Serious Infections (e.g. CNS and Disseminated Zoster) 10 mg/kg IV q8h
Shingles 800mg PO 5 times per day
Prophylaxis dosing varies by indication
eGFR 0 - 10eGFR 10 - 25eGFR 25 - 50eGFR > 505 mg/kg IV q24h, or half of regular dose q24h10 mg/kg IV q24h10 mg/kg IV q12h10 mg/kg IV q8h (Regular dosing)
2.5-5 mg/kg IV q24h
Consider loading dose for serious infections
5-7.5 mg/kg IV q24h
Use upper end for CNS infections
Therapy for herpesviral infections (HSV and VZV) including encephalitis.
Prophylaxis of herpesviral infections if recurrent disease or immunocompromised.
Follow SCr as appropriate.
Check urine for crystals if AKI suspected.
GI upset
Phlebitis
Increased SCr
AKI from crystal nephropathy
Mycophenolate can increase the acyclovir concentration.
May diminish efficacy of zoster or varicella vaccine.
For oral indications, valacyclovir is the pro-drug, which is more bioavailable with more convenient dosing.
Antimicrobial class: Antiviral. Nucleoside analogue.
Pregnancy category: B
Average serum half life: 3 hours
Urine penetration: Therapeutic
CSF penetration: Therapeutic