Antimicrobials
Acyclovir

Acyclovir

None
Moderate

Spectrum of Activity

Dosing

General Information

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 (Zostavax, not Shingrix).

For oral indications, valacyclovir is the pro-drug, which is more bioavailable with more convenient dosing.

Monitor Scr with IV formulation and consider maintenance fluids to minimize risk of AKI.

Antimicrobial class: Antiviral. Nucleoside analogue.

Pregnancy category: B

Average serum half life: 3 hours

Urine penetration: Therapeutic

CSF penetration: Therapeutic