Herpes zoster<\/a> (shingles), but it can also be used to treat chickenpox (chickenpox) in adults or serious infections in children.<\/p>\nThe best results are achieved if treatment begins within 48 hours of the start of the procedure. eruption<\/span>. Oral acyclovir 800 mg five times a day for 7 days accelerates the rate of healing of blisters. In zoster infections, it also reduces the severity and duration of pain and may prevent postherpes. neuralgia<\/span>.<\/p>\nIntravenous acyclovir achieves higher blood levels compared to oral acyclovir. It is recommended for serious infections:<\/p>\n
\n- \nImmunocompromised<\/span> patients with chickenpox, disseminated<\/span> herpes zoster or severe herpes simplex<\/li>\n
- \nAcute<\/span> herpes zoster when it affects the trigeminal nerve (forehead and eyelids)<\/li>\n
- Extensive eczema<\/span> herpetic\n<\/li>\n
- Herpes infection of the brain (encephalitis<\/span>)<\/li>\n
- Herpes infections in newborns.<\/li>\n<\/ul>\n
Intravenous acyclovir is administered over 1 hour every 8 hours for 7 days at a dose of 5 mg\/kg for HSV and 10 mg\/kg for VZV.<\/p>\n
<\/span>Mechanism of action of acyclovir.<\/span><\/h2>\nTo be effective, acyclovir must first be switched to acyclovir monophosphate for a enzyme<\/span> that is only found in viruses, called thymidine kinase (TK). It is then converted to its active triphosphate form by humans. enzymes<\/span> found inside cells.<\/p>\nCMV does not produce thymidine kinase, so the antiviral activity of acyclovir in CMV infections is poor.<\/p>\n
Acyclovir triphosphate (AT) is the active form of the medication. Reduces virus production DNA<\/span> by competing with a natural compound, deoxyguanosine triphosphate, for the viral enzyme DNA polymerase. Incorporation of AT into viral DNA completely prevents the synthesis of new DNA.<\/p>\nViral DNA polymerase binds 10 to 30 times more strongly to AT than cellular<\/span> DNA polymerase. This means that acyclovir is not toxic<\/span>.<\/p>\nUnfortunately, only about 15-20% of the acyclovir dose is absorbed through the intestinal wall, meaning it must be taken frequently as it is only active for two to three hours in the bloodstream.<\/p>\n
<\/span>Acyclovir Side Effects<\/span><\/h2>\nSide effects are rare from acyclovir, but include nausea or vomiting, diarrhea, headache, fever, confusion, lymphadenopathy<\/span>, generalized<\/span> muscle pain and itchy skin.<\/p>\nAcyclovir should be used with caution in patients with kidney disease. The dose should be reduced to prevent buildup of the medication and decrease the risk of the medication damaging the kidneys or nervous system. Acyclovir may also cause abnormal liver function blood tests and, rarely, a decrease in white blood cell count.<\/p>\n
A pregnancy registry of more than 1,000 women who received acyclovir before or during early pregnancy did not show increased rates of miscarriage or birth defects in offspring. However, as with any medication, it should only be given during pregnancy if the benefits are believed to outweigh the risk.<\/p>\n
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<\/span>Other antiviral agents used in herpes infections<\/span><\/h2>\nValacyclovir is a prodrug of acyclovir and has better bioavailability. It can also be used to treat HSV and HZV. It is used to prevent CMV infection after an organ transplant<\/span>. The usual doses are:<\/p>\n\n- HZV: 1 g three times a day for 7 days.<\/span><\/li>\n
- HSV: 500 mg twice daily for 5 days.<\/span><\/li>\n<\/ul>\n
Famciclovir is used for HSV and HZV. <\/span>The usual doses are:<\/span><\/p>\n\n- HZV: 500 mg three times a day for 10 days.<\/span><\/li>\n
- HSV: 125\u2013250 mg three times a day for 5 days<\/span><\/li>\n
- Long-term suppression: 250 mg twice daily<\/span><\/li>\n
- Recurrent HSV of the lips: a single dose of 500 mg at the first signs of blisters<\/span><\/li>\n
- \nRecurrent genital HSV: 100 mg twice daily for 1 day <\/span>at the first signs of blisters.<\/span>\n<\/li>\n<\/ul>\n
<\/p>\n\nNew Zealand approved data sheets are the official source of information for these prescription drugs, including approved uses and risk information. See the New Zealand individual data sheet on the Medsafe website.<\/span><\/em><\/div>\n<\/section>\n<\/div>\n
<\/span><\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"
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