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Acyclovir is an acyclic guanine nucleoside analog which inhibits the viral DNA polymerase. It is active against Herpes simplex virus-1 & 2, Ebstein Barr virus, Cytomegalovirus and Varicella zoster virus infections (1)

Acute treatment of herpes zoster (shingles). Treatment of initial episodes and the management of recurrent episodes of genital herpes. Treatment of chickenpox Recurrent herpes labialis (2,3)

Hypersensitivity to acyclovir or valacyclovir. (2,3)

Nausea, diarrhea, malaise, myalgia Anaphylaxis, angioedema, fever, headache, pain, peripheral edema Aggressive behavior, agitation, ataxia and other CNS symptoms Anemia, leukocytoclastic vasculitis, leukopenia, lymphadenopathy, thrombocytopenia Elevated liver function tests, hepatitis, hyperbilirubinemia, jaundice Visual abnormalities Alopecia and skin disorders. Renal failure Thrombotic Thrombocytopenic purpura/hemolytic uremic syndrome in immunocompromised patients. (2,3)

Probenecid: Increased half-life of acyclovir. (2)

Acyclovir is excreted in the breast milk and this can have deleterious effects on the nursing infant. Safety is not established in <2 years of age. Elderly patients are also more likely to have nausea, vomiting, dizziness, renal or CNS adverse events. (2)

Adult: Non-genital herpes simplex treatment 200 mg five times daily usually for 5 days, longer if new lesions appear during treatment or if healing is incomplete. 400 mg for immunocompromised patients or if absorption is impaired. Genital herpes simplex treatment 200 mg 5 times daily for 5 days or 400 mg three times daily for three days. Longer if new lesions appear or healing is incomplete. Immunocompromised or HIV positive patients 400 mg is given five times daily for 7 to 10 days during first episode or 400 mg three times a day for 5 to 10 days during recurrent injection. Herpes simplex prevention of recurrence 200 mg 4 times daily or 400 mg twice daily reduced to 200 mg two or three times daily interrupted every 6 to 12 months. Varicella and herpes zoster 800 mg five times daily for 7 days. Chicken pox 800 mg five times daily for 7 to 10 days. Intravenous infusion:Severe initial genital herpes, Varicella zoster, Herpes simplex infection 5 mg/kg body weight every 8 h for five days Child Varicella and herpes zoster 20 mg/kg body weight (max. 800 mg) four times daily for 5 days under 2 years 200 mg four times daily for 2 to 5 years 400 mg four times daily. Over 6 years 800 mg four times daily. Chicken pox 20 mg/kg body weight (max 800 mg) four times daily for 5 days (4)

1. Acosta EP, Flexner C. Antiviral agents (nonretroviral). In: Brunton L, Chabner B, Knollmann B eds. Goodman & Gilman’s The Pharmacological basis of Therapeutics. 12th ed. USA: McGraw Hill; 2011:1593-1622. 2. Zovirax [cited 2013 Aug 25]. Available from:,020089s019,019909s020lbl.pdf 3. Zovirax [cited 2013 Aug 25]. Available from: 4. National Formulary of India. 4 th ed. Government of India, Ministry of Health and Family Welfare. India: Indian Pharmacopoeia Commission; 2011.