Antimicrobials
Acyclovir

Acyclovir

None
Moderate

Spectrum of Activity

Dosing

General Information

  • Therapy for herpes viral infections (HSV and VZV) including encephalitis. Not for CMV (cytomegalovirus)
  • Prophylaxis of herpes viral infections if recurrent disease or immunocompromised.

Follow serum creatinine and monitor for neurotoxicity.

  • GI upset
  • Phlebitis with IV
  • Increased creatinine from crystal nephropathy; pre-hydration may limit kidney injury
  • Neurotoxicity: hallucinations, delusions, involuntary movements
  • 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
  • Recommend to infuse dose over a minimum of 1 hour

Antimicrobial class: Antiviral. Nucleoside analogue.

Pregnancy category: B

Average serum half life: 3 hours

Urine penetration: Therapeutic

CSF penetration: Therapeutic (IV only)