Acyclovir

C difficile risk
None
Oral Bioavailability
Moderate
Cost
IV: $20/d Oral: $1/d

Dosing

  • Use adjusted BW in obesity

IVPO5 mg/kg IV q8h400 mg PO 5 x /day

10-15 mg/kg IV q8h

800 mg PO 5 x /day

CrCl > 50 mL/minCrCl 30 - 50 mL/minCrCl 10 - 30 mL/minCrCl < 10 mL/minNo renal adjustment required100% of indicated dose IV q12h100% of indicated dose IV q24h50% of indicated dose IV q24h

CrCl > 30 mL/minCrCl 10 - 30 mL/minCrCl < 10 mL/minNo renal adjustment required400 mg PO TID400 mg PO BID

IVPO (Most Indications)50% of indicated dose IV q24h

  • Give dose after dialysis on HD days400 mg PO BID

IVPO (Most Indications)50% of indicated dose IV q24h400 mg PO BID

IVPO (Most Indications)50% of indicated dose IV q12hNo Data - use IV

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 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

CSF penetration: Therapeutic (IV only)

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