Antimicrobials
Aciclovir

Aciclovir

None
Poor (Less than 20%)
IV$45/d PO$5/d

Spectrum of Activity

General Information

  • Therapy for herpes virus infections (HSV and VZV) including encephalitis
  • Prophylaxis of herpes virus infections if recurrent disease or immunocompromised
  • Follow creatinine, urea, urine output as appropriate, liver enzymes and CBC.
  • BUN/Creatinine and fluid balance must be monitored daily in patients receiving high dose acyclovir. Ensure adequate hydration during and for at least 2 hours following administration. Manufacturer suggests 1 litre of fluid/24 hours/gram of acyclovir and recommends a minimum urine output of 500 mL/24 hours/gram of acyclovir.
  • Nausea
  • Vomiting
  • Diarrhea
  • Headache
  • Phlebitis (IV)
  • Liver or renal dysfunction
  • Crystal nephropathy (keep patient well hydrated)
  •  May diminish efficacy of zoster or varicella vaccine
  •  For oral indications, Valacyclovir is the pro-drug and is more bioavailable with more convenient dosing.

Antimicrobial class: Antiviral, nucleoside analogue

Pregnancy category: B

Average serum half life: Neonates: 4 hours Children 1-12 years: 2-3 hours

CSF penetration: Approximately 50% of plasma concentration

Route of Elimination: Primarily kidney with 60-90% of drug excreted unchanged in the urine