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Acyclovir.

Structure

- Acyclovir-200 - 200 mg Acyclovir;
- Acyclovir-400 - 400 mg Acyclovir;
- Acyclovir-800 - 800 mg Acyclovir;

Without a Prescription

Acyclovir is prescribed for the treatment of Herpes simplex virus infections of the skin and mucous membrane, including:
- After bone marrow transplantation;
- Herpes zoster (shingles) infections;
- Initial and recurrent genital herpes suppression of recurrent Herpes simplex infections in immuno-competent patients;
- Management of severely immunocompromised;
- Namely those with HIV disease;
- Prophylaxis of Herpes simplex infection in immunocompromised patients;
- Varicella infections (chicken pox);

Dosage

Adults
Herpes simplex:
For the treatment of herpes simplex infections, 200 mg Acyclovir should be taken five times daily at approximately four-hourly intervals omitting the night time dose. Treatment should continue for 5 days but in severe initial infections may have to be extended.

In severely immunocompromised patients (e.g. after bone marrow transplant) or in patients with impaired absorption from the gut the dose can be doubled to 400 mg or, alternatively, intravenous dosing could be considered.

Dosing should begin as early possible after the start of an infection; for recurrent episodes this should preferably be during the prodromal period or when lesions first appear.

Suppression of Herpes simplex:
In immunocompetent patients: 200 mg Acyclovir should be taken four times daily at approximately six-hourly intervals. Many patients may be conveniently managed on a regimen of 400 mg taken twice daily at approximately twelve-hourly intervals.

Dosage titration down to 200 mg Acyclovir taken thrice daily at approximately eight-hourly intervals or even twice daily at approximately twelve-hourly intervals, may prove effective.

Some patients may experience break-through infections on total daily doses of 800 mg Acyclovir.

Therapy should be interrupted periodically at intervals of six to twelve months in order to observe possible changes in the natural history of the disease.

Prophylaxis of Herpes simplex infections:
Adults and children
In immunocompromised patients 200 mg Acyclovir should be taken four times daily at approximately 6-hourly intervals.
In severely immunocompromised patients (e.g. after marrow transplant) or in patients with impaired absorption from the gut the dose can be doubled to 400 mg Acyclovir or alternatively, intravenous dosing could be considered.
The duration of prophylactic admini-stration is determined by the duration of the period at risk.

Varicella and herpes zoster:
For varicella and herpes zoster infections 800 mg Acyclovir should be taken 5 times daily at approximately 4-hourly intervals, omitting the night time dose. Treatment should continue for 7 days.

In severely immunocompromised patients (eg. after marrow transplant) or in patients with impaired adsorption from the gut, consideration should be given to intravenous dosing.

Dosing should begin as early as possible after the start of an infection. Treatment yields better results if initiated as soon as possible after onset of the rash.

Management of severely immunocompromised patients:
For management of severely immunocompromised patients, 800 mg Acyclovir should be taken 4 times daily at approximately 6-hourly intervals.

In the management of bone marrow recipients this would normally be preceded by up to one month`s therapy with intravenous acyclovir.

The duration of treatment studied in bone marrow transplant patients was 6 months (from 1 to 7 months post-transplantation). In patients with advanced HIV disease, study treatment was 12 months, but it is likely that these patients would continue to benefit from a longer duration of treatment.

Children:
For treatment of herpes simplex infections, and for prophylaxis of Herpes simplex infections in the immunocompromised, children aged two years and over should be given adult dosages and children below the age of 2 years should be given half the adult dose.

For treatment of varicella infections, children over the age of six years can be given 800 mg Acyclovir 4 times daily and children between the ages of 2-6 years can be given 400 mg Acyclovir 4 times daily.

Children below the age of 2 years can be given 200 mg Acyclovir 4 times daily. Dosing can be more accurately calculated as 20 mg acyclovir/kg bodyweight (not to exceed 800 mg) four times daily. Treatment should continue for 4 days.

Contraindications

Acyclovir is contraindicated for patients who develop hypersensitivity to valacyclovir or acyclovir.

Form

Acyclovir-200 DT - Blister pack of 10 tablets
Acyclovir-400 DT - Blister pack of 5 tablets
Acyclovir-800 DT - Blister pack of 5 tablets

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