyte abnormalities. Maintain adequate hydration.
  
Potentially Life-threatening 
Adverse Drug Reactions
Nausea, vomiting, headache, diarrhoea, rash, haematological changes (occasional), increase in liver enzymes, burning, itching or erythema (topical use). Eye application may produce stinging, superficial punctate keratopathy, blepharitis or conjunctivitis. IV administration: Local reaction, pain, inflammation, phlebitis, extravasation leads to ulceration. Increase in BUN and/or creatinine. Rarely, renal failure.
  
Adverse Drug Reactions Occasionally neurotoxicity after IV use: Lethargy, confusion, agitation, tremors, seizures, coma.
  
InteractionsProbenecid decreases urinary excretion and increases half-life. Risk of renal impairment increased by other nephrotoxic drugs.
  
   
 

 

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