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Acyclovir Brand Names- SITAVIG | Zovirax
What is Acyclovir
Acyclovir is a synthetic purine deoxynucleoside analogue (specifically acyclic guanosine analogue) with potent activity against herpes simplex viruses type 1 and 2 (HSV-1, HSV-2) and much less activity against varicella-zoster virus (VZV).
Clinically, the drug is indicated to treat the following infections: herpes labialis, herpes genitalis, herpes simplex encephalitis, herpes simplex keratitis, neonatal herpes infection, chickenpox (varicella), and shingles (zoster).
In order to be active, the drug must be phosphorylated by viral thymidine kinase to acyclovir monophosphate, and then further converted to acyclovir triphosphate.
After phosphorylation, the drug binds to viral DNA polymerase, is incorporated into viral DNA, and ultimately inhibits viral DNA synthesis. The greater antiviral activity of acyclovir against HSV as compared to VZV is due to its more efficient phosphorylation by HSV thymidine kinase.
Acyclovir is commercially available as a topical cream and ointment, ophthalmic ointment, oral capsule, tablet and suspension, solution for injection, and buccal tablets.
Indications
- acute retinal necrosis (ARN)
- B virus (cercopithecine herpesvirus)
- Bell’s palsy
- complicated herpes simplex virus infection
- cytomegalovirus (CMV)
- cytomegalovirus (CMV) disease prophylaxis
- encephalitis
- hairy leukoplakia
- herpes genitalis
- herpes genitalis prophylaxis
- herpes labialis
- herpes labialis prophylaxis
- herpes simplex infection prophylaxis
- herpes simplex keratitis (dendritic keratitis)
- herpes simplex ocular infection prophylaxis
- herpes simplex virus type 1
- herpes simplex virus type 2
- herpes zoster (shingles) infection
- herpes zoster ocular infection
- neonatal herpes simplex virus infection
- neonatal herpes simplex virus infection prophylaxis
- progressive outer retinal necrosis (PORN)
- varicella (chickenpox) infection
- varicella (chickenpox) infection prophylaxis
- varicella-zoster virus
Side Effects
- abdominal pain
- agitation
- alopecia
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- ataxia
- azotemia
- coma
- confusion
- contact dermatitis
- crystalluria
- delirium
- diarrhea
- disseminated intravascular coagulation (DIC)
- dizziness
- drowsiness
- dysarthria
- edema
- elevated hepatic enzymes
- encephalopathy
- erythema
- erythema multiforme
- fatigue
- fever
- hallucinations
- headache
- hematuria
- hemolysis
- hemolytic-uremic syndrome
- hepatitis
- hyperbilirubinemia
- hypotension
- injection site reaction
- jaundice
- lethargy
- leukocytosis
- leukopenia
- lymphadenopathy
- malaise
- myalgia
- nausea
- neutropenia
- paresthesias
- peripheral edema
- phlebitis
- photosensitivity
- pruritus
- psychosis
- rash
- renal failure (unspecified)
- renal tubular obstruction
- seizures
- skin irritation
- Stevens-Johnson syndrome
- stomatitis
- thrombocytopenia
- thrombocytosis
- thrombotic thrombocytopenic purpura (TTP)
- tissue necrosis
- toxic epidermal necrolysis
- tremor
- urticaria
- vasculitis
- visual impairment
- vomiting
- xerosis
Monitoring Parameters
- serum creatinine/BUN
Contraindications
- acyclovir hypersensitivity
- breast-feeding
- children
- dehydration
- electrolyte imbalance
- extravasation
- famciclovir hypersensitivity
- ganciclovir hypersensitivity
- geriatric
- hepatic disease
- hypoxemia
- immunosuppression
- infants
- intramuscular administration
- milk protein hypersensitivity
- neonates
- neurological disease
- obesity
- ophthalmic administration
- penciclovir hypersensitivity
- pregnancy
- renal failure
- renal impairment
- seizure disorder
- subcutaneous administration
- valacyclovir hypersensitivity
- valganciclovir hypersensitivity
Interactions
- Adefovir
- Aldesleukin, IL-2
- Amikacin
- Aminoglycosides
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Aprotinin
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Capreomycin
- Cidofovir
- Cimetidine
- Cisplatin
- Clofarabine
- Colchicine; Probenecid
- Cyclosporine
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Emtricitabine; Tenofovir disoproxil fumarate
- Entecavir
- Ethotoin
- Foscarnet
- Fosphenytoin
- Gadoterate meglumine
- Gallium Ga 68 Dotatate
- Gentamicin
- Hyaluronidase, Recombinant; Immune Globulin
- Hydantoins
- Immune Globulin IV, IVIG, IGIV
- Inotersen
- Iodipamide Meglumine
- Iohexol
- Ionic Contrast Media
- Iopamidol
- Iopromide
- Ioversol
- Ioxaglate Meglumine; Ioxaglate Sodium
- Isosulfan Blue
- Kanamycin
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lithium
- Mannitol
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Methotrexate
- Mycophenolate
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Paromomycin
- Phenytoin
- Plazomicin
- Polymyxins
- Probenecid
- Streptomycin
- Tacrolimus
- Talimogene Laherparepvec
- Telavancin
- Telbivudine
- Tenofovir Alafenamide
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Theophylline, Aminophylline
- Tizanidine
- Tobramycin
- Vancomycin
- Varicella-Zoster Virus Vaccine, Live
