Antimicrobials
Acyclovir

Acyclovir

None
Low
IV: $$$$ PO: $

Spectrum of Activity

General Information

Therapy for herpesviral infections (HSV and VZV) including encephalitis

Prophylaxis of herpesviral infections if recurrent disease or immunocompromised

Laboratory

  • Cr twice weekly with IV acyclovir (dose adjustment and nephrotoxicity assessment)

Clinical

  • Phlebitis
  • CNS effects (IV)
  • GI effects
  • Ensure adequate hydration for IV acyclovir
  • Malaise
  • Nausea
  • Vomiting
  • Diarrhea
  • Phlebitis (with IV acyclovir)
  • Nephrotoxicity
  • CNS effects with high-dose IV therapy

Mycophenolate can increase the acyclovir concentration

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: 3 hours

CSF penetration: Therapeutic

Urine penetration: Therapeutic