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The total daily dosage of Aciclovir should be based on the type or severity of infection and given in equally divided doses based on consideration of degree of susceptibility of the pathogens, renal function and body-weight.
Aciclovir
• Acute Herpes Zoster:
800 mg every 4 hours, 5 times daily for 7 to 10 days.
• Genital Herpes:
Initial Genital Herpes: 200 mg every 4 hours, 5 times daily for 10 days.
Chronic suppressive therapy for recurrent disease: 400 mg 2 times daily for up to 12 months.
Intermittent therapy: 200 mg every 4 hours, 5 times daily for 5 days.
• Chickenpox:
Children (2 years of age and older): 20 mg/kg/dose 4 times daily (80 mg/kg/day) for 5 days.
Adults and Children (>40 kg): 800 mg 4 times daily for 5 days.
Aciclovir IV
The required dose of Aciclovir IV should be administered by slow intravenous infusion over a one-hour period.
• Herpes Simplex (HSV and HSV) Infections:
Adults and Adolescents (≥12 years): 5 mg/kg, 8 hourly for 7 days.
Pediatrics (<12 years): 10 mg/kg 8 hourly for 7 days.
• Severe Initial Herpes Genitalis:
Adults and Adolescents (≥12 years): 5 mg/kg 8 hourly for 5 days.
• Herpes Simplex Encephalitis:
Adults and Adolescents (≥12 years): 10 mg/kg 8 hourly for 10 days.
Pediatrics (3 months to 12 years of age): 20 mg/kg 8 hourly for 10 days.
• Neonatal Herpes Simplex (Birth to 3 months):
10 mg/kg 8 hourly for 10 days.
• Varicella Zoster:
Adults and Adolescents (≥12 years): 10 mg/kg 8 hourly for 7 days.
Pediatrics (<12 years): 20 mg/kg 8 hourly for 7 days.
Dose adjustment of Tablet for patients with acute or chronic renal impairment, based on Creatinine Clearance, Cr Cl (mL/min/1.73 m2):
For Cr Cl= > 25 : 800 mg 4 hourly 5 times daily
For Cr Cl = 10 to 25 : 200 mg 4 hourly 5 times daily or 400 mg 12 hourly or 800 mg 8 hourly
For Cr Cl = 0 to 10 : 200 mg 12 hourly or 400 mg 12 hourly or 800 mg 12 hourly
Dose adjustment of IV for patients with acute or chronic renal impairment, based on Creatinine Clearance, Cr Cl (mL/min/1.73 m2):
For Cr Cl = > 50 : 100% of recommended dose, 8 hourly
For Cr Cl = 25 to 50 : 100% of recommended dose, 12 hourly
For Cr Cl = 10 to 25 : 100% of recommended dose, 24 hourly
For Cr Cl = 0 to 10 : 50% of recommended dose, 24 hourly
Caution: Rapid or bolus intravenous injection must be avoided. Intramuscular or subcutaneous injection must be avoided.
Reconstitution procedure of IV infusion
Vial containing 250 mg Aciclovir will be reconstituted with 50 ml infusion solution and vial containing 500 mg Aciclovir will be reconstituted with 100 ml infusion solution. Besides, Vial containing 1 gm Aciclovir will be reconstituted with 250 ml infusion solution. 10 ml of the infusion solution will be added to the vial containing 250 mg, 500 mg and 1 gm Aciclovir. Shake well and transfer the required amount of solution to the infusion container. The final concentration of Aciclovir will be not more than 5 mg/ml.
The reconstituted solution should be used within 12 hours. Refrigeration of reconstituted solution may result in the formation of a precipitate which will re-dissolve at room temperature.
Compatible infusion fluids
Sodium Chloride Intravenous Infusion BP (0.45% and 0.9% w/v)
Sodium Chloride (0.18% w/v) and Glucose (4% w/v) Intravenous Infusion BP
Sodium Chloride (0.45% w/v) and Glucose (2.5% w/v) Intravenous Infusion BP
Hartmann\\\'s
It is recommended that Acyclovir IV Injection for Intravenous Infusion should be administered for five to seven days in the treatment of most infections and for at least ten days in the treatment of Herpes simplex encephalitis.
Each 250 mg vial of Acyclovir IV Injection should be reconstituted by the addition of 10 ml of either Water for Injection or Sodium Chloride Intravenous Infusion (0.9% w/v). This provides a solution containing 25 mg Acyclovir per ml.
Each 500 mg vial of Acyclovir IV Injection should be reconstituted by the addition of 10 ml of either Water for Injection or Sodium Chloride Intravenous Infusion (0.9% w/v). This provides a solution containing 50 mg Acyclovir per ml.
The dose of Acyclovir IV injection in children aged 12 years should be calculated on the basis of body surface area. Children in this age group with Herpes simplex infections (except Herpes simplex encephalitis) or Varicella zoster infections should be given Acyclovir Infusion in doses of 250 mg per square metre of body surface area (equivalent to 5 mg/kg in adults). Immunocompromised children in this age group with Varicella zoster virus infection or with Herpes simplex encephalitis should be given Acyclovir IV Infusion in doses of 500 mg per square metre of body surface area (equivalent to 10 mg/kg in adults). Children with impaired renal function require an appropriately modified dose, according to the degree of impairment.
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