Spectrum: Local Antimicrobial Stewardship, for Eastern Health

Acyclovir

C. diff Risk

None

Oral Bioavailability

Poor (Less than 20%)

Approximate Cost

$0.60/day (PO)
$35.40/day (IV)

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Renal

Adult

Serious Infections
(e.g. CNS and Disseminated Zoster)
10mg/kg IV q8h

Shingles
800mg PO 5 times per day

Prophylaxis dosing varies by indication

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 AKI suspected.

Adverse Effects

Adverse Effects

  •  GI upset

  •  Phlebitis

  •  Increased SCr

  •  AKI from crystal nephropathy

Major Interactions

Major Interactions

Mycophenolate can increase the acyclovir concentration.

May diminish efficacy of zoster or varicella vaccine.

Coverage

NLPDP Status

OPEN BENEFIT (PO)
No prescribing restrictions

Additional Information

Additional Information

For oral indications, valacyclovir is the pro-drug, which is more bioavailable with more convenient dosing.

IV Administration
Give over at least 60 min in D5W or NS; maximum concentration 10 mg/mL

EH Prescribing Restrictions
None

Community IV Formulary (Metro Area)
NO

Pharmacology

Pharmacology

Antimicrobial class: Antiviral. Nucleoside analogue.

Pregnancy category: B

Average serum half life: 3 hours

CSF penetration: Therapeutic

Urine penetration: Therapeutic