Acyclovir – capsules, lyophilisate, suspension, tablets

We talk about a cold that has popped up on our lips and immediately remember Acyclovir. This is an immunomodulator belonging to the group of antiviral drugs used to treat herpes types 1 and 2, genital herpes and chickenpox. It contains no toxic elements, it acts selectively - only on the cells of the virus itself, suppressing their reproduction.

Acyclovir-Acri ointment

So, let's start with the fact that herpes does not only occur on the lip; viral diseases affect various parts of the human body. Therefore, Acyclovir is sold in the following forms, each of which has its own indications for use: cream and ointment for topical use 5%, tablets (200 mg, 400 mg, 500 mg), solution for intravenous injection Lyophilisate 250 mg, ophthalmic ointment 3%.

Indications for use

Acyclovir is indicated for the following diseases:

• infectious lesions of the skin and mucous membranes caused by the herpes simplex virus (primary and recurrent genital);
• chicken pox;
• shingles;
• herpetic lesions in children in the first month of life (including intrauterine infection);
• prevention of cytomegalovirus infection in patients who have undergone bone marrow transplantation;
• herpetic lesions of the cornea of ​​the eyes (for eye ointment);
• Epstein-Barr virus infection.

Indications

The drug is prescribed for the treatment of the following conditions:

1. ​Infectious lesions of the skin and mucous surfaces due to herpes viruses.
2. ​Chicken pox.
3. Shingles.
4. Herpes localized in the genital area.
5. ​Primary and secondary herpes diseases in persons with immunodeficiency.
6. ​Viral pathologies among people with a normal level of immune status.

Doses and method of administration

Dosage of the drug Acyclovir

Dosage

The dosage depends on the disease and the severity of its course.

• Hepatic infection of the skin and mucous membranes involves prescribing 200 mg of medication to children and adults 5 times a day at an interval of 4 hours, interrupted by sleep (8 hours). Duration of therapy – 5 days.
• When preventing influenza or ARVI, Acyclovir is prescribed 4 times a day, 200 mg every 6 hours.
• As a complex therapy for severe immunodeficiency, the drug is taken at a dose of 400 mg 5 times a day.
• Chickenpox in children and adults whose body weight exceeds 40 kg requires taking the medicine 800 mg 5 times a day. Children over 2 years of age with a body weight below 40 kg take the drug at a rate of 20 mg per kilogram of weight 4 times a day for 5 days.
• Treatment of herpes zoster involves taking Acyclovir for children over 6 years of age and adults, 800 mg every 6 hours for 5 days. Children from 2 to 6 years old take the medicine 400 mg 4 times a day, and children under 2 years old receive it 4 times a day 200 mg.

How to use Acyclovir

The method of use of Acyclovir depends on the form of release. The tablets are swallowed without chewing, regardless of food intake, with plenty of water. Apply the ointment and cream using a cotton swab to the affected areas in a thin layer 5 times a day (every 4 hours plus a night break). The lyophilisate (intravenously) must first be diluted to the desired concentration. Eye ointment is applied in a 1 cm strip behind the lower eyelid 5 times a day after 4 hours.

Acyclovir ointment

Acyclovir ointment and cream are intended for external use, and application to the surface of the mucous membranes (nasal and oral cavities) is not recommended, but not contraindicated. It is necessary to remember some rules for applying medications to the mucous membrane and consult a doctor!

Herpetic rashes in the oral cavity are localized on the palate, inner sides of the cheeks and lips. As for the nasal cavity, herpes sores appear both in the vestibule of the nose - the thin skin inside the nose - and on the mucous membrane, which is located 1.5-2 cm from the edge of the nostril. If herpes appears on the lip or on the eve of the nose, then the application technique is the same as for the rest of the face and body - on cleansed skin 5 times a day, every 4 hours, with a break at night.

As for the mucous membranes of the mouth and nose, due to the fact that drool and mucus interfere with the penetration of the drug and, at the same time, contribute to the spreading of the ointment over the mucous membrane, which reduces the effectiveness of the drug, the most correct decision would be to switch to the tablet form of Acyclovir. Also, do not forget that the mucous membrane is a very thin tissue, which means that the development of allergic reactions is stronger and more pronounced.

Acyclovir cream

If the ointment still needs to be applied, then clean the oral or nasal cavities before using Acyclovir. It is advisable to rinse them with saline solution or other rinsing or rinsing agent, and then blot the surface with a gauze pad or cotton ball. Then apply a small amount of cream or ointment pointwise. There may be a burning sensation and pain. If they pass, then apply the remaining cream or ointment. If the pain intensifies, then this is an allergic reaction, and the use of the product must be stopped. Remember that the cream and ointment will enter the esophagus through the oral cavity; in small quantities this is not dangerous, but it is better to use another form of Acyclovir.

Acyclovir-SBC 200 mg No. 20 tab.

Instructions for medical use of the drug ACICLOVIR-SBC Trade name Acyclovir - SBC International nonproprietary name Acyclovir Dosage form Tablets 0.2 g Composition One tablet contains the active substance - acyclovir 0.2 g, excipients: lactose monohydrate, magnesium stearate, corn starch, croscarmellose sodium Description Tablets white or almost white, flat-cylindrical shape with a chamfer Pharmacotherapeutic group. Antiviral drugs for systemic use. Direct acting antiviral drugs. Nucleosides and nucleotides. Acyclovir ATC code J05AB01 Pharmacological properties Pharmacokinetics After oral administration, the drug is only partially absorbed from the intestine. Taking the drug simultaneously with food has little effect on its absorption. Bioavailability is 15–30%. The concentration in the blood depends on the dose taken. Protein binding is 9–30%. The drug is widely distributed in tissues and body fluids, including the brain, kidneys, lungs, liver, tear fluid, intestines, muscle tissue, spleen, sperm, vaginal secretions and mucosa, uterus, breast milk, amniotic fluid, contents of herpetic vesicles. The highest concentrations are found in the kidneys, liver and intestines. The concentration in the cerebrospinal fluid is approximately 50% of the concentration in the blood plasma. With oral administration of the drug 1 g per day, the concentration in breast milk can exceed its concentration in plasma by 0.6–4.1 times, in amniotic fluid by 3–6 times; in such cases, acyclovir enters the baby’s body with mother’s milk in dose of 0.0003 g/kg per day. Therefore, it is necessary to prescribe the drug to nursing women with caution. Long-term or repeated courses of the drug in patients with reduced immunity can lead to the emergence of viral strains that are insensitive to acyclovir. This may be caused by a deficiency of viral thymidine kinase or changes in the structure of thymidine kinase and DNA polymerase. A natural metabolite of acyclovir is 9-carboxymethoxymethylguanine. The half-life when taken orally in adults is 3.3 hours. The time to reach the maximum concentration in the blood serum when taken orally is 7.7 hours. The average maximum concentration in the blood serum (stable) when taken orally in adults is as follows: at a dose of 0.2 g (2.5 µmol/l) every 4 hours - 0.6 µg/ml, at a dose of 0.4 g (5.3 µmol/l) every 4 hours - 1.2 µg/ml, at a dose of 0.8 g (6.9 µmol/l) every 4 hours - 1.6 µg/ml. Volume of distribution (Vold) (upon reaching a stable concentration): adults: approximately 48 l/m2 of body surface (37–57 l/m2), children and adolescents (1–18 years): approximately 45 l/m2. For end-stage kidney disease: approximately 41 l/m2. When taken orally, approximately 14% of the total dose is excreted unchanged in the urine, most of the drug is excreted in the form of metabolites; a small part is excreted in the feces. In the process of drug elimination, along with glomerular filtration, the mechanism of tubular secretion appears to be involved. The rate of elimination of the drug from the body slows down with age, although regardless of this, the half-life of the drug increases slightly. In chronic renal failure, the half-life averages 19.5 hours. In the case of hemodialysis, this figure is 5.7 hours, while the concentration of the drug in plasma decreases to 60% of the initial value (with a single 6-hour session). With peritoneal dialysis, drug clearance does not change significantly. Pharmacodynamics Acyclovir - SBC is an antiviral drug, highly active against herpes simplex virus (Herpes simplex (VHS)) types 1 and 2, herpes zoster virus (Varicella zoster (VZV)), varicella zoster virus, Epstein-Barr virus and to a lesser extent - cytomegalovirus. Acyclovir - CBC is a synthetic analogue of the purine nucleoside - deoxyguanidine. After the introduction of acyclovir into a cell affected by the virus, under the influence of the thymidine kinase enzyme secreted by the virus, acyclovir is converted into acyclovir monophosphate. Under the action of cellular guanylate kinase, acyclovir monophosphate is converted into acyclovir diphosphate, which is converted by enzymes of the host cell (virus) into the active form - acyclovir triphosphate. By interacting with DNA polymerase (VHS and VZV), it suppresses viral DNA replication. With the help of viral DNA polymerase, acyclovir triphosphate can be arranged into growing DNA chains, as a result of which a defect appears in the DNA chain and the growth of a new generation of viruses stops. The drug has a highly selective effect on viral DNA synthesis. The incorporation of acyclovir triphosphate into the viral DNA chain and subsequent chain termination blocks further replication of the viral DNA. In patients with severe immunodeficiency, long-term or repeated courses of acyclovir therapy may lead to the formation of resistant strains, and therefore further treatment with Acyclovir-SBC may be ineffective. Indications for use. treatment and prevention of genital herpes: primary cases and recurrent severe herpes in patients with preserved or weakened immunity treatment and prevention of herpes simplex caused by viruses type 1 and 2 (VHS-1 and VHS-2) - primary and recurrent with damage to the skin and mucous membranes , including post-transplant patients receiving immunosuppressive drugs, with HIV infection, during chemotherapy in patients with preserved or weakened immunity, herpes zoster in adult patients, chickenpox in patients with weakened immunity. Method of administration and dosage Acyclovir - SBC is prescribed orally. Treatment should begin at the first signs and symptoms of herpes simplex or VZV infections. Treatment of chickenpox is most effective if it is started on the first or second day after the rash appears. In patients with impaired immunity, to heal lesions of the skin and mucous membranes, the duration of therapy can be increased until scabs or epithelization appear. Acyclovir - SBC can be taken with food, because. this has virtually no effect on absorption. It is recommended to drink it with a glass of water. Intermittent short-term treatment of recurrent genital herpes may be effective for some patients, but treatment should begin during the prodrome or at the first sign of disease. Average doses for adults and children over 6 years of age: Treatment of genital herpes (primary infection): 200 mg 5 times a day for 10 days. The course of treatment and further tactics are determined individually. Patients with reduced immunity, including those after organ or bone marrow transplantation, are prescribed 400 mg 5 times a day. The course of treatment is at least 5 days, if necessary - 10 days; - recurrent infections, intermittent therapy: 200 mg 5 times a day for 5 days; - recurrent infections, long-term suppressive therapy: 400 mg 2 times a day or 200 mg 3-5 times a day; Treatment of herpes simplex affecting the skin and mucous membranes: 200 5 times a day for 10 days. In case of severe immunodeficiency or in case of impaired absorption from the intestine, the dose can be increased to 400 mg 5 times a day; Prevention of herpes simplex affecting the skin and mucous membranes: 400 mg every 12 hours. The duration of the preventive course is determined by the duration of the risk period; Herpes zoster: 800 mg 5 times a day for 7–10 days. For patients with severe immunodeficiency, the option of intravenous administration should be considered; Treatment is most effective if started within 48 hours of the rash appearing. Chicken pox: 800 mg 4 times a day for 5 days. Treatment should begin when the first signs or symptoms of chickenpox appear within 24 hours (after the typical rash appears). Children Children under 6 years of age are not recommended to use the drug. Treatment of infections caused by the herpes simplex virus - children over 6 years of age: 200 mg (1 tablet) 5 times a day (every 4 hours), except during night sleep. The course of treatment is 5 days. In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the dose can be increased to 400 mg 5 times a day. Prevention of infections caused by the herpes simplex virus in children with immunodeficiency - children over 6 years of age: 200 mg 4 times a day (every 6 hours). In case of severe immunodeficiency - 200 mg 5 times a day. Treatment of chickenpox - children over 6 years of age: 800 mg 4 times a day. More accurately, 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. The maximum single dose is 800 mg. The maximum daily dose is 4000 mg. Side effects Often - headache, dizziness - itching, rash, photosensitivity - fatigue, fever Uncommon - urticaria - rapid diffuse hair loss (alopecia) Rare - anaphylaxis, angioedema, shortness of breath - reversible increase in bilirubin levels and liver enzyme activity - increase concentrations of urea and creatinine in the blood Very rarely - acute renal failure - anemia, leukopenia and thrombocytopenia - anxiety, tremor, ataxia, dysarthria, hallucinations, psychotic symptoms, convulsions, drowsiness, encephalopathy, coma (these side effects were observed in patients with renal failure who took the drug in doses higher than recommended) - hepatitis, jaundice Contraindications - hypersensitivity to acyclovir or to any auxiliary component of the drug - pregnancy and lactation - children under 6 years of age - hereditary lactose intolerance or hereditary lactase deficiency, glucose malabsorption/ galactose Drug interactions When Acyclovir-SBC is used simultaneously with other nephrotoxic drugs, the nephrotoxic effect of the latter increases, especially in cases of impaired renal function. With the combined use of Acyclovir - SBC and probenecid, the tubular secretion of acyclovir decreases, the half-life and its concentration in the blood serum and cerebrospinal fluid increase. The simultaneous use of Acyclovir-SBC and zidovudine for HIV infections does not affect the kinetics of these drugs. Special instructions When taking the drug for a long time in recommended doses in patients with impaired renal function, accumulation of acyclovir above the safe level was not observed. When using high doses, it is extremely rare for acyclovir crystals to form in the renal tubules. In this case, it is necessary to increase fluid intake. During treatment, renal function should be monitored (determining the level of urea nitrogen in the blood and creatinine in the blood plasma). If in women with genital herpes the condition does not improve within the 1st week, it is necessary to conduct a gynecological examination (in patients with genital herpes there is an increased risk of developing cervical cancer, so a Pap test should be performed once a year to determine initial changes in the cervix) . When treating genital herpes, sexual contact should be avoided. For chickenpox, therapy is more effective if it is started within 24 hours after the onset of the typical rash. When using the drug, a moderate short-term increase in the level of bilirubin and liver enzymes may occur; in isolated cases - an increase in the concentration of urea and creatinine in the blood; slight deterioration in hematological parameters. Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms When using the drug, care should be taken when driving a vehicle and working with potentially dangerous mechanisms that require increased concentration and speed of psychomotor reactions. Overdose Symptoms: headache, nausea, vomiting, diarrhea, shortness of breath, renal failure, lethargy, convulsions, coma. Treatment Since there is no specific antidote, treatment of adverse effects or overdose should be symptomatic and supportive. Hemodialysis is recommended, especially in patients with acute renal failure. It is necessary to increase the flow of fluid into the body to prevent the formation of crystals in the renal tubules. Release form and packaging 10 tablets in a blister pack made of polyvinyl chloride film or printed varnished aluminum foil. 2 blister packs together with instructions for use in the state and Russian languages ​​are placed in a cardboard pack. Storage conditions Store in a dry place, protected from light, at a temperature not exceeding 25°C. Keep out of the reach of children! Shelf life 3 years Do not use after the expiration date indicated on the package. Conditions for dispensing from pharmacies By prescription, Legal address: 030012 Republic of Kazakhstan, Aktobe, 171 Sankibay Batyr Ave., B Location address: 030003 Republic of Kazakhstan, Aktobe, Aviagorodok, 14. tel +7 7132 227755 [email protected] Address of the organization that accepts claims from consumers on the quality of products (goods) on the territory of the Republic of Kazakhstan: SVS - Pharmacy LLP Legal address: 030012 Republic of Kazakhstan, Aktobe, Sankibay Batyr Ave. 171, B Location address: 030003 Republic of Kazakhstan Aktobe, Aviagorodok, 14.

Can chickenpox be treated with Acyclovir?

Acyclovir can help fight chickenpox

In the instructions for use of Acyclovir, chicken pox (varicella zoster), or simply chickenpox, appears among the indications for use. Acyclovir actively fights it, but it all depends on the immunity of the individual person and the nature of the disease. For moderate and severe forms of chickenpox, Acyclovir is prescribed both in the form of tablets and as a cream or ointment. For adults, the drug is prescribed at an early stage of the disease, and for children under 12 years of age - only in case of intolerance to the painful condition or in severe cases of the disease. The dosage regimen is as follows: adults are recommended to take 1-2 tablets of 400 mg each. every 4 hours 3-5 times a day. The pediatric dose is half the adult dose, and the time interval between doses is increased by 1 hour, but not more than 4 times a day. Cream or ointment is applied pointwise to affected areas up to 5 times a day. If the mucous membranes of the eyes are affected by chickenpox, in this case an eye ointment is used, placed behind the lower eyelid up to 5 times a day. Acyclovir is used for 5 days, but the attending physician may make adjustments to the therapy.

Is it possible to use Acyclovir for a cold?

Acyclovir can be prescribed for ARVI

Acyclovir successfully fights herpes viruses, but sometimes a therapist prescribes Acyclovir for ARVI. Why? It is no secret that with ARVI and colds in general, the immune system is weakened, and this is fertile ground for the manifestation of herpes, which, against the background of the same ARVI, does not alleviate the situation. Although Acyclovir is ineffective in the fight against viruses that cause respiratory diseases, it is used as a prophylactic agent to prevent the development of herpes.

Acyclovir during pregnancy

A pregnant woman's immune system is weakened and may be susceptible to viral infections. Therefore, expectant mothers and those undergoing lactation are asking the question, “Is it possible to use Acyclovir during pregnancy?” According to the instructions, the use of acyclovir during pregnancy is permissible, but with caution. Moreover, this formulation means that use is possible, firstly, only as prescribed by a doctor, and secondly, only when the therapeutic effect is greater than the risk. This applies to all dosage forms. As for the lactation period, the drug passes into breast milk. Therefore, first consult a doctor, and then take the drug. In case of negative reactions, it is necessary to change therapy or stop breastfeeding for a while.

Side effects

Taking Acyclovir in any dosage form can provoke the development of the following side effects:

1. ​Headache, even migraine.
2. ​Dizziness.
3. ​Intense aching pain in the kidney area.
4. ​Dyspeptic disorders - vomiting, feeling of nausea, stool disturbances, abdominal discomfort.
5. Shortness of breath.
6. ​Signs of an allergic reaction - skin rashes, itching. Rarely, anaphylactic shock and urticaria.
7. Systemic manifestations include fatigue, malaise, fever, tissue swelling and visual disturbances.
8. ​Increased sleepiness.
9. ​High excitability.

As a rule, the drug is quite well tolerated by patients. Side effects are observed in rare cases; patients with acute renal failure and other severe concomitant pathologies are most susceptible to them.

Interaction with other drugs and alcohol

Acyclovir and alcohol

When a doctor prescribes a particular drug, the question arises about compatibility not only with other drugs (more on this below), but also with alcohol. After all, a cold often appears at the wrong time, but plans are made to attend an event where there will be strong drinks. What to do in such a situation? Despite the absence of direct contraindications, alcohol and medicine are incompatible.

It is not recommended to take Acyclovir with alcohol

Firstly, alcohol, by suppressing the activity of leukocytes and the production of antibodies, reduces the body's defenses. Secondly, any drug puts a strain on the liver and kidneys, and alcohol has a similar effect. And when the liver cannot cope with processing, enzymes are released that suppress the action of Acyclovir. That is, the effect of the immunomodulator will be zero. Also, this can provoke intoxication of the body and increase the risk of side effects such as nausea and vomiting; convulsions, disturbances of consciousness; tremors and hallucinations; allergies (itching, skin rashes, urticaria, angioedema); loose stools; anemia; shortness of breath, pain in the sternum, increased heart rate; disorders of swallowing and respiratory functions; cephalalgia, dizziness, drowsiness.

If you suffer from a hangover after drinking, this is not the right time to take Acyclovir. When a hangover occurs, the body is already under stress. Taking the drug may cause a deterioration in your general condition.

Acyclovir and antibiotics

It may happen that Acyclovir is taken at the same time as antibiotics. When treating viral diseases, simultaneous use of antibiotics is not recommended, as they will simply interfere with each other. That is, treatment will be ineffective either from Acyclovir or from another drug. The one-time use of medications will not speed up the patient’s recovery, and the liver will not say “thank you” to you, since it creates an additional load, which can lead to negative consequences. In exceptional cases, as prescribed by a doctor, a one-time dose is possible, but it is associated with risks. Be sure to consult with your doctor.

Composition and release form

The drug is available in several dosage forms:

1. ​Pills. Prescribed for the treatment of papillomas in different parts of the body. They are used orally, so they allow you to fight the main problem from the inside. After completing the course of therapy, the level of pathogenic pathogens in the body is noticeably reduced.
2. ​Ointment. Applied topically, it is effective against the most common human papillomavirus infection, which is localized on the surface of the body. The antiviral agent is applied directly on top of the warts, so there is a pronounced therapeutic effect at the local level. When the ointment is distributed on the skin, the main substance penetrates the bloodstream, preventing viral pathologies in the future.
3. ​Solution. Mainly used for chronic forms of the disease. The concentration of the drug is selected by the doctor taking into account the clinical picture and the results of an analysis for the content of viral agents in the blood. In this case, it is highly recommended not to self-medicate, so as not to provoke a worsening of the condition.

The main component is acyclovir, its content differs depending on the dosage form.

Analogs

Acyclovir analogs

Along with Acyclovir, patients with viral diseases are prescribed Remantadine. Is it possible to take Acyclovir and Remantadine at the same time? What's better? Remantadine prevents the proliferation of viral cells, strengthens the immune system, and is also used as a prophylactic during influenza epidemics.

Indications for taking Remantadine are:

• tick-borne viral encephalitis;
• flu;
• herpes type 1 and 2.

The drug can be used by children aged 7 years and older.

The main purpose of Acyclovir is the treatment of herpes, chickenpox and antiviral therapy. By integrating into the DNA structure of viruses, Acyclovir prevents them from multiplying and developing. If necessary, the medicine can be prescribed to children.

You should not take Rimantadine and Acyclovir at the same time, since both of these drugs are similar. Only the attending physician can accurately determine the required drug and calculate the dosage.

Contraindications

Obvious contraindications for Acyclovir are:

1. ​Serious heart pathologies.
2. ​Kidney diseases, especially chronic forms, acute failure.
3. ​Nervous diseases.
4. ​Increased hypersensitivity to the components of the drug.
5. ​Time of bearing a child and breastfeeding.
6. ​Children under 3 years old.

The antiviral drug is used with extreme caution in the treatment of elderly people and the presence of dehydration.

Preventative treatment

The question often arises of how to prevent such an unpleasant situation as the manifestation of herpes. What should be the prevention? The recommendations are simple:

• Get vaccinated every three years to avoid infection or recurrence of the disease;
• Take acyclovir as a preventive measure when the disease may be triggered. Consult your doctor to determine your risk factors;
• Don't forget about hygiene;
• Strengthen your immune system: lead a healthy lifestyle, eat right and move more.

Acyclovir against herpes