None
Poor (Less than 20%)
IV$45/d PO$5/d
CrCl >50 mL/min: No dosage adjustment necessaryRenally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing. Rapid infusion can increase creatinine.
CrCl 25 to 50 mL/min: Administer the usual recommended dose every 12 hours
CrCl 10 to <25 mL/min:Administer the usual recommended dose every 24 hours
CrCl <10 mL/min:Administer 50% of the usual recommended dose every 24 hours
Intermittent haemodialysis:5 mg/kg/dose every 24 hours
Peritoneal dialysis:5 mg/kg/dose every 24 hours
Continuous renal replacement therapy (CRRT): 10 mg/kg/dose every 12 hours
Therapy for herpes virus infections (HSV and VZV) including encephalitis
Prophylaxis of herpes virus infections if recurrent disease or immunocompromised
Follow creatinine, urea, urine output as appropriate, liver enzymes and CBC.
BUN/Creatinine and fluid balance must be monitored daily in patients receiving high dose acyclovir. Ensure adequate hydration during and for at least 2 hours following administration. Manufacturer suggests 1 litre of fluid/24 hours/gram of acyclovir and recommends a minimum urine output of 500 mL/24 hours/gram of acyclovir.
Nausea
Vomiting
Diarrhea
Headache
Phlebitis (IV)
Liver or renal dysfunction
Crystal nephropathy (keep patient well hydrated)
Antimicrobial class: Antiviral, nucleoside analogue
Pregnancy category: B
Average serum half life: Neonates: 4 hours
Children 1-12 years: 2-3 hours
CSF penetration: Approximately 50% of plasma concentration
Route of Elimination: Primarily kidney with 60-90% of drug excreted unchanged in the urine
