Antiviral drug, a synthetic analogue of acyclic purine nucleoside, which has a highly selective effect on herpes viruses. Inside virus-infected cells under the influence of viral thymidine kinase, a number of consecutive reactions of the transformation of acyclovir into mono-, di- and triphosphate of acyclovir occur. Acyclovirtriphosphate is inserted into the viral DNA chain and blocks its synthesis by competitive inhibition of the viral DNA polymerase.
In vitro, acyclovir is effective against herpes simplex virus - Herpes simplex type I and II, against the virus Varicella zoster; higher concentrations are required to inhibit the Epstein-Barr virus. In vivo, acyclovir is therapeutically and prophylactically effective, especially in viral infections caused by Herpes simplex.
When administered orally, the bioavailability is 15-30%. Acyclovir penetrates well into all organs and tissues of the body, including the brain and skin. Binding to plasma proteins is 9-33% and does not depend on its concentration in the plasma. The concentration in the cerebrospinal fluid is about 50% of its concentration in the plasma. Acyclovir penetrates the placental barrier and accumulates in breast milk. The maximum concentration after ingestion of 200 mg 5 times a day is 0.7 μg / ml, the time to reach the maximum concentration is 1.5-2 hours.
Treatment of infections of the skin and mucous membranes caused by Herpes simplex type I and II viruses, both primary and secondary, including genital herpes.
Prevention of exacerbations of recurrent infections caused by Herpes simplex type I and II viruses in patients with normal immune status.
Prevention of primary and recurrent infections caused by Herpes simplex virus type I and II, in patients with immunodeficiency.
In the complex therapy of patients with severe immunodeficiency: with HIV infection (stage of AIDS, early clinical manifestations and a developed clinical picture) and in patients who underwent bone marrow transplantation.
Treatment of primary and recurrent infections caused by the Varicella zoster virus (chickenpox, as well as herpes zoster).
Hypersensitivity to acyclovir, ganciclovir or any auxiliary substance of the drug.
The drug is contraindicated during lactation.
Application in pregnancy and lactation
Acyclovir penetrates the placental barrier and accumulates in breast milk. Use during pregnancy is only possible if the intended benefit to the mother exceeds the potential risk to the fetus. If you need to take acyclovir during lactation, interruption of breastfeeding is required.
Dosing and Administration
It is established individually depending on the severity of the disease.
In the treatment of infections of the skin and mucous membranes caused by Herpes simplex type I and II, adults and children over 2 years of age, the drug is prescribed 200 mg 5 times a day for 5 days with 4 hour intervals during the day and with 8 hours by an interval at night. In more severe cases, the course of treatment can be extended to the doctor's prescription. As part of complex therapy with severe immunodeficiency, including when the clinical picture of HIV infection (including early clinical manifestations of HIV infection and stage of AIDS), after the implantation of the bone marrow is prescribed 400 mg 5 times a day.
To prevent recurrence of infections caused by Herpes simplex type I and II viruses, patients with normal immune status and recurrent disease are prescribed 200 mg 4 times a day every 6 hours.
To prevent infections caused by Herpes simplex type I and II viruses, adults and children older than 2 years with immunodeficiency, it is recommended to prescribe 200 mg 4 times a day every 6 hours, the maximum dose to 400 mg of acyclovir 5 times a day in depending on the severity of the infection.
In the treatment of infections caused by Varicella zoster, adults are prescribed 800 mg 5 times a day every 4 hours in the afternoon and with an 8-hour interval at night. Duration of treatment 7-10 days. Children older than 2 years are prescribed 20 mg / kg 4 times a day for 5 days, children with a body weight of more than 40 kg, the drug is prescribed in the same dosage as adults.
In the treatment of infections caused by Herpes zoster, adults are prescribed 800 mg 4 times a day every 6 hours for 5 days.
In patients with impaired renal function:
When treating and preventing infections caused by Herpes simplex, in patients with creatinine clearance less than 10 ml / min the dosage of the drug should be reduced to 200 mg twice a day at 12 hour intervals.
In the treatment of infections caused by Varicella zoster, in patients with creatinine clearance for less than 10 ml / min it is recommended to reduce the dosage of the drug to 800 mg 2 times a day with 12-hour intervals; with a creatinine clearance of up to 25 ml / min, 800 mg 3 times a day with 8 hour intervals is prescribed. The drug is taken during or immediately after a meal and washed down with a sufficient amount of water. Medicinal interaction A simultaneous application with probenecid results in an increase in the mean half-life and a decrease in the clearance of acyclovir. With simultaneous admission with nephrotoxic drugs, the risk of impaired renal function increases. Storage conditions In dry, sheltered from the world, at a temperature not exceeding 25 ° C, inaccessible to children. The shelf life is 3 years.