Acyclovir

Drug overview for ACYCLOVIR (acyclovir):

Generic name: ACYCLOVIR (ay-SYE-kloe-vir)
Drug class: Topical Antivirals
Therapeutic class: Dermatological

Acyclovir, a synthetic purine nucleoside analog derived from guanine, has antiviral activity in vitro against various Herpesviridae including herpes simplex virus types 1 and 2 (HSV-1 and HSV-2).

Acyclovir is used topically as a 5% cream for the treatment of recurrent herpes labialis (perioral herpes, cold sores, fever blisters) in immunocompetent individuals. Acyclovir is used topically as a 5% ointment in the treatment of limited, non-life-threatening, mucocutaneous herpes simplex virus (HSV-1 and HSV-2) infections in immunocompromised individuals. The manufacturer states that acyclovir ointment may be used topically for the management of initial genital herpes; however, topical therapy is not usually recommended for the treatment of genital herpes.

There is no evidence that topical acyclovir will either prevent transmission of HSV infections to other individuals or prevent recurrent HSV infections when applied in the absence of signs and symptoms of infection. Acyclovir should not be used topically for prevention of recurrent HSV infections.

DRUG IMAGES

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The following indications for ACYCLOVIR (acyclovir) have been approved by the FDA:

Indications:
Genital herpes simplex
Mucocutaneous herpes simplex

Professional Synonyms:
Herpes genitalis
Mucocutaneous herpes simplex infection
Mucocutaneous HSV infection

Dosing information for ACYCLOVIR
DRUG LABEL	DOSING TYPE	DOSING INSTRUCTIONS
ACYCLOVIR 5% OINTMENT	Maintenance	Adults apply to the affected area(s) by topical route every 3 hours 6 times per day

Generic dosing information for ACYCLOVIR
DRUG LABEL	DOSING TYPE	DOSING INSTRUCTIONS
ACYCLOVIR 5% OINTMENT	Maintenance	Adults apply to the affected area(s) by topical route every 3 hours 6 times per day

Moderate List
No disease contraindications

The following adverse reaction information is available for ACYCLOVIR (acyclovir):

Overview
Severe
Less Severe

Adverse reaction overview.

No enhanced Common Adverse Effects information available for this drug.

There are 2 severe adverse reactions.

More Frequent	Less Frequent
None.	None.

Rare/Very Rare
Anaphylaxis Angioedema

There are 8 less severe adverse reactions.

More Frequent	Less Frequent
Abnormal desquamation Dry skin Skin irritation Stinging of skin	Cheilosis Pruritus of skin

Rare/Very Rare
Contact dermatitis Eczema

The following precautions are available for ACYCLOVIR (acyclovir):

Pediatric
Pregnant
Lactation
Geriatric

No enhanced Pediatric Use information available for this drug.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None

Acyclovir has not been shown to be teratogenic in standard tests following subcutaneous administration in rats and rabbits, IV administration in rabbits, and oral administration in mice. However, in nonstandard tests in rats, fetal abnormalities, principally involving the head and tail, were observed at higher subcutaneous acyclovir dosages, which also were associated with maternal toxicity. The drug crosses the placenta in humans following oral or IV administration. There are no adequate and controlled studies to date using acyclovir in pregnant women, and the drug should be used during pregnancy only when the potential benefits justify the possible risks to the fetus.

Although it is not known whether acyclovir is distributed into milk following topical application, the drug is distributed into milk following oral or IV administration. Following oral administration of acyclovir in 2 nursing women, milk acyclovir concentrations were 0.6-4.1

times the simultaneous maternal plasma drug concentrations. Therefore, acyclovir ointment and cream should be used with caution in nursing women. Women who have active herpetic lesions near or on the breast should avoid nursing.

No enhanced Geriatric Use information available for this drug.

The following icd codes are available for ACYCLOVIR (acyclovir)'s list of indications:

Genital herpes simplex
A60	Anogenital herpesviral [herpes simplex] infections
A60.0	Herpesviral infection of genitalia and urogenital tract
A60.00	Herpesviral infection of urogenital system, unspecified
A60.01	Herpesviral infection of penis
A60.02	Herpesviral infection of other male genital organs
A60.03	Herpesviral cervicitis
A60.04	Herpesviral vulvovaginitis
A60.09	Herpesviral infection of other urogenital tract
A60.9	Anogenital herpesviral infection, unspecified
Mucocutaneous herpes simplex
A60	Anogenital herpesviral [herpes simplex] infections
A60.0	Herpesviral infection of genitalia and urogenital tract
A60.00	Herpesviral infection of urogenital system, unspecified
A60.01	Herpesviral infection of penis
A60.02	Herpesviral infection of other male genital organs
A60.03	Herpesviral cervicitis
A60.04	Herpesviral vulvovaginitis
A60.09	Herpesviral infection of other urogenital tract
A60.1	Herpesviral infection of perianal skin and rectum
A60.9	Anogenital herpesviral infection, unspecified
B00.1	Herpesviral vesicular dermatitis
B00.2	Herpesviral gingivostomatitis and pharyngotonsillitis
B00.89	Other herpesviral infection