Aciclovir is a nucleoside analogue antiviral medication specifically designed to combat infections caused by the herpes simplex virus (HSV) and varicella-zoster virus (VZV). It functions by inhibiting viral DNA replication, thereby reducing the severity and duration of outbreaks. Available in oral, topical, and intravenous formulations, aciclovir is a cornerstone in the management of herpes-related conditions, offering both therapeutic and prophylactic benefits. Its established efficacy and favorable safety profile make it a first-line choice for clinicians worldwide.

Features

• Active ingredient: Aciclovir
• Available forms: Tablets, cream, ointment, intravenous injection
• Mechanism: Selective inhibition of viral DNA polymerase
• Bioavailability: Approximately 15–30% (oral)
• Half-life: 2–3 hours in adults with normal renal function
• Excretion: Primarily renal

Benefits

• Reduces healing time for active herpes lesions
• Decreases the frequency of recurrent outbreaks
• Lowers risk of viral transmission to others
• Minimizes pain and discomfort associated with lesions
• Prevents complications in immunocompromised patients
• Supports faster return to normal daily activities

Common use

Aciclovir is primarily indicated for the treatment of infections caused by herpes viruses, including genital herpes, herpes labialis (cold sores), herpes zoster (shingles), and chickenpox. It is also used prophylactically to prevent recurrence in immunocompetent and immunocompromised individuals, and to suppress outbreaks in patients with frequent episodes.

Dosage and direction

Dosage varies based on indication, patient age, renal function, and immune status. For genital herpes: 200 mg orally five times daily for 10 days (initial episode) or 400 mg twice daily for chronic suppression. For herpes zoster: 800 mg orally five times daily for 7–10 days. Topical cream (5%) should be applied to affected area 5 times daily. Always follow healthcare provider instructions; dosage adjustments are necessary for renal impairment.

Precautions

Use with caution in patients with renal impairment; dosage adjustment is required. Ensure adequate hydration to prevent crystalluria. Monitor renal function during intravenous administration. Not a cure for herpes infections; does not eliminate the virus or prevent transmission entirely. Use during pregnancy only if clearly needed. Breastfeeding considerations: aciclovir is excreted in breast milk.

Contraindications

Hypersensitivity to aciclovir, valaciclovir, or any component of the formulation. Avoid in patients with history of severe neurotoxic reactions to the drug.

Possible side effect

Common side effects include nausea, vomiting, diarrhea, and headache. Topical application may cause mild pain, burning, or itching. Rare but serious side effects include renal impairment, neurotoxicity (e.g., confusion, hallucinations), and hematologic abnormalities. IV administration may lead to phlebitis or inflammation at injection site.

Drug interaction

Probenecid may increase aciclovir plasma concentrations. Concurrent use with other nephrotoxic drugs (e.g., aminoglycosides, cyclosporine) may enhance renal adverse effects. Zidovudine may potentiate fatigue and lethargy.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for a missed one. Consistent dosing is crucial for efficacy, especially during acute treatment phases.

Overdose

Symptoms may include agitation, coma, seizures, and renal impairment. Management is supportive; hemodialysis may enhance elimination. Maintain adequate hydration and monitor renal function closely.

Storage

Store at room temperature (15–30°C). Protect from moisture and light. Keep out of reach of children. Do not use beyond the expiration date.

Disclaimer

This information is for educational purposes and does not replace professional medical advice. Always consult a healthcare provider for diagnosis, treatment decisions, and personalized recommendations. Use only as directed.

Reviews

Clinical studies and patient reports consistently affirm aciclovir’s efficacy in reducing outbreak duration and frequency. Many users note significant improvement in quality of life with prophylactic use. Healthcare professionals regard it as a reliable, well-toleroption for herpes management, though individual responses may vary.