Acyclovir is an antiviral medication primarily used to treat infections caused by members of the Herpesviridae family. This drug inhibits the activity of viral DNA polymerase, blocking the viral replication process, thereby alleviating symptoms and accelerating recovery. It is mainly used for the treatment of chickenpox, herpes zoster, herpes simplex virus (HSV) infections, and congenital varicella infections.
Acyclovir can be administered orally or via intravenous injection, with broad clinical applications. Its pharmacological characteristic is its selectivity for herpesviridae viruses, and it is ineffective against other viruses or bacterial infections. After absorption, the drug rapidly distributes to infected tissues, especially in nerve ganglia and skin lesions, resulting in high concentrations and significant efficacy against viruses related to skin and mucous membranes.
Different formulations and routes of administration may have different brand names. Oral tablets, capsules, creams, and intravenous solutions may be marketed under various brand names depending on the manufacturer. Before use, verify that the active ingredient on the medication label is "Acyclovir".
Acyclovir is classified as a "nucleoside antiviral drug," belonging to the subclass of anti-herpesvirus medications. Its chemical structure mimics viral DNA nucleotides, and it interferes with the viral replication cycle through enzymatic reactions. This classification determines its specificity for herpesviridae viruses, and it is ineffective against other virus types such as influenza or HIV.
The drug classification also influences its mechanism of action and side effect profile. Compared to broad-spectrum antiviral drugs, acyclovir’s specificity results in fewer side effects, but accurate diagnosis of the infection type is necessary for effective use.
Main indications include: 1. Herpes zoster (shingles), 2. Primary or recurrent genital herpes, 3. Herpes simplex virus infections in immunocompromised patients. Additionally, it is used for treating or preventing severe herpes-related complications in immunodeficient patients (such as those with HIV).
Special cases include: 4. Chickenpox in children, 5. Herpes simplex infections of the scalp or eyes. In specific situations, such as post-organ transplantation or chemotherapy for cancer, prophylactic administration may be used to reduce infection risk.
Gastrointestinal discomfort is the most common mild reaction, usually resolving within a few days after stopping the medication. Neurological side effects such as dizziness or headache may be related to high blood drug concentrations; in severe cases, immediate discontinuation and medical attention are required.
Patients with liver dysfunction or kidney damage using high doses may experience elevated blood uric acid levels or abnormal renal function indicators. Symptoms such as confusion, seizures, or anuria may indicate drug accumulation toxicity, requiring urgent medical care.
Contraindications: Use is prohibited in individuals allergic to acyclovir or its excipients. Patients with severe renal impairment should have dose adjustments, as the drug is excreted via the kidneys, and accumulation may lead to neurotoxicity.
This medication may trigger severe allergic reactions, including hives and facial swelling; immediate medical attention is necessary if breathing difficulties occur. During intravenous administration, the drug should be infused slowly with monitoring of blood pressure and renal function changes.
Avoid combining with other nephrotoxic drugs (such as aminoglycoside antibiotics), as this may increase renal damage risk. Oral formulations taken with aluminum-containing antacids may reduce absorption; it is recommended to take them at least 2 hours apart.
Caution is advised when used with immunosuppressants, as it may increase hepatic and renal toxicity risks. Consult a physician before using herbal supplements, as some ingredients may affect drug pharmacokinetics.
Treatment of herpes zoster in adults: typically 400 mg orally every 4 hours, for a total of 7-10 days. Intravenous formulations must be administered strictly according to medical instructions, with a maximum daily dose of 10 g for adults.
Pediatric dosing is based on weight: 8-10 mg/kg orally every 8 hours. Higher doses may be required for severe infections or immunodeficient patients, but renal function must be closely monitored. Topical cream is usually recommended to be applied every 2 hours, up to 4 times per day.
If a dose is missed and the missed time is less than 2 hours from the scheduled dose, take the missed dose immediately and reduce the interval before the next dose. If it is close to the next scheduled dose, skip the missed dose and resume the normal dosing schedule; do not double the dose.
When using topical cream, if a dose is missed, apply as soon as possible but avoid applying multiple times to the same area. If multiple doses are missed consecutively leading to symptom worsening, contact a physician to adjust the treatment plan.
Acute overdose may cause renal failure, coma, or seizures. If overdose occurs, seek immediate medical attention for gastric lavage or hemodialysis. Monitoring should include renal function tests, neurological assessment, and urine output.
Discontinue the drug immediately in case of overdose and provide supportive treatment based on the severity of poisoning. Patients with severe renal failure may require short-term hemodialysis to remove residual drug, along with electrolyte monitoring.
Do I need to pay special attention to diet while taking acyclovir?
It is recommended to drink plenty of water to promote drug metabolism and avoid excessive alcohol intake, as alcohol may increase liver burden. For those on high-dose therapy (such as severely immunocompromised patients), doctors may require renal function monitoring, and fluid intake should be adjusted accordingly.
What should I do if I miss a dose?
If the missed dose is close to the next scheduled dose, skip the missed dose and take the medication at the regular time; do not double the dose. Irregular or frequent missed doses may affect efficacy. It is recommended to use pill organizers or reminder apps to help remember doses and communicate with your doctor about your medication plan.
Are there any drug interactions with other antiviral medications?
Combining with other antiviral drugs such as ganciclovir may increase the risk of nephrotoxicity; renal function should be closely monitored. When used with immunosuppressants (such as corticosteroids), the doctor will adjust the dose based on renal function to reduce the risk of complications.
Is skin irritation a common side effect? How can it be alleviated?
Topical application may cause redness, swelling, or burning at the application site, usually resolving within hours after stopping the medication. If blisters, peeling, or increased pain occur, discontinue the medication and seek medical attention, as these may indicate allergic reactions or infection worsening.
Should I avoid sun exposure during acyclovir treatment?
Oral or intravenous administration may increase photosensitivity risk. It is recommended to use SPF 30 or higher sunscreen and physical barriers (such as long-sleeved clothing) when outdoors. If redness occurs after skin contact with the medication, avoid direct sunlight and immediately clean the affected area.
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