Acyvir 250 mg/vial (IV Infusion)

Indications

• Treatment of acute clinical manifestations of Herpes simplex virus in immunocompromised patients
• Treatment of severe primary or non-primary genital herpes in immune competent patients
• Treatment of Varicella zoster virus infection in immunocompromised patients
• Treatment of Herpes zoster (shingles) in immune competent patients with severe acute local or systemic manifestations of the disease
• Treatment of Herpes simplex encephalitis

Pharmacology

Interferes with DNA synthesis and inhibits viral replication; depends on intracellular conversion to Acyclovir Triphosphate

Dosage

• Herpes simplex infection: 5 mg/kg every 8 hours
• Very severe Herpes zoster infection (shingles): 5 mg/kg every 8 hours
• Varicella zoster infection: 10 mg/kg every 8 hours
• Herpes simplex encephalitis: 10 mg/kg every 8 hours

Administration

• Recommended duration: 5-7 days for most infections, at least 10 days for Herpes simplex encephalitis
• Recommended slow intravenous infusion over a one-hour period
• Compatible with specific infusion fluids
• No preservatives, must be reconstituted and used immediately, discarded if unused

Interaction

Co-administration with probenecid and diuretics may affect plasma levels and urinary excretion

Contraindications

Hypersensitivity to Acyclovir or Valacyclovir

Side Effects

• Lethargy, tremors, confusion, hallucinations, agitation, somnolence, psychosis, convulsions, coma
• Phlebitis, nausea, vomiting, reversible increases in liver-related enzymes, pruritus, urticaria, rashes, increases in blood urea and creatinine
• Local inflammatory reactions if inadvertently infused into extracellular tissues

Pregnancy & Lactation

Category B; use during pregnancy or lactation only if benefits outweigh risks

Precautions & Warnings

• For intravenous infusion only and not through any other route
• Must be administered over at least one hour to avoid renal tubular damage
• Accompanied by adequate hydration
• Use with caution in patients with neurological abnormalities, significant hypoxia, or serious renal, hepatic, or electrolyte abnormalities

Use in Special Populations

• Pediatric use: Dose based on body surface area; dosage modification for impaired renal function
• Geriatric use: No specific data available, dosage reduction may be needed
• Renal impairment: Caution advised, dosage modifications based on creatinine clearance

Overdose Effects

• Elevations of serum creatinine, blood urea nitrogen, and renal failure
• Neurological effects including confusion, hallucinations, agitation, seizures, coma
• Adequate hydration essential to reduce possibility of crystal formation in the urine
• Hemodialysis may be considered in case of overdose

Therapeutic Class

Herpes simplex & Varicella-zoster virus infections

Duration of Treatment

5-7 days for most infections; at least 10 days for Herpes simplex encephalitis

Reconstitution

• 250 mg vial: Reconstituted with 10 ml of Water for Injection or Sodium Chloride Intravenous Infusion (0.9% w/v)
• 500 mg vial: Reconstituted with 10 ml of Water for Injection or Sodium Chloride Intravenous Infusion (0.9% w/v)

Storage Conditions

Store at 15°C to 25°C; protected from light and moisture; keep out of the reach of children

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