Clovir 250 mg/vial (IV Infusion)

Indications

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

Pharmacology

• Interferes with DNA synthesis
• Inhibits viral replication
• Antiviral activity depends on intracellular conversion to Acyclovir Triphosphate

Dosage

• 5 mg/kg every 8 hours for Herpes simplex infection
• 5 mg/kg every 8 hours for severe Herpes zoster infection (shingles)
• 10 mg/kg every 8 hours for Varicella zoster infection
• 10 mg/kg every 8 hours for Herpes simplex encephalitis
• Administered by slow intravenous infusion over a one-hour period

Administration

• Recommended for 5-7 days in most infections
• Recommended for at least 10 days in Herpes simplex encephalitis
• Administered by injection into a vein over one hour by a controlled-rate infusion pump
• Can be further diluted for administration by infusion
• Compatible with various infusion fluids

Interaction

• Co-administration with probenecid increases half-life and area under the concentration time curve
• Concurrent use of diuretics in patients over 60 years increases plasma levels significantly

Contraindications

• Hypersensitivity to Acyclovir or Valacyclovir

Side Effects

• Lethargy
• Tremors
• Nausea
• Vomiting
• Reversible increases in liver-related enzymes
• Rashes
• Local inflammatory reactions if infused into extracellular tissues

Pregnancy & Lactation

• Pregnancy category B
• Not well studied in pregnant women
• Should be used during pregnancy only if benefits outweigh risks

Precautions & Warnings

• Intended for intravenous infusion only
• Reconstituted solution has pH of approximately 11.0
• Must be given over at least one hour to avoid renal tubular damage
• Must be accompanied by adequate hydration
• Caution in patients with neurological abnormalities, hypoxia, or renal/hepatic/electrolyte abnormalities

Use in Special Populations

• Pediatric use: Dose calculated based on body surface area
• Geriatric use: Special attention needed for dosage reduction due to low creatinine clearance
• Renal impairment: Dosage modifications suggested based on creatinine clearance

Overdose Effects

• Elevations of serum creatinine and blood urea nitrogen
• Neurological effects including confusion, seizures, and coma
• Adequate hydration essential to reduce possibility of crystal formation in urine

Therapeutic Class

• Herpes simplex & Varicella-zoster virus infections

Duration of Treatment

• Recommended for 5-7 days in most infections
• Recommended for at least 10 days in 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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