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Acyclovir (Ophthalmic)

Medically reviewed by Last updated on Jul 12, 2020.


(ay SYE kloe veer)

Index Terms

  • Aciclovir
  • Avaclyr

Pharmacologic Category

  • Antiviral Agent, Ophthalmic


Acyclovir is converted to acyclovir monophosphate by virus-specific thymidine kinase then further converted to acyclovir triphosphate by other cellular enzymes. Acyclovir triphosphate inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA.


Not detected in blood by existing bioanalytical methods


Trace quantities are detectable in the urine but are not therapeutically relevant

Use: Labeled Indications

Herpetic keratitis: Treatment of acute herpetic keratitis (dendritic ulcers) in patients with herpes simplex (HSV-1 and HSV-2) virus


Hypersensitivity to acyclovir, valacyclovir, or any component of the formulation

Dosing: Adult

Herpetic keratitis: Ophthalmic: Apply a ½-inch ribbon of ointment in the lower cul-de-sac of the affected eye(s) 5 times daily (approximately every 3 hours while awake) until the corneal ulcer heals, then apply a ½-inch ribbon 3 times daily for 7 days.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Herpes simplex keratitis: Children ≥2 years and Adolescents: Ophthalmic: Apply a 1 cm ribbon in the lower eyelid of affected eye(s) 5 times a day (~every 3 hours while awake) until corneal ulcer heals, then apply a 1 cm ribbon 3 times daily for 7 more days


Ophthalmic: For topical ophthalmic use only; avoid touching tip of applicator to eye(s) or other surfaces. After application close the eye(s) for 1 to 2 minutes; excess ointment may be wiped away.


Store at 20°C to 25°C (68°F to 77°F).

Drug Interactions

There are no known significant interactions.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%: Ophthalmic: Eye pain, follicular conjunctivitis, punctate keratitis, stinging of eyes

<1%, postmarketing, and/or case reports: Angioedema, blepharitis, type I hypersensitivity reaction, urticaria


There are no warnings listed in the manufacturer’s labeling.

Pregnancy Considerations

Acyclovir has not been detected in the blood following ophthalmic administration; limited systemic absorption would limit potential exposure to the fetus. Results from a pregnancy registry, established in 1984 and closed in 1999, did not find an increase in the number of birth defects with exposure to systemic acyclovir when compared to those expected in the general population.

Patient Education

What is this drug used for?

• It is used to treat eye infections caused by herpes virus.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Stinging

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Vision changes

• Eye pain

• Severe eye irritation

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine’s uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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