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The data presented below include references to peak steady-state plasma acyclovir concentrations observed in humans treated with 800 mg given orally 5 times a day (dosing appropriate for treatment of herpes zoster) or 200 mg given orally 5 times a day (dosing appropriate for treatment of genital herpes). Acyclovir has been considered the treatment of choice for neonatal HSV disease since 1991. Genital herpes: Typical initial dosage: 200 mg every 4 acyclovir increases levels of emtricitabine by Other (see comment). In 2 trials, acyclovir was administered at 20 mg/kg 4 times daily (up to 3,200 mg per day) for 5 days. This product contains less than 1mmol sodium (23mg) per 5ml dose and per 20ml maximum individual dose, that is to say essentially sodium-free. If you are using acyclovir oral suspension, use a specially marked measuring spoon or other device to measure each dose accurately. Is there any negatives associated with taking a higher dose than what is normally prescribed for suppression. 500 mg/m2/dose IV every 8 hours. Thus, this study is designed to characterize the affect of long-term, low-dose acyclovir suppressive ther-apy on Saliva samples can show traces of it for one to 10 days while blood tests for the drug can detect it for up to six to 48 hours, or two days. Of course, the hair follicle test can detect the drug for up to 90 days, or three months, which is the longest window of detection. Suppression in children with AIDS: 6 mg/kg once daily. The projected area under the curve of a 500-mg twice-a-day dose of valacyclovir is > 3 times greater than that of a 400-mg twice-a-day dose of oral acyclovir . low-dose acyclovir suppressive therapy in our patients with genital herpes caused by HSV-2 who have six or more recur-rences per year. These medications are not usually taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation. These medications may interact and cause very harmful effects. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation. These medications may cause some risk when taken together. Valacyclovir 500 mg orally 2 times/day * Treatment recommended starting at 36 weeks gestation. By mouth. Some examples include, but are not limited to, acyclovir, adefovir dipivoxil, cidofovir, ganciclovir, valacyclovir including pancreatitis, and neuropathy. 400 mg twice daily, alternatively 200 mg 4 times a day; increased to 400 mg 3 times a day, dose may be increased if recurrences occur on standard suppressive therapy or for suppression of genital herpes during late pregnancy (from 36 weeks gestation). which may not respond to continued acyclovir treatment (see section 5.1). These data support the use of suppressive therapy with 300 mg of oral acyclovir per square meter per dose administered three times daily for 6 months after initial treatment of neonatal HSV disease. OR . The frequency of acyclovir-resistant clones was about three per 10000 plaque forming units (PFU), and genital lesions contained up to 3x10(6) PFU of replicating virus in the specimens from the patients with genital herpes with or without acyclovir-suppressive therapy. The efficacy of oral acyclovir 400 mg twice daily in suppressing frequently relapsing genital herpes simplex was evaluated in an open multicenter study. -Efficacy of treatment started more than 72 hours after onset of rash has not been established. a Adapted from Reference 8. b Dose should be decreased in patients with impaired renal function. Page last reviewed: July 16, 2021. Thereafter, patients received open-label acyclovir suppressive therapy. Zovirax (Acyclovir) may treat, side effects, dosage, drug interactions, warnings, patient labeling, reviews, and related medications including drug comparison and health resources. It was demonstrated that acyclovir is not dose proportional over the dosing range 200mg to 800mg. Acyclovir doses are based on weight (especially in children and teenagers). Recurrent genital: 400mg orally three times daily for 5 days. adefovir. The cost of suppressive medications depends on your area as well as the brand and dosage of medication. A randomized, double-blind, comparative trial comparing high- and standard-dose oral acyclovir for first-episode genital herpes infections. 131 patients with frequently recurring genital herpes were treated for 1 year with reducing doses of oral acyclovir. Initial treatment: 200 mg PO q4hr while awake (5 times daily) for 10 days or 400 mg PO q8hr for 7-10 days. Recently, I asked my doctor to increase my dosage to 800 mg of acyclovir twice daily. Recurrent episodes: 500 mg PO q12hr for 3 days (no data on efficacy if started >24 hours after lesion onset) Suppressive therapy (immunocompetent patients): 1 g/day PO. Comment: Coadministration of emtricitabine with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of emtricitabine. As an side, for a quick summary of the various doses for the various herpes medications for active outbreaks vs suppression, see Pages 20-21 of The Herpes Handbook , available here: LINK . 400 mg 2 times daily for up to 12 months, followed by re-evaluation. Acyclovir 400 mg orally 3 times/day . The time to first recurrence in patients who commenced therapy on 400 mg twice a day was statistically significantly shorter than those on 200 mg four times a day (p less than 0.02) and as the total daily dose and frequency of therapy were lowered Suppression of HSV infections; The first few days of herpes zoster infections. Use Caution/Monitor. Neonatal herpes simplex virus infection: Management and prevention. Lindberg, MD will be in honor of Dr. Lindberg who passed away in August 2019.Details to be announced. Inclusion or absence of a drug label link on the Clinical Info site does not imply endorsement or lack thereof by Clinical Info. Usual Adult Dose for Herpes Zoster 1 g orally 3 times a day for 7 days Comments: -Therapy should be started at the earliest sign/symptom of herpes zoster and is most effective when started within 48 hours of rash onset. Initial episode: 1 g PO q12hr for 10 days. Suppression in immunocompetent or HIV-infected patients 38 studies with oral acyclovir, treatment with VALTREX should be initiated within 24 hours after 2; 68 dose is 500 mg once daily. The incidence of bone marrow suppression in the letermovir group was comparable to that of the placebo group. Dose: 1000 mg/day PO divided 5x/day x5 days; Alt: 1600 mg/day PO divided q12h x5 days; 2400 mg/day PO divided q8h x2 days [suppression, 12 yo and older] Dose: 800 mg/day PO divided q12h for up to 12mo HSV infection, immunocompromised pts [PO route, 2 yo and older] Dose: 5-10 mg/kg/dose IV q8h for at least 10 days; Info: use IBW in obese pts; may switch to PO antiviral after 2-7 days to complete course; may extend tx if not healed after 10 days [recurrence] Dose: 800 mg PO tid x2 days; Start: ASAP after sx onset; Alt: 800 mg PO bid x5 days [suppression] Dose: 400 mg PO bid; Info: reassess tx need at 1y Drug and dose Frequency Duration* Cost Acyclovir, 400 mg: Three times per day: 7 to 10 days: $10: Acyclovir, 200 mg: Five times per day: 7 to 10 days: $10: Alternative regimens have included doses ranging from 200 mg 3 times daily to 200 mg 5 times daily. None. FDA label information. Usual Dosing (Adults) Mucocutaneous herpes simplex: IV: 5 mg/kg/dose every 8 hours x 5-10 days. Dosing considerations. Suppressive Therapy of Recurrent HSV-2 Genital Herpes Recommended Regimen Acyclovir 400 mg orally 2 times/day OR Valacyclovir 500 mg orally once a day* OR Valacyclovir 1 g orally once a day OR Famciclovir 250 mg orally 2 times/day Acyclovir capsules, tablets, and oral suspension may be taken with meals or on an empty stomach. Truvada is a two-drug fixed dose combination product containing emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF). Acyclovir prophylaxis. During the first year patients were randomized to receive either 400 mg acyclovir twice daily or placebo. Seventy-one patients were treated for 12 months. Treatment of First Episode of Genital Herpes: Less than 12 years: 40 to 80 mg/kg/day orally in divided doses 3 to 4 times a day for 5 to 10 days. Maximum dose: 1000 mg/day. 12 years or older: 200 mg orally every 4 hours 5 times a day OR 400 mg orally 3 times a day. Duration of therapy: 7 to 10 days. acyclovir. The suppression (prevention of recurrences) of recurrent herpes simplex infections in immunocompetent patients. The Journal seeks to publish high Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). The decrease in bioavailability is believed to be a function of the dose and not the dosage form. Half the adult dose should be used for children under 2 years. Studies in patients with symptomatic recurrent genital herpes have shown that valacyclovir has comparable efficacy to acyclovir [8, 9]. No, acyclovir (Zovirax) is an antiviral medication, not a steroid. It's sometimes prescribed for people taking immunosuppressants to prevent an outbreak while their immune system is lowered. Does acyclovir (Zovirax) speed up healing? This all-day event Science, Society and the Legacy of Donald A.B. Your dose needs may change if you gain or lose weight. In the third trial, doses of 10, 15, or 20 mg/kg were administered 4 NLM Lindberg-King Lecture & Scientific Symposium on September 1, 2022. For an initial outbreak in adults and children over 2 years, oral aciclovir 200 mg, or 400 mg three times daily, should be taken five times a day for 10 days. The suppressive dose of acyclovir is 400mg twice per day. Anonymous $0.88 x tablet acyclovir 200 mg with SEPA. Acyclovir suppression dosage. Objective: To determine if suppressive acyclovir near term decreased the frequency of clinical recurrences at delivery in women with recurrent genital herpes simplex virus (HSV) infection. Dose: 2000 mg PO q12h x1 day; Start: ASAP after sx onset [*suppression] Dose: 500 mg PO qd; Info: reassess tx need at 4mo herpes zoster (shingles) [1000 mg PO q8h x7 days] Start: ASAP w/in 72h of rash onset, maximum efficacy w/in 48h; Info: may use for herpes zoster ophthalmicus renal dosing [if usual dose 500 mg qd] CrCl 29: 500 mg q48h Women with genital infection of any frequency were enrolled. Primary HSV infection-genital (Oral therapy): 200mg every 4 hours while awake (5 times/day) or 400mg orally three times daily for 10 days. 200 mg every 4 hours, 5 times daily for 10 days. -If normal dose is 400 mg orally every 12 hours: Reduce dose to 200 mg orally every 12 hours-If normal dose is 800 mg orally every 4 hours 5 times a day: Reduce dose to 800 mg orally every 12 hours For CrCl 10 to 25 mL/min/1.73 m2:-If normal dose is 800 mg orally every 4 hours 5 times a day: Reduce dose to 800 mg orally every 8 hours IV: 11 Mechanism and efficacy are similar to those of acyclovir. Oral acyclovir reduces viral shedding, reduces pain and heals lesions faster when compared with placebo. The oral acyclovir dosage for treatment of primary or initial nonprimary genital herpes is 200 mg five times daily for 10 days. Clinical Info provides the following link to the DailyMed drug label solely as an example of the labels available for acyclovir. Acyclovir is best taken with a full glass (8 ounces) of water. Suppressive therapy (immunocompetent patients with 9 recurrences annually): 500 mg/day PO; transmission reduction for source partner, 500 mg/day PO. Drink plenty of water while you are taking this medicine to keep your kidneys working properly. I was originally prescribed 400 mg of acyclovir twice daily for suppression of my herpes type 2. c Oral dosage of acyclovir in children should not exceed 80 mg/kg per day (3200 mg/day). Dosing regimes for aciclovir Herpes simplex. During treatment, 73% of the patients were completely free Chronic Suppressive Therapy For Recurrent Disease. Acyclovir (9- [2-hydroxymethyl]guanine) is a nucleoside analog that selectively inhibits the replication of herpes simplex virus types 1 and 2 (HSV-1, HSV-2) and varicella-zoster virus (VZV). Several FDA-approved drug labels may be available for acyclovir. Welcome to the National Library of Medicine, the worlds largest biomedical library and the center of biomedical informatics and computational biology at NIH. Acyclovir 400 mg orally 3 times/day for 710 days OR Famciclovir 250 mg orally 3 times/day for 710 days OR Valacyclovir 1 gm orally 2 times/day for 710 days * Treatment can be extended if healing is incomplete after 10 days of therapy. Dose of 12 mg/kg once daily may be used, based on patients response. ZOVIRAX should be administered to a nursing mother with caution and only when indicated. Complete data are available for 389 of the 430 patients who began the fifth year of study. Valtrex can be harmful to the kidneys, and these effects are increased when it is used together with other medicines that can harm the kidneys. Tell your doctor about all other medications you are using. Acyclovir suppression of frequently recurring genital herpes. Adult. The acyclovir dose when used as suppressive therapy is 400 mg administered twice daily (Table 64.1). Adult dosage (ages 1864 years) Shingles typical dosage: 800 mg every 4 hours, five times per day for 710 days. One year acyclovir suppression of frequently recurring genital herpes: a study of efficacy, safety, virus sensitivity and antibody response. 4 Based on a prospective study including 107 infants treated with acyclovir, the dose approved by the United States Food and Drug Administration (FDA) is 10 mg/kg/dose administered every 8 hours. randomly assigned to oral acyclovir 300 mg/m 2 per dose three times per day or placebo immediately following parenteral acyclovir treatment . Acyclovir is considered an alternative to ganciclovir for Abstract. Valacyclovir is typically more expensive than Acyclovir. Recommended Acyclovir Dose by Clinical Condition a,b,c,d Abbreviations: HSV, herpes simplex virus; IV, intravenous. After intracellular uptake, it is converted to acyclovir monophosphate by virally-encoded thymidine kinase. Maintenance: 3-6 mg/kg IV/PO qDay The median time to engraftment was 19 days in the letermovir group and 18 days in the placebo group. adefovir increases levels of emtricitabine by Other (see comment). Save the Date. Alternative Regimen. Your pharmacy and insurance plan may also play a role in the overall cost. Intermittent treatment for recurrence: 200 Serum enzyme levels generally do not change during oral acyclovir therapy. Baker and colleagues evaluated the ability of daily valacyclovir therapy in a dosage of 500 mg to prevent recurrent symptomatic outbreaks of genital herpes. In children with CNS involvement, acyclovir suppression was associated . and/or the coadministered drug. Oral bioavailability is 77 percent, and the drug is quickly converted to its active form. Babies with skin, eye, and mouth disease can benefit because this therapy helps to prevent skin recurrences, whereas babies with CNS disease may have additional benefit The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents.The Journal publishes original work based on standards of excellence and expert review. Prophylaxis with acyclovir has been shown to decrease the rate of CMV infection and improve survival in hematopoietic cell transplantation (HSCT) recipients. 26-29 weeks' gestation:: 6-12 mg/kg IV/PO . Davis G, et al. These concentrations would potentially expose the nursing infant to a dose of acyclovir up to 0.3 mg/kg/day. Sawyer MH, Freifeld AG, Felser JM, Dale JK et al. Suppression of Recurrent Genital Herpes Among Pregnant Women* Recommended Regimen. Chronic Suppressive Therapy for Recurrent Disease 400 mg 2 times daily for up to 12 months, followed by re-evaluation. Read More. Methods: We conducted a prospective, double-blind, randomized trial in 234 women with recurrent genital herpes. The Encephalitis: 10mg/kg/dose IV every 8 hours. You may need dose adjustments or special tests when taking certain medications together with Valtrex. Top of Page. Recommended duration of therapy is 10-12 weeks after cerebrospinal fluid becomes culture negative; Premature Neonates.
