Spectrum: Local Antimicrobial Stewardship, for AHS Calgary Zone

Acyclovir

C. diff Risk

None

Oral Bioavailability

NA

Approximate Cost

IV$45/d PO$5/d

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Adult

10mg/kg IV q8h for serious infections such as CNS and disseminated zoster

800mg PO 5 times per day for shingles

Prophylaxis dosing varies by indication

Renal

General Information

Common Usage

Common Usage

Therapy for herpesviral infections (HSV and VZV) including encephalitis

Prophylaxis of herpesviral infections if recurrent disease or immunocompromised

Drug Monitoring

Drug Monitoring

Follow SCr as appropriate

Check urine for crystals if suspect AKI

Adverse Effects

Adverse Effects

GI upset, phlebitis - common

Increased SCr, AKI from crystal nephropathy (can check urine for acyclovir crystals)

Major Interactions

Major Interactions

Mycophenolate can increase the acyclovir concentration

May diminish efficacy of zoster or varicella vaccine

Additional Information

Additional Information

For oral indications, Valacyclovir is the pro-drug and is more bioavailable with more convenient dosing.

Pharmacology

Pharmacology

Antimicrobial class: Antiviral, nucleoside analogue

Pregnancy category: B

Average serum half life: 3.0

CSF penetration: Therapeutic

Urine penetration: Therapeutic