Acyclovir

(acycloguanosine)
Anna Dolomisiewicz
 nucleoside analogue
9-[(2-hydroxyethoxy)methyl]guanine
acycloguanosine
Mechanism of Action - 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 &
viral replication by competing with deoxyguanosine
triphosphate for viral DNA polymerase and being
incorporated into viral DNA.
 Indications:
Herpes genitalis
Herpes labialis
Herpetic encephalitis
Chickenpox
Shingles
prophylaxis of CMV infections - such as in bone
marrow & organ transplant recipients & in
persons with HIV infection.
cold sores
 Form
Oral treatment of initial episodes & management of
recurrent episodes of genital herpes; acute herpes zoster
(shingles); varicella (chickenpox).
IV initial & recurrent mucosal & cutaneous herpes simplex
(HSV-1 &HSV-2) in immunocompromised patients; severe
initial clinical episodes of genital herpes in
immunocompetent patients; herpes simplex encephalitis;
neonatal herpes infections; herpes zoster (shingles) in
immunocompromised patients.
Topical for herpes genitalis & mild mucocutaneous
infections in immunocompromised patients; herpes labialis
(with hydrocortisone); primary herpetic gingivostomatitis
 Other use
orolabial (cold sores) infection in
immunocompetent patients
orolabial (cold sores) infection in HIV-infected
patients (adolescents and adults
Disseminated primary eczema herpeticum
Herpes simplexassociated erythema
multiforme
Bells palsy
 Acyclovir for Herpes Labialis
The dose size per
application will vary
depending on the total
lesion area but should
approximate a
one-half-inch ribbon
of ointment per 4 square
inches of surface area
A finger cot or rubber glove should be used when
applying, to prevent autoinoculation of other body sites
and transmission of infection to other persons
Apply as early as possible following the onset of
prodromal symptoms or when lesions appear.
 Trade Names
US: Zovirax
UK: Aciclovir
Canada: Acyclovir Sodium, Apo-Acyclovir; Mylan-
Acyclovir; ratio-Acyclovir; Teva-Acyclovir; Zovirax
Poland: Acyclovir Stada, Antivir, Cusiviral, Hascovir, Herpex,
Heviran, Virolex, Viru-POS, Zovirax; Zovirax Duo (with
Hydrocortisonum)
Sweden: Aciclovir Hospira, Aciclovir Sandoz, Aciklovir
STADA, Anti, Geavir, Xerclear (with Hydrocortisone), Zovirax
Finland: Acyrax, Herpolips, Zovirax
Saudi Arabia: Zovirax
 Side effects
Acyclovir is well tolerated when given orally
no significant interactions with other drugs.
Gastrointestinal disturbances, headache &
rash are the most common side effects.
Intravenous administration of acyclovir can
produce phlebitis and reversible renal
dysfunction.
 http://www.uptodate.com
http://www.ncbi.nlm.nih.gov/pubmed
George M. Brenner, Craig W. Stevens
Pharmacology, 4th edition, Elsevier