ACYCLOVIR TABLETS

Highly selective antiviral drug on the herpes virus. A synthetic analog of acyclic purine nucleoside. In a virus-infected cell, a number of sequential, acyclovir mono-triphosphate-acyclovir conversion reactions take place under the influence of viral thymidine kinases. Involvement of acyclovir triphosphate in the viral DNA strand occurs, after which its synthesis is blocked by competitive inhibition of viral DNA polymerases. Acyclovir is effective against herpes simplex virus type I and II herpes simplex virus, Varicella Zoster virus; Higher concentrations are required to inhibit Epstein-Barr virus.
In vivo therapeutically and prophylactically, acyclovir is primarily effective against viral infections caused by herpes simplex.
When taken orally, the biological penetration is 15-30%. Acyclovir penetrates well into all organs and tissues of the body, including the brain and skin. Plasma protein binding is 9-33% and does not depend on its plasma concentration. Its concentration in spinal cord fluid is 50% of its concentration in plasma. Acyclovir reaches the placental barrier and accumulates in milk. After oral administration: 200 mg 5 times a day, the maximum concentration is 0.7 μg / ml, the maximum concentration is 1.5-2 hours.
Acyclovir is metabolized in the liver to form the pharmacologically inactive compound 9-carboxy methoxymethyl guanine. For a person with a normally functioning kidney, the elimination half-life is 2-3 hours. In patients with severe renal insufficiency, the elimination half-life is 20 hours, and during hemodialysis 5-7 hours (however, the plasma concentration of acyclovir decreases from 60% to baseline. Approximately 84% is excreted unchanged by the kidneys and is more than 14%).

Contraindications
Hypersensitivity to acyclovir, ganciclovir, or any of the excipients. The drug should not be taken during lactation. Be careful - in the history of dehydration, kidney failure, neurological disorders.

Pregnancy and lactation
Acyclovir reaches platsentalur barrier and accumulates in the milk. It can only be taken during pregnancy if the potential benefit to the mother outweighs the potential risk to the fetus. During lactation, if it is necessary to take acyclovir, it is necessary to stop breastfeeding.

Method of administration and dosage
Are determined individually based on the degree of severity of the disease.
In the treatment of skin and mucosal infections caused by Herpes simplex I and II viruses, adults and children over 2 years of age are prescribed 200 mg 5 times a day, at intervals of 4 hours a day for 5 days and at intervals of 8 hours a night. In more severe cases, the course of treatment may be extended as prescribed by a doctor. In case of pronounced immunodeficiency, 400 mg 5 times a day after spinal cord implantation is prescribed as part of complex therapy, including in the advanced clinical picture of HIV infection (including early clinical manifestations of HIV infection and AIDS stage).
For the prevention of recurrence of infections caused by Herpes simplex I and type II viruses, patients with normal immune status are prescribed 200 mg 4 times a day at intervals of 6 hours at night with a recurrence of the disease.
For the prevention of infections caused by Herpes simplex I and II viruses, adults with immunodeficiency and children older than 2 years, the drug is recommended to prescribe 200 mg 4 times a day at intervals of 6 hours. Depending on the severity of the infection, the maximum dose is 400 mg acyclovir 5 times a day.
In the treatment of varicella-zoster virus infections, adults are prescribed 800 mg 5 times a day, every 4 hours and at 8-hour intervals. The duration of the course of treatment is 7-10 days. Children older than 2 years are prescribed 20 mg/kg 4 times a day for 5 days; Children weighing more than 40 kg are prescribed the same dose as adults.
In the treatment of infections caused by the Herpes Zoster virus, adults are prescribed 800 mg 4 times a day, every 6 hours, for 5 days.
In the treatment and prophylaxis of infections of patients with impaired renal function caused by the Herpes simplex virus, patients with a low creatinine clearance of 10 ml/min, the dose of the drug should be reduced to 200 mg twice daily at intervals of 12 hours.
In the treatment of infections caused by the varicella-zoster virus, patients with 10 ml/min - low creatinine clearance are recommended to reduce the dose of the drug to 800 mg 2 times a day at intervals of 12 hours; When creatinine clearance at 25 ml/min, 800 mg 3 times a day at 8-hour intervals is prescribed.
The drug is taken with food or immediately after a meal with a sufficient amount of water.

Side effects
The drug is usually well tolerated.
In some cases from the gastrointestinal tract - pain, nausea, vomiting, diarrhea.
In the blood: a slight increase in the activity of liver enzymes, rarely - a small increase in urea and creatinine levels, hyperbilirubinemia, leukopenia, erythropenia.
From the central nervous system: rarely - headache, weakness; In special cases, tremor, dizziness, increased fatigue, sleep deprivation, hallucinations.
Allergic reactions: skin rash
Other: rarely - alopecia, fever.

Storage conditions
Store in a dry place, protected from light and children. At a temperature not exceeding 25°C,

Conditions of release: Out of prescription.