Buy Acyclovir Online

Acyclovir Injection (acyclovir sodium)

OTHER BRAND NAMES

Zovirax Injection (Discontinued)

THERAPEUTIC CLASS

Nucleoside analogue

DEA CLASS

RX

INDICATIONS

Treatment of initial and recurrent mucosal and cutaneous herpes simplex, and varicella-zoster (shingles) infections in immunocompromised patients. Treatment of severe initial clinical episodes of herpes genitalis in immunocompetent patients. Treatment of herpes simplex encephalitis and neonatal herpes simplex infections.

ADULT DOSAGE

Varicella-Zoster

Immunocompromised:
10mg/kg q8h for 7 days
Max: 20mg/kg q8h

Herpes Simplex

Initial and Recurrent Mucosal/Cutaneous Infections in the Immunocompromised:
5mg/kg q8h for 7 days
Max: 20mg/kg q8h

Genital Herpes

Severe Initial Episodes:
5mg/kg q8h for 5 days
Max: 20mg/kg q8h

Herpes Simplex Encephalitis

10mg/kg q8h for 10 days
Max: 20mg/kg q8h

PEDIATRIC DOSAGE

Herpes Simplex

Initial and Recurrent Mucosal/Cutaneous Infections in the Immunocompromised:
<12 Years:
10mg/kg q8h for 7 days
Max: 20mg/kg q8h

≥12 Years:
5mg/kg q8h for 7 days
Max: 20mg/kg q8h

Genital Herpes

Severe Initial Episodes:
≥12 Years:
5mg/kg q8h for 5 days
Max: 20mg/kg q8h

Herpes Simplex Encephalitis

3 Months-12 Years:
20mg/kg q8h for 10 days
Max: 20mg/kg q8h

≥12 Years:
10mg/kg q8h for 10 days
Max: 20mg/kg q8h

Neonatal Herpes Simplex

Birth-3 Months:
10mg/kg q8h for 10 days
Max: 20mg/kg q8h

Varicella-Zoster

Immunocompromised:
<12 Years:
20mg/kg q8h for 7 days
Max: 20mg/kg q8h

≥12 Years:
10mg/kg q8h for 7 days
Max: 20mg/kg q8h

DOSING CONSIDERATIONS

Renal Impairment
CrCl 25-50mL/min: Administer 100% of recommended dose q12h
CrCl 10-25mL/min: Administer 100% of recommended dose q24h
CrCl 0-10mL/min: Administer 50% of recommended dose q24h
Hemodialysis: Administer additional dose after each dialysis

Other Important Considerations
Dose obese patients at the recommended adult dose using ideal body weight

ADMINISTRATION

IV route

Avoid rapid or bolus inj
Infuse at a constant rate over 1 hr
Infusion concentrations of approx ≤7mg/mL are recommended
Standard, commercially available electrolyte and glucose sol are suitable for administration; biologic or colloidal fluids (eg, blood products, protein sol) are not recommended
Once diluted, each dose should be used w/in 24 hrs

HOW SUPPLIED

Inj: 50mg/mL [10mL, 20mL]

CONTRAINDICATIONS

Hypersensitivity to valacyclovir.

WARNINGS/PRECAUTIONS

Administer over ≥1 hr to reduce risk of renal tubular damage. Renal failure, in some cases resulting in death, reported. Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) in immunocompromised patients reported. Preexisting renal disease, and dehydration make further renal impairment more likely; therapy must be accompanied by adequate hydration. May cause encephalopathic changes; caution with underlying neurologic abnormalities, serious renal, hepatic, or electrolyte abnormalities, or significant hypoxia. Caution in elderly.

ADVERSE REACTIONS

Inj-site inflammation/phlebitis, transient SrCr or BUN elevations, N/V.

DRUG INTERACTIONS

Nephrotoxic drugs may make further renal impairment more likely. Probenecid may increase exposure and T1/2.

PREGNANCY AND LACTATION

Category B, caution in nursing.

MECHANISM OF ACTION

Synthetic purine nucleoside analogue; stops replication of herpes viral DNA by competitive inhibition of viral DNA polymerase, incorporation into and termination of growing viral DNA chain, and inactivation of viral DNA polymerase.

PHARMACOKINETICS

Absorption: Cmax=9.8mcg/mL (5mg/kg), 22.9mcg/mL (10mg/kg). Distribution: Plasma protein binding (9-33%); (Oral) found in breast milk. Metabolism: 9-carboxymethoxymethylguanine (major metabolite). Elimination: T1/2=2.5 hrs (CrCl >80mL/min), 3 hrs (CrCl 50-80mL/min); 3.5 hrs (CrCl 15-50mL/min); 19.5 hrs (anuric); urine (62-91% unchanged) (14.1% metabolite). Refer to PI for more parameters for impaired renal function and pediatrics.

ASSESSMENT

Assess for hypersensitivity to the drug or to valacyclovir, renal/hepatic disease, immunosuppression, neurological abnormalities, electrolyte abnormalities, significant hypoxia, hydration status, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for signs/symptoms of renal failure, TTP/HUS, encephalopathic changes, and other adverse reactions. Monitor renal function.

PATIENT COUNSELING

Inform about potential risks of therapy and advise to report any adverse reactions. Instruct to notify physician if pregnant/nursing.

STORAGE

20-25°C (68-77°F).

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