Composition
Active ingredient: Â
acyclovir 200 mg
Pharmacological action
Antiviral drug-a synthetic analog of thymidine nucleoside.
In infected cells containing viral thymidine kinase, phosphorylation occurs and conversion to acyclovir monophosphate. Under the influence of acyclovir guanylate cyclase, monophosphate is converted to diphosphate and under the action of several cellular enzymes – to triphosphate. The high selectivity of action and low toxicity to humans are due to the lack of the necessary enzyme for the formation of acyclovir triphosphate in intact cells of the macroorganism.
Acyclovir triphosphate, “embedded” in the DNA synthesized by the virus, blocks the reproduction of the virus. The specificity and very high selectivity of its action are also due to its predominant accumulation in cells affected by the herpes virus.
It is highly active against Herpes simplex virus types 1 and 2; Varicella zoster and Varicella zoster viruses; Epstein-Barr virus (types of viruses are listed in ascending order of acyclovir MPC).
Moderately active against CMV.
With herpes, it prevents the formation of new rash elements, reduces the likelihood of skin dissemination and visceral complications, accelerates the formation of crusts, and reduces pain in the acute phase of herpes zoster. It has an immunostimulating effect.
Indications
– Treatment of primary and recurrent severe genital herpes (including in patients with impaired immunity) – orally and parenterally;- prevention is often recurrent (6 or more cases per year) genital herpes (including in patients with impaired immunity) – inside;- treatment of primary and recurrent herpes simplex with lesions of skin and mucous membranes caused by Herpes simplex virus 1 and 2, in patients with impaired immunity – orally, parenterally;prophylaxis of herpes simplex in patients with impaired immunity (including after transplantation and the treatment of immunosuppressive drugs, HIV-infected patients on chemotherapy) – inside;- encephalitis caused by Herpes simplex virus 1 and 2 type – parenteral;- the treatment of herpes zoster, caused by Varicella zoster virus in adults – inside; in patients with impaired immunity and generalized herpes zoster in patients with intact immunity – parenteral;- prevention of herpes zoster, caused by Varicella zoster virus, after an initial period of use of acyclovir for parenteral use in all patients with impaired immunity (including after transplantation and in the treatment of immunosuppressive drugs, HIV-infected patients on chemotherapy) – inside;- herpes zoster with eye disease – orally, parenterally; generalized infection in neonates caused by Herpes simplex virus – parenteral;- varicella in patients with intact immunity within 24 hours after the onset of the rash typical of the interior, in patients with impaired immunity – parenteral.
Use during pregnancy and lactation
Use during pregnancy is only possible if the intended benefit to the mother outweighs the potential risk to the fetus. If it is necessary to use the drug during lactation, stop breastfeeding.
Contraindications
Hypersensitivity (including to valacyclovir), children under 3 years of age (for solid LF).
With caution. Pregnancy and lactation.
Side effects
From the digestive system: in isolated cases – abdominal pain, nausea, vomiting, diarrhea; rarely-transient increase in the activity of liver enzymes, hyperbilirubinemia.
From the hematopoietic system: rarely-leukopenia, erythropenia.
From the central nervous system: rarely-headache, weakness; in some cases-tremor, dizziness, fatigue, drowsiness, hallucinations.
Allergic reactions: skin rash; rarely-allergic dermatitis (when applying the ointment).
Local reactions: when applying the ointment, redness, itching, peeling, burning or tingling may occur.
Other: rarely-alopecia, fever, elevated urea and creatinine levels.
Interaction
When used concomitantly with probenecid, the average half-life increases and the clearance of acyclovir decreases.
When taken concomitantly with nephrotoxic drugs, the risk of developing impaired renal function increases.
How to take, course of use and dosage
The dosage regimen is set individually depending on the severity of the disease.
In the treatment of infections of the skin and mucous membranes caused by the Herpes simplex virus type 1 and 2, adults and children over 2 years of age are prescribed Acyclovir 200 mg 5 times / day for 5 days at intervals of 4 hours during the day and at intervals of 8 hours at night. In more severe cases of the disease, an increase in the course of treatment is possible.
As part of complex therapy for severe immunodeficiency, including with a detailed clinical picture of HIV infection (including early clinical manifestations of HIV infection and the stage of AIDS), after bone marrow implantation,400 mg is prescribed 5 times a day.
To prevent relapses of infections caused by Herpes simplex virus type 1 and 2, patients with normal immune status and with relapse of the disease are prescribed 200 mg 4 times / day every 6 hours.
To prevent infections caused by Herpes simplex virus type 1 and 2, adults and children over 2 years of age with immunodeficiency, the drug is prescribed 200 mg 4 times / day every 6 hours, the maximum dose is 400 mg 5 times/day.
In the treatment of infections caused by the Varicella zoster virus, adults are prescribed 800 mg 5 times/day at intervals of 4 hours during the day and at intervals of 8 hours at night. The duration of treatment is 7-10 days. Children over 2 years of age are prescribed 20 mg / kg of body weight 4 times / day for 5 days, children weighing more than 40 kg are prescribed the drug in the same dosage as adults.
In the treatment of herpes zoster (Herpes zoster), adults are prescribed 800 mg 4 times / day every 6 hours for 5 days. Children over 6 years – 800 mg 4 times a day; 2-6 years-400 mg 4 times a day; under 2 years-200 mg 4 times a day. More precisely, the dose can be determined at the rate of 20 mg / kg, but not more than 800 mg 4 times a day. The course of treatment is 5 days.
In patients with severe renal impairment (CC) in the treatment and prevention of infections caused by the Herpes simplex virus, the drug is prescribed 200 mg 2 times a day at intervals of 12 hours.
In the treatment of infections caused by the Varicella zoster virus, patients with creatinine clearance are prescribed 800 mg 2 times/day at intervals of 12 hours; with creatinine clearance from 10 to 25 ml / min-800 mg 3 times/day at intervals of 8 hours.
The drug should be taken during or immediately after a meal and washed down with a sufficient amount of water.
Overdose
Oral use of 20 g of acyclovir has been reported. Symptoms: agitation, coma, convulsions, lethargy. Precipitation of acyclovir in the renal tubules is possible if its concentration exceeds the solubility in the renal tubules (2.5 mg / ml).
Overdose with parenteral use (with bolus use, or use in high doses, or in patients whose water-electrolyte balance was not properly controlled): increased urea nitrogen, hypercreatininemia, impaired renal function, lethargy, convulsions, coma.
Treatment: maintenance of vital functions, hemodialysis.
Special instructions
Caution should be exercised when prescribing Acyclovir to patients with impaired renal function, elderly patients due to the increased half-life of acyclovir. When using the drug, it is necessary to ensure the intake of a sufficient amount of fluid.
Form of production
Pills.
Storage conditions
Store in a dry place protected from light at a temperature not exceeding 25 °C. Keep out of reach of children.
Shelf
life is 4 years.
Active ingredient
Acyclovir
Conditions of release from pharmacies
By prescription
Dosage form
Tablets
Description
Nursing mothers as prescribed by a doctor, Children over 2 years of age, Pregnant women as prescribed by a doctor, Adults as prescribed by a doctor, Children as prescribed by a doctor
Indications
Cold, Cold Sores
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Side effects of Acyclovir-Acrihin, pills 200mg, 20pcs.
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