acyclovir

(ay sye' kloe ver)
acycloguanosine
Alti-Acyclovir (CAN), Avirax (CAN), Zovirax

Pregnancy Category C

Drug class


Therapeutic actions


Antiviral activity; inhibits viral DNA replication

Indications

Contraindications/cautions


Dosage


Available Forms: Tablets--400, 800 mg; capsules--200 mg; suspension--200 mg/5 mL; powder for injection--500 mg/vial, 1,000 mg/vial; injection--50 mg/mL; ointment--50 mg/g

Adult

Parenteral:

5---10 mg/kg infused IV over 1 h, q8h (15 mg/kg/d) for 7 d.

Oral

Initial genital herpes:
200 mg q4h while awake (1,000 mg/d) for 10 d.
Chronic suppressive therapy:
400 mg bid for up to 12 mo.

Pediatric

Parenteral:

<12 y: 250---500 mg/m2 infused IV over 1 h, q8h (750 mg/m2/d) for 7 d. >12 y: adult dosage.

Oral:

Safety not established.

Geriatric or Renal Impaired

Oral:

Creatinine clearance <10 mL/min: 200 mg q12h.

IV:

Creatinine Clearance (mL/min)Dosage (IV)
>505 mg/kg q8h
25---505 mg/kg q12h
10---255 mg/kg qd
0---102.5 mg/kg qd

Topical

Ointment (all ages):
Apply sufficient quantity to cover all lesions 6×/d for 7 d; 1.25 cm (1/2 in) ribbon of ointment covers 2.5 cm2 (4 in2) surface area q3h.

Pharmacokinetics

RouteOnsetPeakDuration
OralVaries1.5---2 h
IVImmediate1 h8 h

Metabolism: T1/2: 2.5---5 h

Distribution: Crosses placenta; enters breast milk

Excretion: Unchanged in urine

IV facts


Adverse effects

Systemic Administration

Topical Administration


Clinically important interactions


Nursing Considerations


Assessment


History: Allergy to acyclovir, seizures, CHF, renal disease, lactation
Physical: Skin color, lesions; orientation; BP, P, auscultation, perfusion, edema; R, adventitious sounds; urinary output; BUN, creatinine clearance

Implementation



Drug-specific teaching points

Adverse effects in Italic are most common; those in Bold are life-threatening.