Acyclovir

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Generic Name: Acyclovir Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: B

Uses

What is Acyclovir used for?

Acyclovir is used to treat infections caused by certain types of viruses. It treats cold sores around the mouth (caused by herpes simplex), shingles (caused by herpes zoster), and chickenpox.

This medication is also used to treat outbreaks of genital herpes. In people with frequent outbreaks, acyclovir is used to help reduce the number of future episodes.

Acyclovir is an antiviral drug. However, it is not a cure for these infections. The viruses that cause these infections continue to live in the body even between outbreaks. Acyclovir decreases the severity and length of these outbreaks. It helps the sores heal faster, keeps new sores from forming, and decreases pain/itching. This medication may also help reduce how long pain remains after the sores heal. In addition, in people with a weakened immune system, acyclovir can decrease the risk of the virus spreading to other parts of the body and causing serious infections.

How should I take Acyclovir?

Take this medication by mouth with or without food, usually 2 to 5 times a day as directed by your doctor. Drink plenty of fluids while taking this medication unless your doctor directs you otherwise.

If you are using the liquid form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

This medication works best when started at the first sign of an outbreak, as directed by your doctor. It may not work as well if you delay treatment.

Dosage is based on your medical condition and response to treatment. In children, dosage is also based on weight.

This medication works best when the amount of drug in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same times each day.

Continue to take this medication until the full prescribed amount is finished. Do not change your dose, skip any doses, or stop this medication early without your doctor’s approval.

Tell your doctor if your condition persists or worsens.

How do I store Acyclovir?

Acyclovir is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Acyclovir in the bathroom or the freezer. There may be different brands of Acyclovir that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Acyclovir down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Acyclovir?

Before taking acyclovir, tell your doctor or pharmacist if you are allergic to it; or to valacyclovir; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, conditions related to a weakened immune system (such as HIV disease, bone marrow transplant, kidney transplant).

This drug may rarely make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Do not have certain immunizations/vaccinations (such as vaccines against the varicella virus) without the consent of your doctor.

Older adults may be more sensitive to the side effects of the drug, especially kidney problems (change in the amount of urine, back/side pain), dizziness, drowsiness, and mental/mood changes (such as confusion, hallucinations, loss of consciousness).

Acyclovir does not protect against the spread of genital herpes. To lower the chance of giving herpes to your partner, do not have sexual contact during an outbreak or if you have symptoms. You can spread genital herpes even if you do not have symptoms. Therefore, always use an effective barrier method (latex or polyurethane condoms/dental dams) during all sexual activity. Consult your doctor or pharmacist for more details.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. However, this drug is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Acyclovir during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Acyclovir. Acyclovir is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Acyclovir?

Nausea, diarrhea, headache, or vomiting may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: dizziness, drowsiness, signs of kidney problems (such as a change in the amount of urine, unusual back/side pain), mental/mood changes (such as agitation, confusion, hallucinations), shaky/unsteady movement, trouble speaking.

This medication may rarely cause a life-threatening disorder that affects the blood cells, kidneys, and other parts of the body. This disorder is more likely to occur if you have conditions related to a weakened immune system (such as HIV disease, bone marrow transplant, kidney transplant). Seek immediate medical attention if any of these rare but serious side effects occur: extreme tiredness, slow/fast/irregular heartbeat, easy bruising/bleeding, new fever, bloody/dark urine, severe stomach/abdominal pain, yellowing eyes/skin, sudden vision changes, loss of consciousness, seizures.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Acyclovir?

Some products that may interact with this drug include: other drugs that may cause kidney problems (including nonsteroidal anti-inflammatory drugs-NSAIDs such as ibuprofen, naproxen).

Acyclovir is very similar to valacyclovir. Do not use medications containing valacyclovir while using acyclovir.

Acyclovir may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Acyclovir?

Acyclovir may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Acyclovir?

Acyclovir may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Acyclovir.

What is the dose of Acyclovir for an adult?

Usual Adult Dose for Herpes Simplex – Mucocutaneous/Immunocompetent Host

Treatment of First Episode of Genital Herpes:

200 mg orally every 4 hours 5 times a day for 10 days (manufacturer dosing)

400 mg orally 3 times a day for 5 to 10 days (CDC recommendation)

Severe Disease or Complications Requiring Hospitalization:

5 mg/kg IV every 8 hours for 5 days (manufacturer dosing)

5 to 10 mg/kg IV every 8 hours for 2 to 7 days or until clinical improvement is observed, followed by oral antiviral therapy to complete at least 10 days of total therapy (CDC recommendation)

Episodic (Intermittent) Therapy: Effective treatment requires therapy initiation within 1 day of lesion onset or during the prodrome preceding an episode/recurrence

200 mg orally every 4 hours 5 times a day for 5 days (manufacturer dosing)

400 mg orally 3 times a day for 5 days OR 800 mg orally 2 times a day for 5 days OR 800 mg orally 3 times a day for 2 days (CDC recommendations)

Comments:

-All patients with newly acquired genital herpes should receive antiviral therapy as first episodes can cause a prolonged clinical illness, even among persons with mild clinical manifestations initially; therapy should be initiated at the earliest sign or symptom of primary infection.

-IV therapy is indicated for patients with severe infection.

-CDC STD treatment Guidelines may be consulted for additional guidance.

Use: For the initial treatment and recurrent episodes of mucosal and cutaneous herpes simplex (HSV-1 and HSV-2).

Usual Adult Dose for Herpes Simplex – Mucocutaneous/Immunocompromised Host

Concomitant HIV infection:

-Treatment of First Episode of Genital Herpes:

400 mg orally 3 times a day for 5 to 10 days (guideline recommendation)

Duration of therapy: 5 to 10 days

-Severe Disease:

5 mg/kg IV every 8 hours after lesions begin to regress, may change to oral therapy; continue treatment until lesions have completely healed (guideline recommendation)

Episodic (Intermittent) Therapy: Effective treatment requires therapy initiation within 1 day of lesion onset or during the prodrome preceding an episode/recurrence

400 mg orally 3 times a day for 5 to 14 days

Comments:

-Immunocompromised patients can have prolonged or severe episodes of genital, perianal, or oral herpes.

-Clinical manifestations of genital herpes may worsen during immune reconstitution early after initiation of antiretroviral therapy.

-Suppressive or episodic therapy with oral antiviral agents is effective in decreasing the clinical manifestations of HSV in persons with HIV infection.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the treatment of initial and recurrent mucosal and cutaneous herpes simplex (HSV-1 and HSV-2) in immunocompromised patients.

Usual Adult Dose for Herpes Simplex Encephalitis

10 mg/kg IV every 8 hours

Duration of therapy: 10 days (manufacturer); 21 days (CDC)

Comments:

-The Center for Disease Control and Prevention (CDC) recommends 21 days of IV therapy to treat HSV encephalitis.

Use: For the treatment of HSV encephalitis.

Usual Adult Dose for Herpes Zoster

800 mg orally every 4 hours 5 times a day for 7 to 10 days

Immunocompromised host:

10 mg/kg IV every 8 hours for 7 days

Concomitant HIV infection:

-Localized Dermatomal: 800 mg orally 5 times a day for 7 to 10 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)

-Extensive Cutaneous Lesion or Visceral Involvement: 10 to 15 mg/kg IV every 8 hours until clinical improvement (i.e. no new vesicle formation or improvement of signs and symptoms of visceral disease), then switch to oral therapy

Duration of therapy: 7 to 14-day course (oral plus IV)

Comments:

-Treatment should be initiated as soon as possible after a diagnosis of herpes zoster; parenteral dosing is based on ideal body weight (IBW).

-Oral acyclovir therapy should be considered an alternative therapy to treat acute localized dermatomal herpes zoster in HIV-infected adults according to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents; IV acyclovir is preferred therapy with extensive cutaneous lesion or visceral involvement.

Use: For the acute treatment of herpes zoster (shingles).

Usual Adult Dose for Varicella-Zoster

Immunocompetent Host: 800 mg orally 4 times a day for 5 days

Immunocompromised Host: 10 mg/kg IV every 8 hours for 7 days

HIV-Infected Adults:

-Uncomplicated course: 800 mg orally 5 times a day for 5 to 7 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)

-Severe or complicated course: 10 to 15 mg/kg IV every 8 hours for 7 to 10 days; may switch to oral therapy after defervescence if no evidence of visceral involvement

Comments:

-Therapy should be initiated at the earliest sign or symptom of chickenpox; there is no information of efficacy when initiated more than 24 hours after onset of symptoms.

-According to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, oral acyclovir therapy should be considered alternative therapy for the treatment of uncomplicated cases of chickenpox; IV acyclovir is the preferred therapy for severe or complicated cases.

Use: For the treatment of chickenpox (varicella).

Usual Adult Dose for Herpes Simplex Labialis

Immunocompetent host:

Apply 50 mg (1 buccal tablet) as a single-dose to the upper gum region (canine fossa)

Comments:

-Tablet should be applied within 1 hour after the onset of prodromal symptoms and before the appearance of any signs of herpes labialis lesions.

-Tablet should be applied on the same side of the mouth as the herpes labialis symptoms.

-Use of buccal tablets has not been studied in immunocompromised subjects.

Concomitant HIV infection:

Oral tablets: 400 mg orally 3 times a day for 5 to 10 days

Comment: Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the treatment of herpes simplex labialis (cold sores).

Usual Adult Dose for Herpes Simplex – Suppression

Daily Suppressive Therapy for Recurrent Disease: 400 mg orally 2 times a day

-Alternative regimens from 200 mg orally 3 times a day to 200 mg orally 5 times a day have been used

Concomitant HIV infection: 400 to 800 mg orally 2 to 3 times a day

Comments:

-Suppressive therapy has been shown to reduce the frequency of recurrences by 70% to 80% in patients who have frequent recurrences.

-The frequency of recurrences has been shown to decrease over time and therefore continued therapy should be reevaluated at least annually.

-Experience has shown immunocompromised persons (i.e. hematopoietic stem-cell recipients) who received daily suppressive antiviral therapy were less likely to develop drug-resistant

HSV compared with those receiving episodic therapy; however, resistance is possible and should be suspected and investigated if lesions persist or recur.

-CDC STD Treatment Guidelines and the Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For secondary prophylaxis and treatment of recurrent HSV disease.

Usual Adult Dose for Herpes Zoster – Prophylaxis

HIV-Infected Adults (guideline dosing):

-Post-Exposure Prophylaxis: 800 mg orally 5 times a day for 5 to 7 days; begin 7 to 10 days after exposure

Comments:

-Varicella-zoster immune globulin is the preferred therapy for postexposure prophylaxis; oral antiviral therapy may be used when passive immunization is not possible; if antiviral therapy is used, varicella vaccines should not be given for at least 72 hours following last dose.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For HIV-infected person who has had close contact with a person who has active varicella or herpes zoster and is susceptible to the virus (e.g. no history of vaccination or either condition, or is known to be seronegative).

Usual Adult Dose for Varicella-Zoster – Prophylaxis

HIV-Infected Adults (guideline dosing):

-Post-Exposure Prophylaxis: 800 mg orally 5 times a day for 5 to 7 days; begin 7 to 10 days after exposure

Comments:

-Varicella-zoster immune globulin is the preferred therapy for postexposure prophylaxis; oral antiviral therapy may be used when passive immunization is not possible; if antiviral therapy is used, varicella vaccines should not be given for at least 72 hours following last dose.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For HIV-infected person who has had close contact with a person who has active varicella or herpes zoster and is susceptible to the virus (e.g. no history of vaccination or either condition, or is known to be seronegative).

What is the dose of Acyclovir for a child?

Usual Pediatric Dose for Herpes Simplex – Mucocutaneous/Immunocompetent Host

Treatment of First Episode of Genital Herpes:

Less than 12 years: 40 to 80 mg/kg/day orally in divided doses 3 to 4 times a day for 5 to 10 days

Maximum dose: 1000 mg/day

12 years or older: 200 mg orally every 4 hours 5 times a day OR 400 mg orally 3 times a day

Duration of therapy: 7 to 10 days

Severe Disease or Complications Requiring Hospitalization:

Less than 12 years: 10 mg/kg IV every 8 hours for 7 days

12 years or older: 5 mg/kg IV every 8 hours for 7 days

Recurrence of Genital HSV Infection:

Less than 12 years: 20 to 25 mg/kg orally twice a day; Maximum dose: 400 mg

12 years or older: 200 mg orally 5 times a day for 5 days OR 800 mg orally 2 times a day for 5 days OR 800 mg orally 3 times a day for 2 days

Comments:

-All patients with newly acquired genital herpes should receive antiviral therapy as first episodes can cause a prolonged clinical illness, even among persons with mild clinical manifestations initially; therapy should be initiated at the earliest sign or symptom of primary infection; IV therapy is indicated for patients with severe infection.

Use: For the treatment of first episode or recurrence of mucosal and cutaneous herpes simplex (HSV-1 and HSV-2).

Usual Pediatric Dose for Herpes Simplex Encephalitis

3 months to 12 years old: 10 to 20 mg/kg IV every 8 hours

12 years or older: 10 mg/kg IV every 8 hours

Duration of therapy: 10 days (manufacturer); 21 days (CDC)

Comments:

-The Center for Disease Control and Prevention (CDC) recommends 21 days of IV therapy to treat HSV encephalitis.

-Acyclovir is the drug of choice for local and disseminated herpes simplex infection in infants and children.

-CDC STD Treatment Guidelines and the Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children may be consulted for additional guidance.

Use: For the treatment of Herpes Simplex Encephalitis

Usual Pediatric Dose for Herpes Simplex – Mucocutaneous/Immunocompromised Host

Less than 12 years: 10 mg/kg IV every 8 hours for 7 days (manufacturer dosing)

12 years or older: 5 mg/kg IV every 8 hours for 7 days (manufacturer dosing)

Concomitant HIV infection (guideline dosing):

-Mild Symptomatic Gingivostomatitis:

20 mg/kg orally 4 times a day for 7 to 10 days

Maximum dose: 400 mg

-Moderate to Severe Gingivostomatitis:

5 to 10 mg/kg IV 3 times a day

-May switch to oral therapy after lesions have begun to regress; treat until lesions have completely healed

Comments:

-Acyclovir is the drug of choice for local and disseminated herpes simplex in HIV-infected and exposed infants and children; children with severe immunosuppression and moderate to severe lesions should be treated initially with IV therapy and may require longer therapy.

-Immunocompromised patients may have prolonged or severe episodes; clinical manifestations of genital herpes may worsen during immune reconstitution early after initiation of antiretroviral therapy.

-CDC STD Treatment Guidelines and the Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children may be consulted for additional guidance.

Use: For the treatment of initial and recurrent mucosal and cutaneous herpes simplex (HSV-1 and HSV-2) in immunocompromised patients

Usual Pediatric Dose for Herpes Zoster

Immunocompetent Host:

-Parenteral:

Less than 1 year: 10 mg/kg IV every 8 hours for 7 to 10 days

1 year or older: 500 mg/m2 IV every 8 hours for 7 to 10 days

-Oral: 12 years or older: 800 mg orally 5 times a day for 5 to 7 days

Immunocompromised Host: 10 mg/kg IV every 8 hours for 7 to 10 days

HIV-exposed and HIV-Infected Children:

-Uncomplicated Zoster:

20 mg/kg orally 4 times a day for 7 to 10 days; Maximum dose: 800 mg

-Severe immunosuppression (CDC immunologic category 3), trigeminal or sacral nerve involvement, extensive multidermatomal, or disseminated zoster:

10 mg/kg IV every 8 hours until cutaneous lesions and visceral disease are clearly resolving; then may switch to oral therapy to complete a 10 to 14-day course

HIV-Infected Adolescents:

-Localized Dermatomal: 800 mg orally 5 times a day for 7 to 10 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)

-Extensive Cutaneous Lesion or Visceral Involvement: 10 to 15 mg/kg IV every 8 hours until clinical improvement (i.e. no new vesicle formation or improvement of signs and symptoms of visceral disease), then switch to oral therapy

Duration of therapy: 7 to 14-day course (oral plus IV)

Comments:

-Acyclovir is the oral drug of choice for treating herpes zoster in HIV-infected children; it should be given for 7 to 10 days, although longer durations should be considered if lesions are slow to resolve.

-Initial IV therapy is recommended in children with more severe immunosuppression.

-According to the Guidelines for the Prevention and Treatment of Opportunistic Infections, oral acyclovir therapy in adolescents should be considered alternative therapy for the treatment of uncomplicated cases of herpes zoster; IV acyclovir is preferred therapy for extensive cutaneous lesion or visceral involvement.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children and HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the acute treatment of herpes zoster (shingles).

Usual Pediatric Dose for Varicella-Zoster

Immunocompetent host:

2 years or older (40 kg or less): 20 mg/kg orally 4 times a day for 5 days

2 years or older (over 40 kg): 800 mg orally 4 times a day for 5 days

Maximum doses: Single: 800 mg; Daily: 3200 mg/day

Immunocompromised host:

Less than 1 year: 10 mg/kg IV 3 times a day for 7 to 10 days

1 year or older: 500 mg/m2 IV 3 times a day for 7 to 10 days

HIV-exposed and HIV-infected Children

-Mild disease with no or moderate immune suppression (CDC immunologic category 1 and 2): 20 mg/kg orally 4 times a day for 7 to 10 days and until no new lesions for 48 hours

Maximum dose: 800 mg

-Severe immune suppression (CDC immunologic category 3): 10 mg/kg or 500 mg/m2 IV every 8 hours for 7 to 10 days and until no new lesions for 48 hours

HIV-Infected Adolescents:

-Uncomplicated course: 800 mg orally 5 times a day for 5 to 7 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)

-Severe or complicated course: 10 to 15 mg/kg IV every 8 hours for 7 to 10 days; may switch to oral therapy after defervescence if no evidence of visceral involvement

Comments:

-Therapy should be initiated at the earliest sign of chickenpox, no later than 24 hours after onset of rash.

-In children 1 year or older, body surface area may be used for dosing instead of body weight.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children and HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the treatment of chickenpox (varicella).

Usual Pediatric Dose for Herpes Simplex – Suppression

Neonatal period (less than 1 year): 300 mg/m2 orally 3 times a day for 6 months

Secondary Prophylaxis in HIV-Exposed and HIV-infected Children:

20 mg/kg orally twice a day

Maximum dose: 800 mg

Comments:

-Suppressive therapy following treatment of neonatal HSV disease involving the CNS or skin, eyes, and mouth may prevent cutaneous recurrences and possibly provide superior neurodevelopmental outcomes.

-Beyond the neonatal period, recurrent HSV episodes can be treated successfully and chronic prophylaxis is generally not warranted; however, it may be considered for children with severe and recurrent mucocutaneous (oral or genital) disease.

-Secondary prophylaxis should be re-evaluated periodically (at least annually) as the frequency and severity of infection changes over time.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children and HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the secondary prophylaxis of recurrent HSV disease.

Usual Pediatric Dose for Herpes Simplex Labialis

Concomitant HIV infection:

20 mg/kg orally 4 times a day for 5 days

Maximum dose: 400 mg

Adolescents: 400 mg orally 3 times a day for 5 to 10 days

Comments:

-The safety and efficacy of buccal tablets in pediatric patients has not been evaluated.

-Use of buccal tablets in younger children may present a choking risk.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the treatment of recurrent herpes simplex labialis (cold sores).

Usual Pediatric Dose for Herpes Zoster – Prophylaxis

HIV-Infected Children or Adolescents (guideline dosing):

Post-exposure Prophylaxis in HIV-Infected Children or Adolescents:

20 mg/kg orally 4 times a day (maximum dose 800 mg) for 7 days beginning 7 to 10 days after exposure

Comments:

-Varicella-zoster immune globulin is the preferred therapy for postexposure prophylaxis; oral antiviral therapy may be used when passive immunization is not possible; if antiviral therapy is used, varicella vaccines should not be given for at least 72 hours following last dose.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children or HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For HIV-infected person who has had close contact with a person who has active varicella or herpes zoster and is susceptible to the virus (e.g. no history of vaccination or either condition, or is known to be seronegative).

Usual Pediatric Dose for Varicella-Zoster – Prophylaxis

HIV-Infected Children or Adolescents (guideline dosing):

Post-exposure Prophylaxis in HIV-Infected Children or Adolescents:

20 mg/kg orally 4 times a day (maximum dose 800 mg) for 7 days beginning 7 to 10 days after exposure

Comments:

-Varicella-zoster immune globulin is the preferred therapy for postexposure prophylaxis; oral antiviral therapy may be used when passive immunization is not possible; if antiviral therapy is used, varicella vaccines should not be given for at least 72 hours following last dose.

-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children or HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For HIV-infected person who has had close contact with a person who has active varicella or herpes zoster and is susceptible to the virus (e.g. no history of vaccination or either condition, or is known to be seronegative).

Precautions

Safety and efficacy of oral formulations have not been established in patients younger than 2 years.

Safety and efficacy of buccal tablets have not been established in pediatric patients.

How is Acyclovir available?

Acyclovir is available in the following dosage forms and strengths:

  • Oral capsule,
  • Intravenous powder for injection,
  • Oral tablet,
  • Oral suspension,
  • Compounding powder,
  • Intravenous solution,
  • Buccal tablet.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Acyclovir, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 17, 2018 | Last Modified: August 17, 2018

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