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acyclovir (injection)

Pronunciation

Generic Name: acyclovir (injection) (a SYE klo veer)
Brand Name: Zovirax

What is acyclovir?

Acyclovir is an antiviral drug. It slows the growth and spread of the herpes virus so that the body can fight off the infection. Acyclovir will not cure herpes, but it can lessen the symptoms of the infection.

Acyclovir injection is used to treat severe infections caused by herpes viruses, including severe forms of genital herpes, shingles, herpes encephalitis (swelling of the brain), and herpes infections in people with other diseases that weaken the immune system.

Acyclovir may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about acyclovir injection?

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Acyclovir will not treat a viral infection such as the common cold or flu.

Treatment with acyclovir should be started as soon as possible after the first appearance of symptoms (such as tingling, burning, blisters).

Herpes infections are contagious and you can infect other people, even while you are being treated with acyclovir. Avoid letting infected areas come into contact with other people. Avoid touching an infected area and then touching your eyes. Wash your hands frequently to prevent passing the infection to others.

Acyclovir will not prevent the spread of genital herpes. Avoid sexual intercourse or use a latex condom to prevent spreading the virus to others.

What should I discuss with my healthcare provider before using acyclovir injection?

You should not use this medication if you are allergic to acyclovir or valacyclovir (Valtrex).

If you have any of these other conditions, you may need an acyclovir dose adjustment or special tests:

  • kidney disease (or if you are on dialysis);

  • liver disease;

  • a brain or nervous system disorder such as Parkinson's disease, schizophrenia, or tardive dyskinesia; or

  • an electrolyte imbalance (such as high or low levels of calcium, sodium, or potassium in your blood).

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Herpes virus can be passed from an infected mother to her baby during childbirth. If you have genital herpes, it is very important to prevent herpes lesions during your pregnancy so that you do not have a genital lesion when your baby is born.

Acyclovir can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use acyclovir injection?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Acyclovir is injected into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Acyclovir must be given slowly, and the IV infusion can take at least 1 hour to complete.

Treatment with acyclovir should be started as soon as possible after the first appearance of symptoms (such as tingling, burning, blisters).

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Drink plenty of liquids while you are using acyclovir to keep your kidneys working properly.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Acyclovir will not treat a viral infection such as the common cold or flu.

Lesions caused by herpes viruses should be kept as clean and dry as possible. Wearing loose clothing may help to prevent irritation of the lesions.

Store acyclovir injection at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include agitation, seizure (convulsions), hallucinations, and urinating less than usual or not at all.

What should I avoid while using acyclovir injection?

Herpes infections are contagious and you can infect other people, even while you are being treated with acyclovir. Avoid letting infected areas come into contact with other people. Avoid touching an infected area and then touching your eyes. Wash your hands frequently to prevent passing the infection to others.

Acyclovir will not prevent the spread of genital herpes. Avoid sexual intercourse or use a latex condom to prevent spreading the virus to others.

Acyclovir injection side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using acyclovir and call your doctor at once if you have a serious side effect such as:

  • urinating less than usual or not at all;

  • fever, chills, body aches, flu symptoms;

  • a red, blistering, peeling skin rash;

  • jaundice (yellowing of the skin or eyes);

  • swelling, pain, tenderness, or skin changes where the injection was given;

  • pale skin, easy bruising or bleeding, weakness; or

  • confusion, tremors, agitation, tiredness, hallucinations, or seizure (convulsions).

Less serious side effects may include:

  • nausea, vomiting, diarrhea, stomach pain, loss of appetite;

  • muscle pain, numbness or tingling;

  • loss of coordination;

  • drowsiness;

  • headache, feeling light-headed; or

  • swelling in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Acyclovir dosing information

Usual Adult Dose for Herpes Simplex -- Mucocutaneous/Immunocompetent Host:

Treatment of First Episode of Genital Herpes:
200 mg orally every 4 hours 5 times a day for 10 days (manufacturer dosing)
400 mg orally 3 times a day for 5 to 10 days (CDC recommendation)

Severe Disease or Complications Requiring Hospitalization:
5 mg/kg IV every 8 hours for 5 days (manufacturer dosing)
5 to 10 mg/kg IV every 8 hours for 2 to 7 days or until clinical improvement is observed, followed by oral antiviral therapy to complete at least 10 days of total therapy (CDC recommendation)

Episodic (Intermittent) Therapy: Effective treatment requires therapy initiation within 1 day of lesion onset or during the prodrome preceding an episode/recurrence
200 mg orally every 4 hours 5 times a day for 5 days (manufacturer dosing)
400 mg orally 3 times a day for 5 days OR 800 mg orally 2 times a day for 5 days OR 800 mg orally 3 times a day for 2 days (CDC recommendations)

Comments:
-All patients with newly acquired genital herpes should receive antiviral therapy as first episodes can cause a prolonged clinical illness, even among persons with mild clinical manifestations initially; therapy should be initiated at the earliest sign or symptom of primary infection.
-IV therapy is indicated for patients with severe infection.
-CDC STD treatment Guidelines may be consulted for additional guidance.

Use: For the initial treatment and recurrent episodes of mucosal and cutaneous herpes simplex (HSV-1 and HSV-2).

Usual Adult Dose for Herpes Simplex -- Mucocutaneous/Immunocompromised Host:

Concomitant HIV infection:

-Treatment of First Episode of Genital Herpes:
400 mg orally 3 times a day for 5 to 10 days (guideline recommendation)
Duration of therapy: 5 to 10 days

-Severe Disease:
5 mg/kg IV every 8 hours after lesions begin to regress, may change to oral therapy; continue treatment until lesions have completely healed (guideline recommendation)

Episodic (Intermittent) Therapy: Effective treatment requires therapy initiation within 1 day of lesion onset or during the prodrome preceding an episode/recurrence
400 mg orally 3 times a day for 5 to 14 days

Comments:
-Immunocompromised patients can have prolonged or severe episodes of genital, perianal, or oral herpes.
-Clinical manifestations of genital herpes may worsen during immune reconstitution early after initiation of antiretroviral therapy.
-Suppressive or episodic therapy with oral antiviral agents is effective in decreasing the clinical manifestations of HSV in persons with HIV infection.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the treatment of initial and recurrent mucosal and cutaneous herpes simplex (HSV-1 and HSV-2) in immunocompromised patients.

Usual Adult Dose for Herpes Simplex Encephalitis:

10 mg/kg IV every 8 hours
Duration of therapy: 10 days (manufacturer); 21 days (CDC)

Comments:
-The Center for Disease Control and Prevention (CDC) recommends 21 days of IV therapy to treat HSV encephalitis.

Use: For the treatment of HSV encephalitis.

Usual Adult Dose for Herpes Zoster:

800 mg orally every 4 hours 5 times a day for 7 to 10 days

Immunocompromised host:
10 mg/kg IV every 8 hours for 7 days

Concomitant HIV infection:
-Localized Dermatomal: 800 mg orally 5 times a day for 7 to 10 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)
-Extensive Cutaneous Lesion or Visceral Involvement: 10 to 15 mg/kg IV every 8 hours until clinical improvement (i.e. no new vesicle formation or improvement of signs and symptoms of visceral disease), then switch to oral therapy
Duration of therapy: 7 to 14-day course (oral plus IV)

Comments:
-Treatment should be initiated as soon as possible after a diagnosis of herpes zoster; parenteral dosing is based on ideal body weight (IBW).
-Oral acyclovir therapy should be considered an alternative therapy to treat acute localized dermatomal herpes zoster in HIV-infected adults according to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents; IV acyclovir is preferred therapy with extensive cutaneous lesion or visceral involvement.

Use: For the acute treatment of herpes zoster (shingles).

Usual Adult Dose for Varicella-Zoster:

Immunocompetent Host: 800 mg orally 4 times a day for 5 days
Immunocompromised Host: 10 mg/kg IV every 8 hours for 7 days

HIV-Infected Adults:
-Uncomplicated course: 800 mg orally 5 times a day for 5 to 7 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)
-Severe or complicated course: 10 to 15 mg/kg IV every 8 hours for 7 to 10 days; may switch to oral therapy after defervescence if no evidence of visceral involvement

Comments:
-Therapy should be initiated at the earliest sign or symptom of chickenpox; there is no information of efficacy when initiated more than 24 hours after onset of symptoms.
-According to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, oral acyclovir therapy should be considered alternative therapy for the treatment of uncomplicated cases of chickenpox; IV acyclovir is the preferred therapy for severe or complicated cases.

Use: For the treatment of chickenpox (varicella).

Usual Adult Dose for Herpes Simplex Labialis:

Immunocompetent host:
Apply 50 mg (1 buccal tablet) as a single-dose to the upper gum region (canine fossa)

Comments:
-Tablet should be applied within 1 hour after the onset of prodromal symptoms and before the appearance of any signs of herpes labialis lesions.
-Tablet should be applied on the same side of the mouth as the herpes labialis symptoms.
-Use of buccal tablets has not been studied in immunocompromised subjects.

Concomitant HIV infection:
Oral tablets: 400 mg orally 3 times a day for 5 to 10 days

Comment: Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the treatment of herpes simplex labialis (cold sores).

Usual Adult Dose for Herpes Simplex -- Suppression:

Daily Suppressive Therapy for Recurrent Disease: 400 mg orally 2 times a day
-Alternative regimens from 200 mg orally 3 times a day to 200 mg orally 5 times a day have been used

Concomitant HIV infection: 400 to 800 mg orally 2 to 3 times a day

Comments:
-Suppressive therapy has been shown to reduce the frequency of recurrences by 70% to 80% in patients who have frequent recurrences.
-The frequency of recurrences has been shown to decrease over time and therefore continued therapy should be reevaluated at least annually.
-Experience has shown immunocompromised persons (i.e. hematopoietic stem-cell recipients) who received daily suppressive antiviral therapy were less likely to develop drug-resistant
HSV compared with those receiving episodic therapy; however, resistance is possible and should be suspected and investigated if lesions persist or recur.
-CDC STD Treatment Guidelines and the Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For secondary prophylaxis and treatment of recurrent HSV disease.

Usual Adult Dose for Herpes Zoster -- Prophylaxis:

HIV-Infected Adults (guideline dosing):
-Post-Exposure Prophylaxis: 800 mg orally 5 times a day for 5 to 7 days; begin 7 to 10 days after exposure

Comments:
-Varicella-zoster immune globulin is the preferred therapy for postexposure prophylaxis; oral antiviral therapy may be used when passive immunization is not possible; if antiviral therapy is used, varicella vaccines should not be given for at least 72 hours following last dose.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For HIV-infected person who has had close contact with a person who has active varicella or herpes zoster and is susceptible to the virus (e.g. no history of vaccination or either condition, or is known to be seronegative).

Usual Adult Dose for Varicella-Zoster -- Prophylaxis:

HIV-Infected Adults (guideline dosing):
-Post-Exposure Prophylaxis: 800 mg orally 5 times a day for 5 to 7 days; begin 7 to 10 days after exposure

Comments:
-Varicella-zoster immune globulin is the preferred therapy for postexposure prophylaxis; oral antiviral therapy may be used when passive immunization is not possible; if antiviral therapy is used, varicella vaccines should not be given for at least 72 hours following last dose.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For HIV-infected person who has had close contact with a person who has active varicella or herpes zoster and is susceptible to the virus (e.g. no history of vaccination or either condition, or is known to be seronegative).

Usual Pediatric Dose for Herpes Simplex - Congenital:

Neonatal Herpes:
Birth to 3 months: 10 mg/kg IV every 8 hours for 10 days (manufacturer dosing)

Birth to 3 months: 20 mg/kg IV every 8 hours (CDC recommendation)
-Duration of therapy: Disease limited to the skin and mucous membranes: 14 days; Disseminated disease or disease involving the CNS: 21 days

Follow with oral suppressive therapy: 300 mg/m2 orally 3 times a day for 6 months

Comments:
-Neonates born to women who acquire HSV near term should be treated due to high risk of infection; infants exposed to HSV during birth should be followed by a pediatric infectious-disease specialist.
-For neonatal HSV with CNS involvement, confirm virus is absent from cerebrospinal fluid prior to stopping therapy; CSF HSV DNA PCR should be performed on days 19 and 21 and repeated as needed.
-Following IV treatment, oral prophylaxis for 6 months should be considered in those with CNS or skin, eyes, and mouth disease as it may be associated with superior neurodevelopmental outcome and prevent cutaneous recurrences.
-CDC STD Treatment Guidelines and the Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children may be consulted for additional guidance.

Use: For known or suspected neonatal HSV.

Usual Pediatric Dose for Herpes Simplex -- Mucocutaneous/Immunocompetent Host:

Treatment of First Episode of Genital Herpes:
Less than 12 years: 40 to 80 mg/kg/day orally in divided doses 3 to 4 times a day for 5 to 10 days
Maximum dose: 1000 mg/day

12 years or older: 200 mg orally every 4 hours 5 times a day OR 400 mg orally 3 times a day
Duration of therapy: 7 to 10 days

Severe Disease or Complications Requiring Hospitalization:
Less than 12 years: 10 mg/kg IV every 8 hours for 7 days
12 years or older: 5 mg/kg IV every 8 hours for 7 days

Recurrence of Genital HSV Infection:
Less than 12 years: 20 to 25 mg/kg orally twice a day; Maximum dose: 400 mg
12 years or older: 200 mg orally 5 times a day for 5 days OR 800 mg orally 2 times a day for 5 days OR 800 mg orally 3 times a day for 2 days

Comments:
-All patients with newly acquired genital herpes should receive antiviral therapy as first episodes can cause a prolonged clinical illness, even among persons with mild clinical manifestations initially; therapy should be initiated at the earliest sign or symptom of primary infection; IV therapy is indicated for patients with severe infection.

Use: For the treatment of first episode or recurrence of mucosal and cutaneous herpes simplex (HSV-1 and HSV-2).

Usual Pediatric Dose for Herpes Simplex Encephalitis:

3 months to 12 years old: 10 to 20 mg/kg IV every 8 hours

12 years or older: 10 mg/kg IV every 8 hours

Duration of therapy: 10 days (manufacturer); 21 days (CDC)

Comments:
-The Center for Disease Control and Prevention (CDC) recommends 21 days of IV therapy to treat HSV encephalitis.
-Acyclovir is the drug of choice for local and disseminated herpes simplex infection in infants and children.
-CDC STD Treatment Guidelines and the Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children may be consulted for additional guidance.

Use: For the treatment of Herpes Simplex Encephalitis

Usual Pediatric Dose for Herpes Simplex -- Mucocutaneous/Immunocompromised Host:

Less than 12 years: 10 mg/kg IV every 8 hours for 7 days (manufacturer dosing)
12 years or older: 5 mg/kg IV every 8 hours for 7 days (manufacturer dosing)

Concomitant HIV infection (guideline dosing):
-Mild Symptomatic Gingivostomatitis:
20 mg/kg orally 4 times a day for 7 to 10 days
Maximum dose: 400 mg
-Moderate to Severe Gingivostomatitis:
5 to 10 mg/kg IV 3 times a day
-May switch to oral therapy after lesions have begun to regress; treat until lesions have completely healed

Comments:
-Acyclovir is the drug of choice for local and disseminated herpes simplex in HIV-infected and exposed infants and children; children with severe immunosuppression and moderate to severe lesions should be treated initially with IV therapy and may require longer therapy.
-Immunocompromised patients may have prolonged or severe episodes; clinical manifestations of genital herpes may worsen during immune reconstitution early after initiation of antiretroviral therapy.
-CDC STD Treatment Guidelines and the Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children may be consulted for additional guidance.

Use: For the treatment of initial and recurrent mucosal and cutaneous herpes simplex (HSV-1 and HSV-2) in immunocompromised patients

Usual Pediatric Dose for Herpes Zoster:

Immunocompetent Host:
-Parenteral:
Less than 1 year: 10 mg/kg IV every 8 hours for 7 to 10 days
1 year or older: 500 mg/m2 IV every 8 hours for 7 to 10 days
-Oral: 12 years or older: 800 mg orally 5 times a day for 5 to 7 days

Immunocompromised Host: 10 mg/kg IV every 8 hours for 7 to 10 days

HIV-exposed and HIV-Infected Children:
-Uncomplicated Zoster:
20 mg/kg orally 4 times a day for 7 to 10 days; Maximum dose: 800 mg
-Severe immunosuppression (CDC immunologic category 3), trigeminal or sacral nerve involvement, extensive multidermatomal, or disseminated zoster:
10 mg/kg IV every 8 hours until cutaneous lesions and visceral disease are clearly resolving; then may switch to oral therapy to complete a 10 to 14-day course

HIV-Infected Adolescents:
-Localized Dermatomal: 800 mg orally 5 times a day for 7 to 10 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)
-Extensive Cutaneous Lesion or Visceral Involvement: 10 to 15 mg/kg IV every 8 hours until clinical improvement (i.e. no new vesicle formation or improvement of signs and symptoms of visceral disease), then switch to oral therapy
Duration of therapy: 7 to 14-day course (oral plus IV)

Comments:
-Acyclovir is the oral drug of choice for treating herpes zoster in HIV-infected children; it should be given for 7 to 10 days, although longer durations should be considered if lesions are slow to resolve.
-Initial IV therapy is recommended in children with more severe immunosuppression.
-According to the Guidelines for the Prevention and Treatment of Opportunistic Infections, oral acyclovir therapy in adolescents should be considered alternative therapy for the treatment of uncomplicated cases of herpes zoster; IV acyclovir is preferred therapy for extensive cutaneous lesion or visceral involvement.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children and HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the acute treatment of herpes zoster (shingles).

Usual Pediatric Dose for Varicella-Zoster:

Immunocompetent host:
2 years or older (40 kg or less): 20 mg/kg orally 4 times a day for 5 days
2 years or older (over 40 kg): 800 mg orally 4 times a day for 5 days
Maximum doses: Single: 800 mg; Daily: 3200 mg/day

Immunocompromised host:
Less than 1 year: 10 mg/kg IV 3 times a day for 7 to 10 days
1 year or older: 500 mg/m2 IV 3 times a day for 7 to 10 days

HIV-exposed and HIV-infected Children
-Mild disease with no or moderate immune suppression (CDC immunologic category 1 and 2): 20 mg/kg orally 4 times a day for 7 to 10 days and until no new lesions for 48 hours
Maximum dose: 800 mg
-Severe immune suppression (CDC immunologic category 3): 10 mg/kg or 500 mg/m2 IV every 8 hours for 7 to 10 days and until no new lesions for 48 hours

HIV-Infected Adolescents:
-Uncomplicated course: 800 mg orally 5 times a day for 5 to 7 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)
-Severe or complicated course: 10 to 15 mg/kg IV every 8 hours for 7 to 10 days; may switch to oral therapy after defervescence if no evidence of visceral involvement

Comments:
-Therapy should be initiated at the earliest sign of chickenpox, no later than 24 hours after onset of rash.
-In children 1 year or older, body surface area may be used for dosing instead of body weight.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children and HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the treatment of chickenpox (varicella).

Usual Pediatric Dose for Herpes Simplex -- Suppression:

Neonatal period (less than 1 year): 300 mg/m2 orally 3 times a day for 6 months

Secondary Prophylaxis in HIV-Exposed and HIV-infected Children:
20 mg/kg orally twice a day
Maximum dose: 800 mg

Comments:
-Suppressive therapy following treatment of neonatal HSV disease involving the CNS or skin, eyes, and mouth may prevent cutaneous recurrences and possibly provide superior neurodevelopmental outcomes.
-Beyond the neonatal period, recurrent HSV episodes can be treated successfully and chronic prophylaxis is generally not warranted; however, it may be considered for children with severe and recurrent mucocutaneous (oral or genital) disease.
-Secondary prophylaxis should be re-evaluated periodically (at least annually) as the frequency and severity of infection changes over time.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children and HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the secondary prophylaxis of recurrent HSV disease.

Usual Pediatric Dose for Herpes Simplex Labialis:

Concomitant HIV infection:

20 mg/kg orally 4 times a day for 5 days
Maximum dose: 400 mg

Adolescents: 400 mg orally 3 times a day for 5 to 10 days

Comments:
-The safety and efficacy of buccal tablets in pediatric patients has not been evaluated.
-Use of buccal tablets in younger children may present a choking risk.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For the treatment of recurrent herpes simplex labialis (cold sores).

Usual Pediatric Dose for Herpes Zoster -- Prophylaxis:

HIV-Infected Children or Adolescents (guideline dosing):

Post-exposure Prophylaxis in HIV-Infected Children or Adolescents:
20 mg/kg orally 4 times a day (maximum dose 800 mg) for 7 days beginning 7 to 10 days after exposure

Comments:
-Varicella-zoster immune globulin is the preferred therapy for postexposure prophylaxis; oral antiviral therapy may be used when passive immunization is not possible; if antiviral therapy is used, varicella vaccines should not be given for at least 72 hours following last dose.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children or HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For HIV-infected person who has had close contact with a person who has active varicella or herpes zoster and is susceptible to the virus (e.g. no history of vaccination or either condition, or is known to be seronegative).

Usual Pediatric Dose for Varicella-Zoster -- Prophylaxis:

HIV-Infected Children or Adolescents (guideline dosing):

Post-exposure Prophylaxis in HIV-Infected Children or Adolescents:
20 mg/kg orally 4 times a day (maximum dose 800 mg) for 7 days beginning 7 to 10 days after exposure

Comments:
-Varicella-zoster immune globulin is the preferred therapy for postexposure prophylaxis; oral antiviral therapy may be used when passive immunization is not possible; if antiviral therapy is used, varicella vaccines should not be given for at least 72 hours following last dose.
-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Exposed and HIV-Infected Children or HIV- Infected Adults and Adolescents may be consulted for additional guidance.

Use: For HIV-infected person who has had close contact with a person who has active varicella or herpes zoster and is susceptible to the virus (e.g. no history of vaccination or either condition, or is known to be seronegative).

What other drugs will affect acyclovir injection?

Before using acyclovir, tell your doctor if you are also taking probenecid (Benemid). If you are using probenecid, you may need a dose adjustment or special tests during treatment with acyclovir.

There may be other drugs that can interact with acyclovir. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about acyclovir injection.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03.

Last reviewed: December 03, 2013
Date modified: July 02, 2017

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