Aciclovir Sandoz®
Inside, with a small amount of water, if possible, after meals. For the greatest effectiveness of acyclovir, it is necessary to start taking the drug as soon as possible after the onset of skin symptoms of the disease.
Use in adults
Treatment of infections caused by herpes simplex viruses
For the treatment of infections caused by the herpes simplex virus, the recommended dose of Acyclovir Sandoz® is 200 mg (1 tablet) 5 times a day every 4 hours, except during night sleep. Usually the course of treatment is 5 days, but can be extended for severe primary infections.
In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the oral dose of Acyclovir Sandoz® can be increased to 400 mg (2 tablets) 5 times a day.
Treatment should begin as soon as possible after infection occurs; in case of relapses, it is recommended to prescribe the drug already in the prodromal period or when the first elements of the rash appear.
Prevention of recurrence of infections caused by the herpes simplex virus in patients with normal immune status.
To prevent relapses of infections caused by the herpes simplex virus in patients with normal immune status, the recommended dose of Acyclovir Sandoz® is 200 mg (1 tablet) 4 times a day (every 6 hours). For many patients, a more convenient treatment regimen of 400 mg (2 tablets) 2 times a day (every 12 hours) is suitable.
In some cases, lower doses of Acyclovir Sandoz® are effective - 200 mg (1 tablet) 3 times a day (every 8 hours) or 2 times a day (every 12 hours).
The treatment period should not exceed 6-12 months.
If, while taking a daily dose of 800 mg, a relapse of infection occurs, 200 mg of Acyclovir Sandoz® (1 tablet) should be prescribed 5 times a day (every 4 hours) for 5 days. Then you should return to the original dose.
Prevention of infections caused by herpes simplex virus in patients with immunodeficiency
For the prevention of infections caused by the herpes simplex virus in patients with immunodeficiency, the recommended dose of Acyclovir Sandoz® is 200 mg 4 times a day (every 6 hours). In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the oral dose of Acyclovir Sandoz® can be increased to 400 mg 4 times a day (every 6 hours). The duration of the preventive course of therapy is determined by the length of the period when there is a risk of infection. It is important to remember that patients with impaired immunity may develop resistance to the drug.
Treatment of chickenpox and herpes zoster
For the treatment of chickenpox and herpes zoster, the recommended dose of Acyclovir Sandoz® is 800 mg 5 times a day; The drug is taken every 4 hours, with the exception of the period of night sleep. The course of treatment is 7 days.
The drug should be prescribed as soon as possible after the onset of infection, since in this case the treatment is more effective.
Treatment of patients with severe immunodeficiency
For the treatment of patients with severe immunodeficiency, the recommended dose of Acyclovir Sandoz® is 800 mg 4 times a day (every 6 hours). Patients who have undergone bone marrow transplantation are recommended to undergo a course of intravenous acyclovir therapy for 1 month before prescribing Acyclovir Sandoz®.
Use in children over 3 years of age
Treatment of infections caused by the herpes simplex virus; prevention of infections caused by a virus, herpes simplex, in children with immunodeficiency
- from 3 years and older - the same doses as for adults.
Treatment of chickenpox
- over 6 years old - 800 mg (4 tablets) 4 times a day;
- from 3 to 6 years - 400 mg (2 tablets) 4 times a day.
More precisely, the dose can be determined at the rate of 20 mg/kg body weight (but not more than 800 mg) 4 times a day. The course of treatment is 5 days.
There are no data on the prevention of recurrence of infections caused by the herpes simplex virus and on the treatment of herpes zoster in children with normal immunity.
Treatment of pediatric patients with severe immunodeficiency
According to the very limited information available, for the treatment of children over 3 years of age with severe immunodeficiency, the same doses of the drug can be used as for the treatment of adults with immunodeficiency (800 mg 4 times a day, every 6 hours).
Use in elderly patients
In old age, there is a decrease in the clearance of acyclovir in the body in parallel with a decrease in creatinine clearance.
Elderly patients should receive a sufficient amount of fluid while taking high doses of Acyclovir Sandoz® orally; if they have renal failure, it is necessary to consider reducing the dose of the drug.
Use in patients with renal failure
Caution must be exercised when prescribing Acyclovir Sandoz® to patients with renal failure.
In patients with renal failure, oral administration of acyclovir at recommended doses for the treatment and prevention of infections caused by the herpes simplex virus does not lead to the accumulation of the drug to concentrations exceeding established safe levels. However, in patients with severe renal failure (creatinine clearance less than 10 ml/min), it is recommended to reduce the dose of the drug to 200 mg 2 times a day (every 12 hours).
For the treatment of chickenpox, herpes zoster, as well as for the treatment of patients with severe immunodeficiency, the recommended doses of Acyclovir Sandoz® are:
- for moderate renal failure (creatinine clearance 10-25 ml/min) 800 mg 3 times a day every 8 hours;
- for severe renal failure (creatinine clearance less than 10 ml/min) 800 mg 2 times a day every 12 hours.
Acyclovir Sandoz, 200 mg, tablets, 25 pcs.
The drug can be taken with food, since food intake does not significantly impair the absorption of acyclovir.
Adults
Treatment of infections caused by Herpes simplex virus types 1 and 2
The recommended dose is 200 mg 5 times a day (every 4 hours, except during night sleep). As a rule, the course of treatment is 5 days, but can be extended for severe primary infections.
In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the dose of acyclovir can be increased to 400 mg. As an alternative, the use of acyclovir by IV infusion may be considered.
Treatment should begin as soon as possible after infection occurs; in case of relapses, it is recommended to prescribe acyclovir already in the prodromal period or when the first elements of the rash appear.
Prevention of relapse of infections caused by Herpes simplex virus types 1 and 2 in patients with normal immune status
The recommended dose is 200 mg 4 times a day (every 6 hours); a regimen of 400 mg 2 times a day (every 12 hours) can be used.
In some cases, lower doses of acyclovir are effective - 200 mg 3 times / day (every 8 hours) or 200 mg 2 times / day (every 12 hours).
Some patients may experience exacerbation of infection when taking a total daily dose of 800 mg.
Treatment with acyclovir should be periodically interrupted for 6-12 months to identify possible changes in the course of the disease.
Prevention of infections caused by Herpes simplex virus types 1 and 2 in immunocompromised patients
The recommended dose of acyclovir is 200 mg 4 times a day (every 6 hours).
In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the dose of acyclovir can be increased to 400 mg 4 times a day. As an alternative, the use of acyclovir by IV infusion may be considered.
The duration of the preventive course of therapy is determined by the length of the period when there is
risk of infection.
Treatment of primary and recurrent infections caused by the Varicella zosler virus - chickenpox and herpes zoster
The recommended dose of acyclovir is 800 mg 5 times a day (every 4 hours, except during night sleep). The course of treatment is 7 days.
In cases of severe immunodeficiency (for example, after bone marrow transplantation) or in cases of impaired absorption from the intestine, the use of acyclovir in the form of intravenous infusion should be considered.
The drug should be prescribed as soon as possible after the onset of infection, because in this case, treatment is more effective.
Children aged 3 years and older
Treatment of infections caused by Herpes simplex virus types 1 and 2; prevention of infections caused by Herpes simplex virus types 1 and 2 in patients with immunodeficiency
Acyclovir is used in the same doses as for adults.
Treatment of chickenpox
Children aged 6 years and older - 800 mg 4 times a day; at the age of 3 to 6 years - 400 mg 4 times a day per day. More precisely, the dose can be determined at the rate of 20 mg/kg body weight (but not more than 800 mg) 4 times/day. The course of treatment is 5 days.
Prevention of recurrence of infections caused by Herpes simplex virus types 1 and 2; treatment of herpes zoster
There are no data on dosage regimen.
Elderly patients
The dose of the drug should be adjusted depending on the degree of renal failure.
It is necessary to ensure that adequate water balance is maintained.
Patients with impaired renal function
Acyclovir should be prescribed with caution. It is necessary to ensure that adequate water balance is maintained.
In patients with renal failure, oral administration of acyclovir in recommended doses for the treatment and prevention of infections caused by Herpes simplex virus types 1 and 2 does not lead to the accumulation of the active substance to concentrations exceeding the established safe level. However, in patients with CC <10 ml/min, it is recommended to reduce the dose of acyclovir to 200 mg 2 times a day (every 12 hours).
When treating chickenpox and herpes zoster, the recommended doses of acyclovir are:
CC < 10 ml/min - 800 mg 2 times/day (every 12 hours);
CC 10-25 ml/min - 800 mg 3 times/day (every 8 hours).
Acyclovir Sandoz
Use during pregnancy and breastfeeding
The use of acyclovir during pregnancy is possible in cases where the expected benefit to the mother outweighs the potential risk to the fetus.
IV use of acyclovir during lactation is contraindicated (excreted in breast milk).
Experimental studies on animals have shown that acyclovir penetrates the placental barrier.
Use for renal impairment
Use is not recommended for severe renal impairment.
In case of renal failure, adjustment of the dosage regimen is necessary.
It should be taken into account that when using acyclovir, acute renal failure may develop due to the formation of sediment from acyclovir crystals, which is especially likely with rapid intravenous administration, simultaneous use of nephrotoxic drugs, in patients with impaired renal function and with insufficient water load.
When using acyclovir, it is necessary to monitor renal function (determining the level of urea nitrogen in the blood and creatinine in the blood plasma).
Use in children
Orally for children over 2 years old - 200-400 mg 3-5 times a day, if necessary - 20 mg/kg (up to 800 mg per dose) 4 times a day. In children under 2 years of age, use a dose equal to half the dose for adults. The duration of treatment is 5-10 days.
Use in elderly patients
Treatment of elderly patients should be carried out with a sufficient increase in water load and under the supervision of a physician, because in this category of patients, the half-life of acyclovir increases.
special instructions
Use is not recommended for severe renal impairment.
It should be taken into account that when using acyclovir, acute renal failure may develop due to the formation of sediment from acyclovir crystals, which is especially likely with rapid intravenous administration, simultaneous use of nephrotoxic drugs, in patients with impaired renal function and with insufficient water load.
When using acyclovir, it is necessary to monitor renal function (determining the level of urea nitrogen in the blood and creatinine in the blood plasma).
Treatment of elderly patients should be carried out with a sufficient increase in water load and under the supervision of a physician, because in this category of patients, T1/2 of acyclovir increases.
When treating genital herpes, you should avoid sexual intercourse or use condoms, because the use of acyclovir does not prevent transmission of the virus to partners.
Acyclovir in the form of dosage forms for external use should not be applied to the mucous membranes of the mouth, eyes, or vagina.
