Drug information provided by: Merative, Micromedex. However, the drug is unlikely to harm a nursing infant. [34408], 10 mg/kg/dose IV every 8 hours for 14 to 21 days. [34408] For disseminated disease in persons living with HIV, 10 to 15 mg/kg/dose IV every 8 hours for 21 days is recommended.[34361]. It helps the sores heal faster, keeps new sores from forming, and decreases pain/itching. Clinical practice guidelines suggest an antiviral plus oral corticosteroid within 72 hours of symptom onset to modestly increase probability of functional facial nerve recovery. 400 mg PO twice daily. Most Concomitant use may increase acyclovir or emtricitabine concentrations. Hold the tablet in place with slight pressure for 30 seconds.Once adhered, the tablet will gradually dissolve. If concomitant use is unavoidable, closely monitor for adverse reactions. Tenofovir is primarily excreted via the kidneys by a combination of glomerular filtration and active tubular secretion. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Varicella-Zoster Virus Vaccine, Live: (Major) If possible, discontinue acyclovir at least 24 hours before administration of the varicella-zoster virus vaccine, live. Emtricitabine; Tenofovir Disoproxil Fumarate: (Moderate) Monitor for acyclovir or emtricitabine-related adverse events during concomitant use. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Follow all directions on your medicine label and package. CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. Many people using this medication do not have serious side effects. Acyclovir excretion in the urine ranged from less than 0.02% to 9.4% of the daily dose. Once lesions begin to regress, a change to oral dosing is recommended. Amphotericin B lipid complex (ABLC): (Moderate) Concurrent use of amphotericin B and other nephrotoxic medications, including acyclovir, may enhance the potential for drug-induced renal toxicity. 5 to 10 mg/kg/dose IV every 8 hours for at least 7 days or until clinical improvement, then oral antiviral therapy to complete at least 10 days of total therapy or until lesions are completely healed. ZOVIRAX Ointment 5% is a formulation for topical administration. Do not apply to unaffected skin or inside the mouth or nose. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment. Store the diluted infusion solution at room temperature, 15 to 25 degrees C (59 to 77 degrees F). Lamivudine; Tenofovir Disoproxil Fumarate: (Moderate) Monitor for changes in serum creatinine and phosphorus if tenofovir disoproxil fumarate is administered in combination with nephrotoxic agents, such as acyclovir. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Once lesions begin to regress, a change to oral dosing is recommended. 500 mg/m2/dose IV every 8 hours during the period of risk has been used. Do not store for later use.- Store at controlled room temperature (between 68 and 77 degrees F)Sitavig:- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees FZovirax:- Protect from light- Store between 59 to 77 degrees FZovirax Cream:- Store at 77 degrees F; excursions permitted to 59-86 degrees FZovirax Ointment:- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F- Store in a dry placeZovirax Powder:- Store between 59 to 77 degrees FZovirax Suspension:- Protect from light- Store between 59 to 77 degrees F. Acyclovir is contraindicated in patients who have developed acyclovir hypersensitivity or valacyclovir hypersensitivity. Medscape Education, Integrating New Treatments and Individualizing Care in CMV Infection Post-Transplant, encoded search term (acyclovir topical (Zovirax topical%2C Sitavig)) and acyclovir topical (Zovirax topical, Sitavig), Practice Guidelines Highlights From the Past Year, Herpetic Anterior Uveitis Following PfizerBioNTech Coronavirus Disease 2019 Vaccine, Herpes Simplex Virus (HSV) in Emergency Medicine. Topical medicine is for use only on the skin. Nucleoside and Nucleotide DNA Polymerase Inhibitor AntiviralsTopical Antivirals, Synthetic antiviral with activity against herpes simplex virus type 1 and 2 and varicella-zoster virusUsed to treat herpes labialis, herpes genitalis, herpes simplex encephalitis, herpes simplex keratitis, neonatal herpes infection, chickenpox (varicella), shingles (zoster)Potent activity against herpes simplex viruses type 1 and 2 and much less activity against varicella-zoster virus, Sitavig, Zovirax, Zovirax Cream, Zovirax Ointment, Zovirax Powder, Zovirax Suspension, Acyclovir/Acyclovir Sodium Intravenous Inj Sol: 1mL, 50mgAcyclovir/Acyclovir Sodium/Zovirax/Zovirax Powder Intravenous Inj Pwd F/Sol: 500mgAcyclovir/Zovirax Oral Cap: 200mgAcyclovir/Zovirax Oral Tab: 400mg, 800mgAcyclovir/Zovirax/Zovirax Cream Topical Cream: 5%Acyclovir/Zovirax/Zovirax Ointment Topical Ointment: 5%Acyclovir/Zovirax/Zovirax Suspension Oral Susp: 5mL, 200mgSitavig Buccal Tablet, SL: 50mg. Concurrent administration of any of the varicella-zoster virus vaccines (Zostavax, Varivax, ProQuad) with antiviral medications known to be effective against varicella zoster virus has not been evaluated. However, guidelines recommend prophylaxis with other agents, including valacyclovir, ganciclovir, and valganciclovir; use of acyclovir has been deemed inferior and, thus, fallen out of favor. Tenofovir is primarily excreted via the kidneys by a combination of glomerular filtration and active tubular secretion. There is no cure for herpes and acyclovir will not prevent you from developing symptoms in the future. EPIFOAM (hydrocortisone acetate 1% and pramoxine hydrochloride 1%) Topical Aerosol. 20 to 80 mg/kg/day (Max: 800 mg/day) PO divided twice daily for at least 12 months. Vancomycin: (Moderate) Closely monitor renal function if concomitant use with acyclovir and vancomycin is necessary. For prevention of early reactivation in HCT recipients, initiate therapy beginning 1 day prior to transplant and continue until marrow engraftment. 10 mg/kg/dose IV every 8 hours for 7 to 10 days for severe or complicated infections. Because of similar chemical structures and possible cross-sensitivity, acyclovir should not be used in patients with famciclovir hypersensitivity, ganciclovir hypersensitivity, penciclovir hypersensitivity, or valganciclovir hypersensitivity. For extensive cutaneous lesions or visceral involvement in persons living with HIV, oral acyclovir may be used as stepdown therapy after IV acyclovir to complete 10 to 14 days of therapy. Renal impairment, which may include hypophosphatemia, has been reported with the use of tenofovir disoproxil fumarate; a majority of the cases occurred in patients who had underlying systemic or renal disease or who are concurrently taking nephrotoxic agents. Most You can spread genital herpes even if you do not have symptoms. Initiate therapy at the first sign of symptoms (i.e., within 24 hours). Carefully monitor renal function during concomitant therapy. Encephalopathic changes have been associated with systemic acyclovir use. This survey is being conducted by the WebMD marketing sciences department. The FDA-approved labeling recommends using ideal body weight when dosing obese adult patients. Dosage forms: topical cream (5%), topical ointment (5%) If positive, continue acyclovir for 7 additional days. Most Initiate therapy at the first sign of symptoms (i.e., within 24 hours). You may report side effects to Health Canada at 1-866-234-2345. 400 mg PO twice daily plus topical ophthalmic steroid for at least 10 weeks, then 400 mg PO twice daily as long-term prophylaxis. Cold sores can spread easily. The dose size per application will vary depending upon the lesion area but should approximate 0.5-inch ribbon of ointment per 4 square inches of surface area. Contact the applicable plan Read the Patient Information Leaflet if available from your pharmacist before you start using acyclovir and each time you get a refill. This is not a complete list of possible side effects. Tell your doctor if your condition lasts or gets worse after treatment is finished. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. Initiate therapy within 48 to 72 hours of rash onset. Tenofovir containing products should be avoided with concurrent or recent use of a nephrotoxic agent; patients receiving concomitant nephrotoxic agents should be carefully monitored for changes in serum creatinine and phosphorus, and urine glucose and protein. Iomeprol: (Moderate) Concomitant use of acyclovir and contrast agents should be avoided when possible, as use of these drugs together may increase the risk for nephrotoxicity. In the US - Call your doctor for medical advice about side effects. Monitor for renal toxicity if concomitant use is required. Until more data are known, clinicians should be prepared to make adjustments in hydantoin dosing if acyclovir therapy is added or discontinued. The FDA-approved labeling recommends the use of ideal body weight when dosing obese adult patients. Coadministration of drugs that reduce renal function or compete for active tubular secretion, such as acyclovir and emtricitabine, may increase the risk of adverse reactions. 5 mg/kg/dose IV every 8 hours. 500 mg/m2/dose IV every 8 hours during the period of risk has been used. a herpes simplex infection of the skin, mouth or genitals, FDA Labeling for acyclovir ointment on RxList. Post-exposure prophylaxis is indicated for persons living with HIV who lack evidence of immunity to varicella with substantial exposure to a contact with varicella or herpes zoster. Distributed into human milk following oral or IV administration. Enter your medication into the WebMD interaction checker. Wash your hands before and after applying this medicine. Consult your doctor before breast-feeding. [34408] Similar consideration should be given to pediatric patients. These are general recommendations only and therapy should be individualized based on therapeutic drug monitoring; some patients may require higher doses to optimize therapy. Phenytoin: (Minor) In a single case report, the addition of acyclovir to a regimen of phenytoin and valproate led to a clinically significant decrease in phenytoin serum concentrations and loss of seizure control. Coadministration of drugs that reduce renal function or compete for active tubular secretion, such as acyclovir and emtricitabine, may increase the risk of adverse reactions. Renal impairment, which may include hypophosphatemia, has been reported with the use of tenofovir disoproxil fumarate; a majority of the cases occurred in patients who had underlying systemic or renal disease or who are concurrently taking nephrotoxic agents. Wear a glove or a finger cot or use a cotton swab when applying the ointment to avoid spreading the virus to other body parts and to other people.. Acyclovir topical cream is usually applied 5 times daily for 4 days. The 5% cream should be used only for treatment of herpes labialis (perioral herpes, cold sores, fever blisters) and should not be used to treat genital herpes. ReconstitutionReconstitute 500 mg or 1 g vial with 10 or 20 mL, respectively, of sterile water for injection (preservative-free) to give a concentration of 50 mg/mL. Select a condition to view a list of medication options. 800 mg PO 5 times daily for 7 to 10 days. Concurrent administration with drugs that decrease renal function may increase concentrations of tenofovir. Acyclovir has a relatively short serum half-life and is quickly cleared from the body. Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate: (Moderate) Monitor for acyclovir or emtricitabine-related adverse events during concomitant use. The FDA-approved labeling recommends using ideal body weight when dosing obese adult patients. Does acyclovir topical interact with other drugs you are taking? 11 Acyclovir ointment is 0.02-9.4% absorbed. Do not apply the topical ointment or cream to the eye.Use a finger cot or rubber glove when applying to avoid transmission of the virus to other sites or persons.Wash hands thoroughly after administration. Initiate therapy at the first sign of symptoms (i.e., within 24 hours). Crosses placenta following oral or IV administration. Advise patient that 5% cream is only for treatment of herpes labialis (perioral herpes, cold sores, fever blisters) and should not be used to treat genital herpes. For treatment of herpes labialis, importance of applying to affected areas as directed and at the first sign or symptom (e.g., tingling, redness, bump, itching). Monitor patients for changes in renal function if these drugs are coadministered. 400 to 800 mg PO twice daily to prevent early reactivation or 800 mg PO twice daily to prevent late reactivation; administer during the period of risk. Elderly patients are also more likely to have CNS adverse events (e.g., somnolence, hallucinations, confusion, or coma) possibly related to changes in renal function. Properly discard this product when it is expired or no longer needed. [34361] Use ideal body weight when dosing persons with obesity. 400 mg PO 3 times daily for 5 to 10 days. 5 mg/kg/dose IV every 8 hours for 5 days. This information does not assure that this product is safe, effective, or appropriate for you. The duration of therapy is not well defined and should be based on clinical, virologic, and immunologic responses in consultation with an ophthalmologist. Until more data are known, clinicians should be prepared to make adjustments in hydantoin dosing if acyclovir therapy is added or discontinued. If positive, continue acyclovir for 7 additional days. 20 mg/kg/dose IV every 8 hours for 21 days. Do not share this medication with others. No dosage adjustment is necessary for patients receiving 400 mg PO every 12 hours or 200 mg PO 5 times per day.CrCl 10 mL/min/1.73 m2 or less: reduce recommended IV dose by 50% and extend dosing interval to every 24 hours. Acyclovir inhibits viral DNA synthesis and must be phosphorylated intracellularly to be active. Avoid letting infected areas come into contact with other people. Probenecid; Colchicine: (Moderate) Probenecid decreases the renal tubular secretion of acyclovir and can increase serum and CSF concentrations of acyclovir, increasing the potential for toxicity. Concomitant use may increase acyclovir or emtricitabine concentrations. Renal impairment, which may include hypophosphatemia, has been reported with the use of tenofovir disoproxil fumarate; a majority of the cases occurred in patients who had underlying systemic or renal disease or who are concurrently taking nephrotoxic agents. Not appreciably absorbed into systemic circulation following topical application to intact skin. 80 mg/kg/day PO (Max: 3,200 mg/day) per FDA-approved product labeling; however, 4,000 mg/day has been used off-label; safety and efficacy of buccal tablet not established. [34408] The FDA-approved labeling recommends the use of ideal body weight when dosing obese adult patients.[34408]. Use this medication at the first sign of infection (such as tingling, burning, redness). Apply sufficient quantity of cream to cover the lesions 5 times daily for 4 days. How is this medicine (Acyclovir Ointment) best taken? Fosphenytoin: (Minor) In a single case report, the addition of acyclovir to a regimen of phenytoin and valproate led to a clinically significant decrease in phenytoin serum concentrations and loss of seizure control. Acyclovir levels in plasma ranged from <0.01 to 0.28 mcg/mL in 8 patients with normal renal function, and from <0.01 to 0.78 mcg/mL in one patient with impaired renal function. Further, a prospective epidemiologic registry of acyclovir use during pregnancy was established in 1984 and completed in April 1999. To lower the chance of giving herpes to your partner, do not have sexual contact during an outbreak or if you have symptoms. [34361] The FDA-approved duration is 5 days. Concomitant administration of nephrotoxic drugs, such as acyclovir, increases the risk of renal failure after administration of mannitol. As the administered dose increases, the bioavailability decreases, resulting in less than dose proportional increase in acyclovir concentrations (e.g., 200 mg Cmax, 0.83 mcg/mL; 400 mg Cmax, 1.21 mcg/mL; 800 mg Cmax, 1.61 mcg/mL). This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Prospective epidemiologic registry of acyclovir use the diluted infusion solution at room temperature, 15 to 25 degrees C 59... For severe or complicated infections use during pregnancy was established in 1984 and completed in 1999. Until more data are known, clinicians should be consulted before taking drug. Drug Shortages Resource Center for information on Shortages of one or more of these preparations with other.! 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