When should you use Acyclovir ointment, and when will it be useless?

Acyclovir is prescribed to treat viral diseases. The drug is usually used in the treatment of herpetic infections. The mechanism of action is based on disruption of the division of pathogens in the body. The drug is well tolerated and highly effective. Can be used in patients over three years of age.

The medicinal substance is included in the list of the most effective and safe medicines according to the World Health Organization.

Dosage forms

Before using Acyclovir for influenza and ARVI, as well as in the treatment of herpesvirus infections, it is worth considering the main forms of release of this drug. In pharmacies it is found in the form of tablets, ointments, creams, and lyophilisates. The choice depends on the characteristics of the disease:

• 5% ointment or cream. This form of Acyclovir is used for colds that are localized on the surface of the skin, genitals, and lips. But it is highly effective only for mild forms of herpes. If the infection worsens, Acyclovir may be additionally prescribed in the form of tablets or injections. The external remedy can be used about 5 times a day, it is applied in a thin layer to the affected area. Ointment or cream eliminates the feeling of itching, irritation, and soothes pain. Also prevents the appearance of bubbles;
• Pills. This form of Aceclovir is used for moderate or severe herpesvirus infection, as well as for colds and flu. Capsules or tablets with dosages of 200, 400 and 800 mg are available on sale. The choice of dosage depends on the severity of the disease, as well as on the chosen treatment regimen. Additionally, external agents - ointments and creams - are used together with tablets;
• Lyophilisate. Often, in case of complications and exacerbations, Acyclovir is prescribed to be used against influenza, herpes and other colds as part of injections. The solution is intended for intravenous infusion. The dosage is calculated depending on age, indications, and severity of the disease.

Price and analogues

The cost of tablets in Russia is from 35 to 60 rubles, ointments - from 70 to 190 rubles, but in large cities (Moscow, St. Petersburg and others) the price can reach 400 rubles per package. In Ukraine, the medicine costs from 18 to 210, and sometimes up to 370 hryvnia. The following drugs are analogues of Acyclovir:

• "Ciclovir";
• "Vivorax";
• "Zovirax";
• "Supraviran";
• "Citivir";
• "Virolex";
• "Herperax";
• "Lizavir";
• "Akrikhin"
• "Cyclovax";
• "Gerpevir";
• "Provirsan";
• "Gervirax";
• "Hexal";
• "Herpesin".

Also, acyclovir can be replaced with drugs such as Abamun, Arbimax, Acivir, Atsik, Motivir, Deytiforin, Ribavirin, Florenal.

Recommendations

When treating stomatitis, only 3% ointment is used: the product is applied in a thin layer only to the affected areas.

The five percent composition cannot be used for conjunctivitis and herpes of the eyes; the drug is also not applied to the eyelids. Once on the mucous membrane of the eye, the 5% composition causes severe irritation.

Eye ointment is not used to treat herpes on the lips or rashes on the body: a three percent composition will not be effective enough to cope with a viral infection.

For skin rashes and herpes on the lips/genitals, only a 5% composition is used.

We learned what Acyclovir ointment is and found out how to use it to treat children.

As you can see, Acyclovir ointment is effective for eliminating herpes, chickenpox, stomatitis, conjunctivitis, even in children under 3 years of age. Use the product only with your doctor’s permission, do not exceed the dosage and duration of the course.

Analogues of the drug

Acyclovir is the name of the active ingredient and trade name. You can purchase other medications based on this chemical compound at the pharmacy.

Popular analogues:

• Acyclovir-TEVA.
• Zovirax.
• Acyclovir-SANDOS.

Analogue

Analogues can be used with the permission of a doctor.

Acyclovir for children

Instructions for use for children state that the drug is prescribed for therapeutic purposes and to prevent recurrent infectious and inflammatory diseases caused by HSV of the first and second types, Varicella-Zoster virus and Herpes Zoster. The medication is used for herpes sore throat in children, chickenpox and herpes zoster.

Acyclovir is prescribed for angina in children in a five-day course of 200 mg four times a day. If there are indications, the duration of administration can be increased to 7 or 10 days.

To suppress the Varicella-Zoster virus in chickenpox, 20 mg of the active substance of the drug is prescribed for each kilogram of the child’s body weight. The duration of the therapeutic course is 5 days, and the maximum dose of Acyclovir should not exceed 800 mg.

Babies over 3 months of age who are affected by HSV 1 and HSV 2 are prescribed intravenous administration of 250 mg every 8 hours. In the case of an immunodeficiency state, in the presence of non-inflammatory diseases of the brain, lichen or chickenpox, the single dose is doubled - to 500 mg.

For newborns, intravenous administration is prescribed at 10 mg per kilogram of weight, with an eight-hour interval between injections.

For the treatment of encephalitis, children under 12 years of age are prescribed 20 mg per kilogram of body weight every 8 hours for 10 days. For the treatment of herpes zoster, children in preschool age and up to 12 years old use 20 mg/kg body weight for a week.

For the treatment of diseases that develop as a result of the development of the Herpes Zoster virus, children over 3 years of age are prescribed the drug in an adult dosage.

An increased dose of Acyclovir is prescribed for children under 2 years of age if there is a decrease in immune resistance, disruption of the digestive system, which is manifested by a deterioration in the absorption of drugs through the mucous membranes of the organs.

Absorption and excretion

When administered orally, the drug is absorbed in the intestines and enters the bloodstream. The bioavailability indicator reaches thirty percent. Nutrition does not affect the degree of absorption of the chemical compound. The drug is distributed in tissues and organs. The degree of binding to blood proteins can reach thirty-three percent. Penetration through biological barriers is observed, so the substance is found in breast milk and cerebrospinal fluid. Conversion in the liver ends with the formation of an inactive metabolite.

Manifestation of infection

When administered orally and intravenously, it is excreted in the urine and slightly through the digestive tract. With topical use, a small amount of the substance is found in the urine, but there is no systemic therapeutic effect.

Instructions for use for children

At what age children are given the drug depends on its form. Thus, Acyclovir tablets are approved for use from 12 months, since the reaction of newborns to the components of the drug is not known. External remedies are also allowed for babies who are already one month old.

Use of tablets

How to take Acyclovir to a child? Children are advised to take tablets as follows:

Usually five days of therapy is enough. If the situation is complex, the course of treatment is 10 days. For preventive purposes against relapse of the disease, an alternative therapy is offered: take two Acyclovir pills of 200 mg every 12 hours.

To rid a baby of shingles, a child over three years old is prescribed 800 mg of the drug every six hours.

For preventive purposes, the pharmaceutical drug is recommended in tablets when there is an increased likelihood of infection with herpes, for example, in acute respiratory viral infections, and weakening of the defenses. It is correct for the child to take two Acyclovir tablets every 12 hours or one tablet four times a day.

Before giving Acyclovir to your baby, you need to prepare a glass of water to drink. And during the healing process, the child needs to drink more liquids.

Applying ointment and cream

Acyclovir in these forms is approved for children under one year of age. How to properly apply them to the skin? The dose of the pharmaceutical is determined depending on the baby’s weight: for each kilogram no more than 80 mg. In this case, you cannot apply more than 0.25 g of the composition per 25 square centimeters of skin. Adolescents over 12 years of age are allowed to apply up to 125 mg to a similar area.

The ointment is applied to problem areas every four hours with a night break.

Therapy lasts five days. If the skin rash remains after this period, then the time of therapy is extended for another five days. The use of the cream is similar to the ointment.

To cure a generalized infection in a newly born baby, provoked by a herpetic pathogen, the doctor may prescribe a medication for external use with a dosage of 10 mg per kilogram of the baby’s weight every 8 hours. Completion of the full course of therapy – 10 days.

Ophthalmic and intravenous injections

Acyclovir in the form of an eye ointment is prescribed to children to cure herpetic ailments that affect the organs of vision.
The ointment is “packed” into the conjunctival sacs at least 5 times a day, taking a break at night. When the unpleasant symptoms disappear, you will need to continue using the ointment for another three days.

The dose of a pharmaceutical drug for intravenous administration is determined by weight (in newborns) or by body surface area (in babies older than three months). The drug is injected at eight-hour intervals to check renal function. If studies reveal changes in creatinine, the dose is adjusted. Typically, injections are given for five days, but can be prescribed for a longer period.

Pharmacological properties

Pharmacodynamics

Acyclovir-Akrikhin is an antiviral agent; is a synthetic analogue of an acyclic purine nucleoside, which is highly selective against herpes viruses.

The mechanism of action of the drug is as follows: acyclovir, penetrating into infected cells containing viral thymidine kinase, is phosphorylated and converted into acyclovir monophosphate. Then, under the influence of the enzyme guanylate cyclase, acyclovir, the monophosphate is converted into diphosphate and then (under the influence of a number of cell enzymes) into triphosphate. After this, acyclovir triphosphate begins to integrate into the DNA of the virus and blocks its synthesis due to competitive inhibition of the DNA polymerase of the viral cell. The high selectivity of action and specificity are also due to the fact that acyclovir accumulates mainly in cells affected by herpes infection.

Acyclovir-Akrikhin is highly active against Varicella zoster (the virus that causes herpes zoster and chickenpox), Herpes simplex types 1 and 2 and human herpes virus type 4 (Epstein-Barr virus). Acyclovir has moderate activity against cytomegalovirus.

For herpes, Acyclovir-Akrikhin helps prevent the appearance of new elements of the rash, reduces the risk of damage to internal organs and skin dissemination, reduces pain in the acute phase of herpes zoster, and accelerates the process of crust formation.

Pharmacokinetics

The bioavailability of acyclovir when administered orally ranges from 15 to 30%. It penetrates well into all tissues and organs; in the cerebrospinal fluid its concentration is 50% of the plasma concentration. Acyclovir passes through the placental and blood-brain barriers and passes into breast milk. From 9 to 33% of the active substance binds to plasma proteins.

The maximum plasma concentration of acyclovir after taking 200 mg of the drug 5 times a day is 0.7 mcg/ml. To achieve this indicator it takes 1.5–2 hours.

Metabolism occurs in the liver. As a result, pharmacologically inactive 9-carboxymethoxymethylguanine is formed. When taken orally, the half-life is 2–3 hours. In patients with severe renal failure, it extends to 20 hours, and in patients on hemodialysis – up to 5.7 hours (plasma concentration of acyclovir decreases to 60% of the original value).

About 84% of the drug is excreted unchanged and about 14% is excreted in the form of a metabolite. The main route of elimination is through the kidneys; less than 2% of acyclovir is excreted in feces; trace amounts were detected in exhaled breath.

When Acyclovir-Akrikhin is applied externally (in the form of an ointment), the absorption of acyclovir on intact skin areas is minimal; it is not detected in urine and blood. If the skin is affected, then the absorption is moderate. The serum concentration of acyclovir is up to 0.28 mcg/ml in individuals with normal renal function and up to 0.78 mcg/ml in patients with chronic renal failure. Up to 9.4% of the daily dose of the drug is excreted in the urine (through the kidneys).

Acyclovir for herpangina

The disease is significantly different from herpetic sore throat. The causative agent is the Coxsackie virus from the enterovirus family. It is characterized by high infectiousness, the transmission mechanism is predominantly fecal-oral.

Most often, the Coxsackie virus affects children; resistance to the disease does not develop during recovery. Children with this disease need more time for the recovery period. Adults can also be infected with this virus, but less frequently due to proper hygiene. With herpes sore throat in children and adults, small ulcers covered with a white coating are visualized on the mucous membranes of the tonsils. This clinical picture is not similar to that developing with tonsillitis.

Currently, a vaccine against the Coxsackie virus has not been developed, so only symptomatic therapy is carried out. There is an opinion that taking Acyclovir improves the condition of herpangina, but it must be remembered that this disease is caused by a virus that is not related to herpes, therefore, its use in this situation is not justified. However, there are no direct contraindications to its use in this disease.

special instructions

There are some other nuances that need to be noted when studying the instructions for using Acyclovir tablets. For children and adults, this drug is prescribed exclusively by a doctor - it can be used as prescribed by a physician, in order to avoid complications and side effects.

The duration of therapy or repeated treatment of immunocompromised patients with this drug often leads to the emergence of strains of viruses that are not sensitive to its effects. And many strains exhibit a relative lack of viral thymidine kinase.

The drug should be taken with caution in case of impaired kidney function and in elderly people, as their half-life of acyclovir is increased.

While taking the medication, you must also drink enough fluids.

Monitoring renal function is very important

Of course, during the treatment of herpes it is also necessary to abstain from sexual intercourse, even in the absence of clinical manifestations and when using barrier contraception. The doctor is obliged to inform his patient about the likelihood of transmission of the virus during the period of rash, as well as about cases of so-called asymptomatic virus carriage.

Is it possible to take Acyclovir if you plan to drive? There is no information in the instructions about the effect on the ability to drive various mechanisms and vehicles. But you need to take into account that dizziness often develops during therapy, and therefore it is better to refrain from driving, if possible.

Also, you should not engage in activities that require increased concentration of attention and speed of psychomotor reactions.

Use of Acyclovir

The method of using tablets is oral (by mouth).

For herpes caused by herpes simplex viruses, a single dosage for children 1 - 2 years old is half a tablet, and for children over 2 years old - 1 pill. The frequency of use of the medication is 4 or 5 times in 24 hours. The child should be given a tablet and filtered water to drink. The therapeutic course lasts 5 days, but if necessary, the doctor will extend the treatment to 10 days.

Acyclovir for chickenpox in children is used after a doctor’s prescription. The dose is calculated depending on the patient’s weight - 20 mg/1 kg of body weight four times a day. Chicken pox is treated for 5 days. To prevent herpes infection in case of weakened immunity, tablets are given in a dosage of 2 pieces with an interval of 12 hours or 1 tablet four times.

The ointment is applied to the damaged area without going onto clean skin, since after treatment a dense film is formed. The choice of dose depends on the weight of the child and the area of ​​the damaged area. The rash is lubricated immediately after its appearance; ointment is not used before bedtime. The therapeutic course lasts 5 days.

Treat the damaged areas with cream or apply a gauze pad about 5 times in 24 hours. The dose is determined for each patient individually. Treatment lasts 5–10 days. Eye ointment is placed into the conjunctival cavity about 5 times a day with an interval of 4 hours. Use a strip of ointment about 1 cm long. After eliminating the symptoms, the eyes are treated for another 3 days.

The powder is used to prepare an injection solution, which is injected into a vein. The dosage for newborns is calculated by weight, and for children from 3 months - by body area. The medicine is administered at intervals of 8 hours. In this case, it is necessary to monitor the functionality of the kidneys. If the creatinine concentration is abnormal, the dose of the drug is adjusted.

The injections are given for 5 days, but the duration of treatment depends on the symptoms and the child’s response to the drug. For example, for herpes encephalitis, the solution is administered for 10 days.

special instructions

Pills

During treatment, it is necessary to monitor creatinine levels and urea levels in the blood. The patient must receive sufficient fluids.

With long-term or repeated therapy with acyclovir in patients with reduced immunity, viral strains that are insensitive to the action of Acyclovir-Akrikhin may appear. Most of these strains showed a relative deficiency of the enzyme thymidine kinase; strains of viruses with altered DNA polymerase or altered thymidine kinase have also been isolated.

Acyclovir-Akrikhin does not protect against sexual transmission of herpes, so during treatment you should abstain from sexual intercourse, even if there are no clinical manifestations of the disease.

Ointment for external use

The maximum therapeutic effect is achieved if treatment with the drug is started as early as possible. The ointment should be used immediately after the first signs of the disease appear (itching, burning, tingling, redness and a feeling of tension).

Acyclovir-Akrikhin should not be applied to the mucous membranes of the eyes and mouth, as severe local inflammation may occur.

When treating genital herpes, it is necessary to avoid sexual intercourse or use condoms during this period, since acyclovir does not protect against sexual transmission of the virus.

Impact on the ability to drive vehicles and complex mechanisms

Patients undergoing treatment with Acyclovir-Akrikhin in the form of tablets should be careful when driving vehicles and performing other work that requires special concentration and quick reaction.

Mode of application

Patients should take the tablets immediately after meals with plenty of liquid.

The dosage for each patient is determined by specialists based on the type of infection and the severity of the disease:

1. For herpetic lesions of the mucous membranes and skin, a 200 mg tablet is prescribed five times a day. The medicine should be taken every 4 hours. The duration of therapy is five days. When treating genital herpes, the course of treatment is usually delayed by 10 days.
2. When carrying out complex therapy of patients with HIV or AIDS, a 400 mg tablet is prescribed five times a day. The same dosage is determined for patients who have undergone bone marrow transplantation.
3. To treat shingles, patients are prescribed 2 tablets of 400 mg five times a day. The duration of therapy varies from 7 to 10 days. Babies over three years old are prescribed the usual dose of medication.
4. When treating chickenpox, children from 3 to 6 years old are prescribed 400 mg of the drug four times a day, from 6 years old 800 mg, adults 800 mg. The course of therapy is at least five days.

Pharmacological properties

The drug has a pronounced antiviral effect.

Penetrating into the human body, the active component of the drug begins to integrate into the DNA of the virus and blocks its synthesis.

The medication is highly effective against the following viruses:

• herpes;
• smallpox;
• zoster;
• cytomegalovirus;
• Epstein Bar.

In case of heretic lesion, the active component of the drug has the following pharmacological effects:

• prevents the appearance of new lesions;
• reduces the likelihood of contamination of clean skin;
• accelerates the process of formation of crusts on lesions;
• reduces pain, etc.

Acyclovir for children instructions for use

Acyclovir: instructions for use for children

Often, for herpes infections in children, doctors resort to prescribing specific drugs. Acyclovir is an antiviral drug that is produced in tablet form, as well as in the form of a cream for surface application and an eye ointment. This medicine is often used in children to treat herpes infections.

Can Acyclovir be given to children?

The drug acyclovir orally is prescribed to children from one year old, since there are no adequate results of studies of its negative effect on the body of a newborn baby and children under twelve months. Taking the drug for up to a year at the discretion of the doctor is permitted in extremely rare cases. For children from the age of one month, pediatricians can suggest the use of an ointment that specifically affects herpes viruses.

For severe and moderately severe forms of chickenpox in a baby, the pediatrician may prescribe the use of acyclovir. In most cases, children under one year of age relatively rarely become ill with this childhood infection. For chickenpox, an antiviral drug based on acyclovir is used both internally and externally, lubricating the affected areas of the skin with ointment.

Release form and indications for use

Antiviral ointment with acyclovir is widely used for the local treatment of herpes simplex, as well as herpes of the third type. Acyclovir can be used for prophylactic purposes against herpes infections against the background of immunosuppressive conditions (HIV infection, chemotherapy). For this purpose, acyclovir tablets are used.

Ointment dosage

In order to prevent an overdose of the drug, when applying the ointment, the weight of the child is taken into account (up to 80 mg of the drug is applied per kg of weight). For areas of skin with an area of ​​25 square meters. cm should be applied up to 0.25 g. For children over twelve years old - up to 125 mg per 25 square meters. see. The ointment must be applied every four hours, including a break at night, for five days in a row. If the rash does not go away completely, the duration of applying the ointment is increased by ten days.

Dosage of Acyclovir tablets

For children from one to two years of age, acyclovir is prescribed at a dose of 100 mg (half a tablet), 6 times a day, for a course of 5 days. From two to five years of age, children should take 400 mg every 6 hours, from six years of age and older - 800 mg every 6 hours. Children over three years old when treating herpes zoster need to take 800 mg of the drug every six hours. In newborns, for the treatment of generalized herpes infection of the first type, a neonatologist may recommend taking acyclovir three times a day at a dose of ten mg per kg of the child’s weight, for a ten-day course.

Acyclovir eye cream dosage

For the treatment of keratitis caused by the herpes virus, acyclovir is used in the form of an eye cream, which is placed into the conjunctival sac five times a day, with a break at night. Treatment takes about seven days. The use of the cream must be continued for another three days after the clinical symptoms of infection have ceased.

Adverse reactions

Like any pharmacological drug, acyclovir in a child’s body can cause side effects, when they occur, the pills should be stopped, which requires immediate consultation with a qualified specialist. During therapy with this drug, disturbances in the functioning of the stomach and intestines, intestinal colic, rashes on the skin of the child’s body, fatigue, changes in hematological blood parameters in a clinical analysis, and febrile symptoms may occur.

When the drug is administered intravenously, children over two years of age may experience alarming changes in the functioning of the central nervous system, namely: irritability, increased convulsive activity, trembling of the arms and legs, hallucinations, and coma. It is necessary to take into account that long-term therapy with acyclovir may contribute to the adaptation of strains of herpes infection to this antiviral drug, which in the future reduces the effectiveness of the therapy. Infectious disease doctors strongly recommend using ten-day courses of treatment. We must not forget that when taking acyclovir, the child must drink the required amount of water throughout the day.

Video instructions for use.

pharmachologic effect

This drug is a synthetic analogue of thymidine nucleoside, which penetrates cells affected by the virus and stops the development and reproduction of the pathogen. The active substance in the ointment can integrate into the DNA of the virus and thereby disrupt its reproduction. At the same time, the substance does not disrupt normal genetic information in human cells and does not have a toxic effect.

Acyclovir hexal, acyclovir pharmaco (the second word in the name of the medicine indicates the manufacturer) or any other ointment with the same active substance, when used in a timely manner, can achieve the following results:

• no new rashes;
• prevention of skin dissemination;
• reducing the risk of developing visceral complications;
• increasing the rate at which crusts appear on the affected area;
• relieving acute pain from herpes zoster;
• increasing immunity.

Acceleration of tissue healing when using ointment occurs due to the removal of tissue swelling and improved blood circulation in them. If you start applying the medicine to the affected areas in a timely manner, then heavy rashes will not appear.

The eye ointment is also effective against viruses from the herpes family. The infection can affect the eyes, leading to serious consequences if not treated promptly. The concentration of the drug is reduced, since penetration into the eye tissue is easier for the active substance, and it is not partially lost.

The drug is not effective against fungal and bacterial infections and cannot be used even in complex therapy, since it will not relieve the manifestations of the pathology.

Instructions for use for diseases

Here are general recommendations for the use of drugs in tablet form. Instructions for each medication are developed by the manufacturer. It can be modified in each individual preparation. It depends on the form of release, composition, active substance, additional components of the drug, and other factors. Prescriptions for taking medications are prescribed by the attending physician.

REFERENCE. It is preferable to give the medicine to children during or immediately after meals. A sufficient amount of liquid is required for washing down. The dosage is determined by the treating pediatrician and should be strictly adhered to.

Herpes virus, sore throat, stomatitis

For the treatment of herpes virus, herpetic sore throat, stomatitis, it is recommended to take Acyclovir 200 mg tablets. Children over 6 years of age are prescribed a daily dose of 800 mg in 4 doses. For children from 2 to 6 years old, a daily dose of 400 mg and 4 doses of the medication are recommended. The dosage is selected based on the height, weight, age of the baby, severity of the disease, by the attending physician. It is recommended for infants to grind the tablet into powder and give it in the form of syrup, mixing with water.

The duration of course therapy is 5 days. In acute forms of the disease, at the discretion of the doctor, the dosage is increased to five times a day. In addition to tablets, in order to reduce skin rashes, external use of Acyclovir 3% ointment is allowed. The presence of stomatitis does not imply the use of ointment inside the oral cavity. It is applicable on the outer skin around the lips.

Chicken pox

The dosage of Acyclovir for chickenpox from 2 to 6 years is 400 mg in 4 doses per day, at the age of 6 years and older - 800 mg in 4 doses. The course of taking the drug for chickenpox should be maintained for 5 days. Aciclovir should be taken within the first 24 hours after the onset of signs of the disease (rashes on the skin). If necessary, the tablet can be divided into parts. The main thing is to remember that you need to drink plenty of fluids so that the medicine reaches the gastrointestinal tract without dissolving prematurely.

ARVI

The official instructions for taking the drug do not contain information about its use for acute respiratory viral infections. Sometimes your doctor may prescribe medication to prevent cold complications. When the immune system is weakened, there is a risk of contracting the herpes virus. The dose of the drug in this case is prescribed by the pediatrician.

For young patients with kidney disease, medications for the treatment of viral diseases are prescribed with extreme caution. Patients with frequent relapses of herpes infections are at risk of developing viral DNA resistance to the components of the drug

In this case, it is replaced by analogues

Patients with frequent relapses of herpes infections are at risk of developing viral DNA resistance to the components of the drug. In this case, it is replaced by analogues.

Do I need a prescription to buy acyclovir?

By affecting the gastrointestinal tract (gastrointestinal tract), this drug can cause:

• nausea;
• vomiting;
• diarrhea;
• abdominal pain, etc.

The most common side effects of this drug on blood cells are:

• hemolytic anemia (decrease in the concentration of hemoglobin and/or red blood cells in the peripheral blood due to their premature destruction);
• leukocytosis/leukopenia (increase or decrease in the number of leukocytes in peripheral blood);
• thrombocytosis/thrombocytopenia (increase or decrease in the number of platelets in peripheral blood);
• DIC syndrome (disseminated intravascular coagulation syndrome due to a sharp decrease in the number of platelets and coagulation factors), etc.

on average 250 – 500 mg

• hematuria (blood in the urine);
• acute renal failure with rapid intravenous administration (a sharp decrease in the excretory function of the kidneys, accompanied by the accumulation of urea and residual nitrogen in the blood).

From the nervous system the following may appear:

• dizziness;
• hallucinations;
• confusion;
• seizures;
• delirium, etc.

0,6-1,4

Negative reactions

As a rule, Acyclovir tablets do not cause side effects even in children. In some patients with renal impairment or other concomitant diseases, not always, but observed:

• skin rashes;
• nausea;
• stomach ache;
• headache;
• vomit;
• diarrhea;
• insomnia;
• dizziness;
• confusion of thoughts;
• drowsiness;
• feeling of alienation.

Very rarely, even with a tendency to exhibit secondary reactions in patients, the drug could cause temporary convulsions, psychosis, hallucinations, difficulty breathing, increased hair loss and changes in laboratory parameters of the liver and kidneys. With long-term use of the medication as an eye ointment, inflammation of the conjunctiva is possible.

In any case, after stopping drug therapy, all minor symptoms disappear within 24 hours on their own and do not require specialized treatment.

Side effects

During the use of the medicine, undesirable effects may occur due to the action of the chemical compound on tissues and organs. Side effects depend on the dosage form used, dosage and condition of the patient. A typical adverse reaction is the sensitivity of the immune system to the substances contained in the drug (allergy).

Side effects of tablets and infusions

• Nervous system: cephalalgia, dizziness, convulsive reactions, sleep disturbance, coma, encephalopathy, increased excitability, impaired consciousness, tremor, speech impairment, psychopathological manifestations, hallucinations, impaired coordination of muscle movements.
• Digestive system: vomiting, abdominal discomfort, inflammation of the liver tissue (tablets), jaundice (tablets).
• Skin and subcutaneous tissues: itching, skin rashes, diffuse alopecia, toxic epidermal necrolysis, Stevens-Johnson syndrome, urticaria, hypersensitivity, Quincke's edema.
• Hematopoietic system: increased levels of liver enzymes, decreased platelet levels, increased concentrations of urea and creatinine, increased bilirubin levels, deficiency of leukocytes or red blood cells, anemia.
• Other: allergic reactions, vascular inflammation (infusion), respiratory failure, renal dysfunction, dysfunction of the liver tissue, renal colic, weakness, increased body temperature, inflammation at the injection site, tissue swelling, muscle pain, enlarged lymph nodes, decreased severity vision.

Undesirable manifestations from the nervous system are usually associated with impaired renal function. These effects are reversible. To reduce the load on the excretory system, it is necessary to maintain a water-salt balance during therapy and administer the solution intravenously slowly.

Side effects of cream and ointment

• Immediate allergic reactions, including angioedema.
• Soreness.
• Unpleasant sensations in the skin area.
• Inflammation of the conjunctiva.
• Inflammation of the cornea.
• Skin rashes.
• Erythemal reactions.
• Inflammation of the mucous membranes.
• Inflammation of the edges of the eyelids.

When used topically, the drug practically does not enter the bloodstream, so systemic adverse reactions do not occur.

Composition and principle of action of the drug

The medicine is available in several forms, which ensure complete elimination of herpetic infection; the drug is also used prophylactically in case of risk of infection. The main active ingredient is acyclovir. Its content per 1 g in dosage forms:

• tablets – 200, 400 mg;
• ointment – ​​30 mg;
• cream – 50 mg;
• eye ointment – ​​30 mg;
• lyophilisate for infusion in vials – 250, 500, 1000 mg;
• suspension – 200 mg.

Such a variety of medicinal types is necessary to overcome any localization of the virus. Acyclovir for children is used for infection with the first two types of herpes, Varicella zoster, Epstein-Barr virus and cytomegalovirus.

Once in the body, acyclovir undergoes a transformation stage during the phosphorylation process. It is gradually transformed into triphosphate, which is able to integrate into the DNA of viral cells, breaking their structure.

As a result of this interaction, the virus loses its ability to reproduce and replicate. The main feature of acyclovir is its ability to accumulate only in infected cells, without affecting healthy ones.

As a result, new rashes do not appear, old ones fade, become crusty and heal. With shingles in children, pain is reduced. The drug also stimulates the immune system, increasing the body's defenses in case of danger of viral infection.

Acyclovir, when taken orally and intravenously, penetrates well into all liquids, providing a therapeutic effect in case of systemic damage. Bioavailability – 15-30%. This amount of the substance is sufficient to suppress the virus.

When used externally, acyclovir cream and ointment are absorbed only by herpes-infected skin areas. It penetrates into the bloodstream slightly.

The ophthalmic version of the drug is adsorbed by the mucous membranes and passes into the intraocular fluid, ensuring the removal of the virus from the cornea.

Metabolized in the liver, excreted mainly by the kidneys, about 2% in the intestines.

Therapeutic effect

According to the classification, it belongs to antiviral medications. The chemical compound selectively acts on herpes viral particles. The drug enters the cell infected by the pathogen, after which the viral enzyme converts this compound into triphosphate. The resulting acyclovir triphosphate binds to the pathogen's DNA molecule and disrupts the reproduction of the genetic structure, blocking the action of a specialized enzyme. The formation of new viral particles is disrupted. Further spread of infectious agents in the patient's body is prevented.

The drug selectively acts on infected cells and practically does not interact with healthy tissues of the body. For the creation of such an effective remedy, Gertrude Elion was awarded the Nobel Prize.

Possible contraindications and side effects

The main contraindications to taking acyclovir tablets are:

• Hypersensitivity to the substance.
• Breastfeeding period.
• Children under three years of age.

Taking the medicine only in isolated cases can cause disruption of the normal functioning of the digestive system, dizziness, headache, drowsiness, tremor, skin rash, etc.

In case of existing neurological disorders, renal failure, pregnancy, the prescription is made by a doctor only after a thorough study of the relationship between the therapeutic effect of the tablets and the harmful effects of side effects.

Indications and contraindications

An oral drug for the treatment of colds, ARVI, and flu is used only after examination by a doctor. Self-medication is prohibited, especially when it comes to children's health. If there are contraindications or adverse reactions, your health condition may worsen.

Acyclovir for influenza stops the action of viruses without affecting healthy cells. The immune system copes independently with new types of viruses.

This drug is prescribed at the discretion of the doctor; if the negative dynamics exceed more than five days, there is a risk of herpes. For the medication, the indications are varied, triggered by a viral infection.

Main indications:

• Exacerbation of herpetic infection.
• Cytomegalovirus.
• Lichen.
• Chickenpox.

Often the drug is included in complex therapy for manifested immune deficiency (HIV, after bone marrow transplant).

During the flu, Acyclovir is prescribed if the patient has ever had herpes, in order to prevent its recurrence against the background of a cold.

Improper self-medication or incorrect use of Acyclovir leads to adverse reactions. You need to fully study the instructions for the drug in advance and list the restrictions.

Contraindications and side effects are interrelated. The medicine should not be used in case of sensitivity to the composition, dysfunction of the central nervous system, pathology of the excretory organs, or in persons over 60 years of age.

Contraindications include pregnancy and breastfeeding. At the discretion of the physician, Acyclovir may be prescribed during pregnancy if the benefit to the mother is greater than the risk to the fetus.

Acyclovir is useful in preventing colds or acute respiratory infections. But even in such circumstances, you cannot take it for a long time, because viruses adapt to the medications and will be ineffective.

To quickly strengthen the immune system, the patient needs to additionally take vitamin complexes. During the advanced stage of the disease, the drug will not show all its healing properties. In an advanced stage, there is no point in taking medicine, especially if the disease has caused a deterioration in health due to infection.

According to studies conducted in pregnant women, it was found that when taking Acyclovir in the first three months of pregnancy, the risk of heart disease in the fetus increased, therefore, if necessary, the drug is replaced with an analogue.

Instructions for use and dosage

Pills

For the treatment of infections caused by herpes simplex viruses, 1/2 tablet is often prescribed as a single dose for children 1-2 years old, and a whole tablet for children over two years old. The drug is taken four or five times a day. It is recommended to take the tablet with plenty of water. The average duration of therapy with Acyclovir is 5 days, but if indicated, tablets can be taken for up to 10 days.

For chickenpox, a single dosage of Acyclovir tablets is often selected individually, since for effective treatment a small child needs to calculate the dose by weight. It is 20 mg of active substance per kilogram of baby’s weight. The calculated dose is given 4 times a day for 5 days.

For example, a 1.5-year-old child weighs 11 kilograms and, according to calculations, a single dosage will be 220 mg, so he is given 1 tablet containing 200 mg of acyclovir. And at 7 years old with a weight of 21 kg, 420 mg of the active substance is required per dose, so the child can be given either 2 tablets with 200 mg of acyclovir, or 1 tablet containing 400 mg of the drug. The maximum single dose is 800 mg of acyclovir.

External means

Acyclovir ointment is carefully applied to the affected areas of the skin, being careful not to smear the drug on clean skin, since the medicine forms a dense film on the surface. The dosage of the ointment is determined by the doctor, taking into account the baby’s weight and the area of ​​his skin. Treatment of the rash begins from the very first days of its appearance, but the medicine is not applied to the skin at night. Treatment often lasts 5 days.

Apply Acyclovir cream with a clean hand or a cotton swab to the affected skin up to 5 times a day. The amount of medicine in this form is determined individually. Skin treatment is prescribed for a period of 5 to 10 days.

Eye ointment is used 5 times a day with pauses between application into the lower conjunctival sac for about 4 hours. A strip of ointment for 1 application is approximately 1 cm long. After recovery, treatment is continued for at least another three days.

Injections

The dosage of Acyclovir for intravenous injections is calculated by body weight (in newborns) or by body surface area (in children over 3 months). The drug is administered at intervals of 8 hours, monitoring kidney function. If tests reveal changes in creatinine levels, the dosage is adjusted.

Often injections are given for five days, but depending on the disease and the patient’s body’s response to treatment, injections may be prescribed for a longer period. For example, for herpetic encephalitis, Acyclovir is administered for 10 days.

Acyclovir injection is a slow infusion over one hour or longer (the medicine is administered by drip). To give an injection, water for injection or sodium chloride solution is added to the powder. Acyclovir can also be combined with glucose solutions.

For what pathologies is it prescribed?

Use of acyclovir

Name of the disease Mechanism of therapeutic action Dosage of the drug Herpes simplex virus types 1 and 2 (genital) The drug penetrates the infected cell and is converted into the active form - acyclovir triphosphate using a number of enzymes from both the cell and the virus itself. Next, this substance is integrated into the DNA molecule of the virus, causing a chain break and blocking the process of replication (reproduction) of its genome. In case of moderate disease, adults and children are recommended to combine systemic use of the drug with local forms. Systemically, adults and children over 2 years of age are recommended to take 200 mg 5 times a day. Children under 2 years of age are prescribed 100 mg 5 times a day. The last dose of the drug should be taken at least 2 - 3 hours before bedtime. Externally use 5% ointment or cream 4 - 5 times a day, applying it in a thin layer, without rubbing it into the affected areas of the skin. In more severe cases of the disease, treatment begins with prescribing the drug intravenously in the form of droppers 3 times a day, 5 - 10 mg/kg or 0.5 g/m2 per dropper for both adults and children. Drip administration of the drug involves being under constant supervision of medical personnel

In addition, it is important to monitor hourly diuresis (urine output) in order to promptly identify possible early signs of acute renal failure. The rate of administration of the drug should be slow, no more than 250 ml of standard solution per 1 hour

After the patient’s condition improves and clear positive dynamics are determined, the patient is transferred to the tablet form of the drug. For concomitant herpetic keratitis, 3% eye ointments are used. They are placed behind the lower eyelid in a strip 0.5 - 1 cm long 5 times a day for 5 - 10 days. Shingles (herpes zoster) Since this representative of the herpes virus family is less responsive to treatment with this drug, increased doses of the drug are used to improve the therapeutic effect. The optimal dose for oral administration for adults and children over 2 years of age is 800 mg 5 times a day. For children under 2 years of age, 400 mg 5 times a day is indicated. The course of treatment takes from 7 to 15 days, and in some cases even up to one month. The drug is administered dropwise and externally in the same way as for the herpes simplex virus. Chickenpox (chickenpox) Doses for the treatment of chickenpox are identical to those for herpes zoster and are 800 mg and 400 mg for adults and for children under 2 years of age, respectively, 5 times a day. However, due to the fact that chickenpox is often more severe in adults, treatment with the drug is indicated specifically for this age group. Treatment of chickenpox in children with this drug is not recommended for two reasons. Firstly, chickenpox goes away on its own with traditional treatment with brilliant green and paracetamol. Secondly, with the use of this drug, a weaker immunity against this infection is developed, which contributes to its relapse (repeated exacerbation) throughout life. Cytomegalovirus For these diseases, treatment is prescribed by the doctor on an individual basis, depending on the goals (prevention or cure) and the patient’s concomitant diseases. Epstein-Barr virus

What is Acyclovir

Nucleosides are the building blocks for DNA, through which genetic information is transmitted at the cellular level. Nucleoside analogues created synthetically allow the drug to penetrate cells affected by the virus and affect the processes occurring there. One of these analogues is Acyclovir. The mechanism of its action is due to the transformation under the influence of viral and human enzymes into monophosphate, then into diphosphate and, finally, into the active form - acyclovir triphosphate, which blocks the reproduction of the viral cell.

Compound

The main active ingredient included in the tablets is Acyclovir, which is a white crystallized powder with a dosage of 200, 400, 800 mg. Additional substances that are used to give the medicine the necessary technological qualities, ensure dosage accuracy and strength:

• lactose or milk sugar is a diluent;
• starch - leavening agent;
• Aerosil - anti-friction (anti-slip) substance;
• polyvinylpyrrolidone - binding ingredient;
• calcium stearate - a lubricant to simplify the swallowing process.

Indications for prescribing the drug to children

Acyclovir can be used to relieve herpetic lesions in a child’s body, or for other forms of viral infection that are sensitive to the components of the drug.

The drug is indicated for children to take orally with the following disorders:

• herpes sore throat;
• chicken pox;
• as a prevention of herpes;
• weakened immune system;
• cytomegalovirus infection;
• Epstein-Barr virus;
• for the prevention of complications due to acute respiratory diseases, influenza, enterovirus infections.

Possible side effects:

• lightheadedness
• vomit,
• loose stools,
• headache,
• impaired coordination of movements,
• weakness,
• skin rashes,
• intestinal pain,
• itching of the skin, peeling,
• mood swings (drowsiness, hyperactivity),
• convulsions,
• pathological changes in blood composition,
• the occurrence of hallucinogenic visions.

After taking Acyclovir, children may experience malaise, swelling of the skin, and impaired respiratory function.

IMPORTANT! If any side effects occur, you should immediately consult a doctor! Otherwise, you can cause irreparable harm to the health of the little patient!

Drug interactions

When administered in combination with probenecid, the mean half-life increases and the clearance of the drug decreases. When taken with nephrotoxic drugs, the risk of developing renal dysfunction increases; when taken with immunostimulants, the effect of acyclovir is enhanced. When mixing solutions, the alkaline reaction of the main active element should be taken into account.

The side effects of Acyclovir Akrikhin are the same.

Dosage

Before use	Dosage	A course of treatment
Before applying the cream and after treatment, you should wash your hands with soap. Do not rub damaged areas of skin.	Adults and children: Apply cream to the affected parts five times a day every 4 hours, except at night.	The course is 5 days, maximum 10 days. The greatest effect is achieved when treatment is started in the prodromal period (before the rash).
Before and after the procedure, wash your hands thoroughly with soap.	Adults and children: A 1 cm long strip of ophthalmic ointment is placed in the lower conjunctival sac every 4 hours five times a day.	The course of treatment is until complete healing, plus another 3 days after healing.
After preparing the solution, the drug is administered intravenously, drip.	Adults and children from 12 liters: 5-10 mg per 1 kg of weight, with an interval between injections - 8 hours. Children 2 months-12 liters: 250-500 mg / m2 of body surface, with an interval between injections - 8 hours. 0-3 months: 10 mg per 1 kg of weight, with an interval between injections of 8 hours.	The duration of treatment is determined individually.

Pills

Take during or immediately after meals with water.

Treatment of diseases of the mucous membranes and skin (Herpes simplex 1 and 2 t):	Adults: 200 mg five times a day for 5 days in a row, keeping a 4-hour break between doses (night break - 8 hours). In severe cases, the course is extended to 10 days.
Severe immunodeficiency, condition after bone marrow transplantation:	Adults: 400 mg five times a day.
Prevention of recurrence of infections, Herpes simplex 1 and 2 t. in people with normal immunity:	200 mg four times a day or 400 mg twice a day.
Prevention of infections that cause Herpes simplex 1 and 2 in patients with immunodeficiency:	200 mg four times a day or 400 mg five times a day (in severe condition). The preventive course is established individually, taking into account the risk of developing infections.
Treatment for Varicella zoster virus infections:	Adults: 800 mg five times a day every 4 hours with an 8-hour break at night, course 7-10 days. Children: 20 mg per 1 kg of weight four times a day. within 5 days.
Treatment for Herpes zoster virus infections:	Adults and children over 3 years of age: 800 mg four times a day every six hours for 5 days.
Treatment and prevention of infections caused by Herpessimplex 1 and 2 tons in children with normal immunity and immunodeficiency:	Children 3-6 years: 400 mg four times a day; Children from 6 liters: 800 mg four times a day. Course 5 days.

Indications for use

Cream - skin infections caused by the Varicella zoster and Herpes simplex viruses (lichen, herpes of the skin, chicken pox). Ointment - herpetic keratitis and other eye lesions caused by Herpes simplex 1 or 2 t.

Pills:

• Viral infections of the mucous membranes and skin (Herpes simplex viruses 1 and 2 t.), primary and secondary, including genital herpes;
• Prevention of exacerbations of recurrent viral infections (Herpes simplex 1 and 2 t.) in a normal state of immunity and in people with immunodeficiency;
• As a drug for complex treatment in groups of patients with severe immunodeficiency and people after bone marrow transplantation;
• Therapy of acute and recurrent diseases caused by the Varicella zoster and Herpes zoster viruses).

Lyophilisate:

• Viral infections, the etiological factor of which is Herpes simplex viruses 1 and 2 t. and Varicella zoster;
• Prevention of diseases caused by these viruses;
• Severe immunodeficiency (as a drug for complex treatment);
• Treatment of patients after bone marrow transplantation (prevention of cytomegalovirus infection).

What is Acyclovir ointment used for, instructions

Acyclovir ointment according to the instructions helps against herpes of the lips, face, genitals (genital). It allows you to relieve pain and itching from shingles and chicken pox, and stop the spread of viral infection. Treatment is more effective if it is started at the very first symptoms. There is no point in using the drug for hemorrhoids, burns, acne, and dermatitis.

We recommend reading about how and when to use Levomikol ointment. From the article you will learn how to properly use the ointment in urology, gynecology, dentistry, for burns, open and purulent wounds, and acne. And here is more information about ointments for wound healing.

For herpes

The use of Acyclovir for herpes is the main indication for the ointment. The drug disrupts the reproduction of the virus and as a result:

• reduces the risk of skin spread;
• prevents new bubbles from appearing;
• dries out the elements;
• stops the introduction of a viral infection into the bloodstream;
• reduces itching and soreness;
• stimulates local immune defense.

Used for application on lips and face. It is important to be careful when lubricating the affected area:

• fingers must be in gloves (finger caps);
• Before and after application, wash your hands thoroughly;
• Do not allow the ointment to get into the eyes and mucous membranes of the mouth.

For those patients who have reduced immunity, there are often repeated relapses of herpes. They need to additionally use (as prescribed by a dermatologist) drugs for internal use with acyclovir, stimulants of immune defense, carry out preventive courses in the fall and spring, and change antiviral agents.

For hemorrhoids

There is no point in using Acyclovir ointment for hemorrhoids, since this disease is associated with the expansion of the venous plexuses in the rectum. The drug does not even have an analgesic effect and does not reduce inflammation unless it is associated with a herpetic infection.

For hemorrhoidal disease, ointments Aurobin, Proctosedyl, Relief and a number of other drugs are used.

For burns

Treatment of burns with Acyclovir is not carried out. The ointment does not contain wound-healing components, it does not accelerate tissue restoration, but on the contrary, it can increase burning and pain.

In such cases, it is much more effective to apply drugs with dexpanthenol - Panthenol, Pantestin, Bepanten, and in case of signs of infection - Levomekol, Bepanten plus.

For lips

It is recommended to start using Acyclovir for herpes lips as early as possible, at the first sensation of itching or tingling. A small volume of the drug is needed at a time, but it must completely cover the site of inflammation and neighboring tissues. It is recommended to lubricate the skin every 4 hours in the first 2 days, and from days 3 to 5 - every 6. The minimum course is 5, and the maximum is 10 days.

For the nose

When a herpetic infection affects the nasal openings, treatment is carried out in exactly the same way as for the lips:

• lubricate with a gloved finger or apply with a cotton swab, which is immediately thrown away;
• interval between application – 4-6 hours;
• the course lasts 5-10 days.

Manifestations of herpes
If the process spreads to the mucous membrane, then Acyclovir is needed in the form of an eye ointment. It is distinguished by a base that does not irritate more delicate areas, and a lower concentration of the active substance.

For dermatitis

Dermatitis is not an indication for the use of Acyclovir ointment, since it does not contain components that relieve inflammation or dry out the skin. The disease can be caused by:

• allergy;
• chemical or mechanical irritation;
• infections;
• hormonal imbalances in the body;
• use of medications.

Therefore, in each case, treatment is selected individually, but it does not include antiviral agents, which include Acyclovir.

For chicken pox

Acyclovir is used in the treatment of chickenpox, it is caused by the herpes virus type 3, which is affected by this drug. The use of antiviral drugs in adults and children with reduced immunity is especially important.

The ointment is applied locally to the blisters without pre-treatment 4-5 times a day. The course continues until the rash elements dry out - approximately 7-10 days.

The photo shows an example of applying Acyclovir ointment for chickenpox

For shingles

Acyclovir ointment for herpes zoster:

• reduces pain;
• shortens the treatment period;
• helps dry and heal the skin.

The effectiveness of the external agent is enhanced by the simultaneous administration of acyclovir in injections or tablets. The sooner you start using antiviral drugs, the greater the chance of stopping the spread of the disease and its repeated exacerbations.

Application is recommended to be carried out with a clean disposable spatula, a cotton swab, and fingers wearing sterile gloves. Lubricate the affected skin area every 4 hours, covering at least 0.3-0.5 cm of the adjacent area. An area of ​​5x5 cm will require about 1.25-1.5 cm of ointment. Most often, the course of treatment is 10 days.

For acne

Acyclovir will not help with acne. Acne occurs against the background of hormonal disorders in the body, and the direct cause of pustules is bacteria or mites (demodex). The drug will not affect any of these factors. Ointments for acne are prescribed individually, most often they are Skinoren, Curiosin, Ugrisept, Klindovit.

For genital herpes

Treatment with Acyclovir in the form of an ointment for genital herpes helps:

• reduce the severity of the disease;
• shorten the duration of therapy;
• reduce pain and itching in the genital area;
• slow down the spread of the virus.

The drug is applied to the affected area 5 times a day for at least 10 days. It is important to consider that the use of Acyclovir does not prevent infection of a sexual partner with herpes, therefore, sexual contact must be excluded for the entire period of therapy.

None of the antiviral drugs individually today gives a 100% guarantee of curing this disease. Therefore, a combination of acyclovir with interferon is considered a more radical method. For this, a drug such as Gerpferon is recommended (189 rubles for 5 g). It additionally contains an anesthetic component (lidocaine). The combined ointment provides relief already on the 5th day of use, and interferon prevents the risk of re-exacerbation.

To prevent infection with genital herpes you must:

• avoid casual sexual contact, especially without a condom, but even with one, contact of mucous membranes cannot be ruled out;
• after a questionable connection, treat the genitals with a solution of miramistin, which has antiviral and antibacterial activity, then apply a thin layer of Acyclovir cream in the first 2 hours;
• lead a healthy lifestyle without smoking and alcohol abuse, get good sleep, play sports or exercise, as the state of the immune system depends on this;
• include in your diet as much fresh plant food and lean protein as possible (fish, chicken, turkey, fermented milk drinks, 2-5% cottage cheese);
• Wash your hands thoroughly if you have herpes on your lips or face.

Watch the video about the symptoms and treatment of genital herpes:

Features of treatment with Acyclovir in children

In children, due to thin and more moisturized skin, Acyclovir can penetrate into the bloodstream. Since there is no proven safety of using 5% ointment up to 12 years of age, at a younger age only the drug with 2.5% and 3% concentration, ophthalmic form, is allowed. Apply the product in a thin layer for no more than 5-7 days. The regimen and duration of treatment is determined only by the doctor.

Acyclovir ointment is hormonal or not

Acyclovir is not considered a hormonal ointment, but there are drugs (for example, Zovirax Duo) in which the same active ingredient is combined with hydrocortisone (hormone). This combination is necessary to enhance the antipruritic and anti-inflammatory effects.

Interaction of Acyclovir with other drugs

Currently, there is no data on clinically significant antagonism of Acyclovir with other drugs. The therapeutic effect is enhanced when taken in parallel with drugs that stimulate the immune system.

Probenecid is able to slow down the process of removing the antiviral drug from the body.

To prevent functional disorders of the kidneys, it is not recommended to take Acyclovir together with drugs that have nephrotoxic properties.

Acyclovir for the prevention of herpes

Acyclovir is used both for the treatment of herpes and for its prevention. No matter how the patient uses it, it is necessary to know the basic rules of administration that will allow the medicine to act effectively in the body. Taking Acyclovir for herpes:

• Do not take medicine without water. The tablets must be taken with water, and in large quantities. In general, for the entire duration of therapy it is required to maintain a drinking regime - drink as much water as possible. This will be a good help for the kidneys so that they can get rid of all residual effects after using Acyclovir as soon as possible.
• You should not take Acyclovir tablets to prevent herpes without eating first. An empty stomach is not a condition in which you can take this medicine, or any medicine at all. The tablet is taken immediately with food or after breakfast, lunch or dinner.
• You need to adhere to a certain treatment regimen. You should not make independent adjustments to it or change anything without the doctor’s knowledge. The course itself must be completed to the end, treated for as many days as necessary, even if the symptoms no longer bother you. Otherwise, it may lead to relapse.
• If the patient accidentally forgot to take a pill at a certain time, then during the next appointment you should not swallow 2 at once - this is wrong.
• In addition to treatment with Acyclovir, you should not neglect additional means of strengthening the body. It is advisable to take vitamins to improve immunity.
• With repeated relapses, the dose of the medicine will be higher.
• You should not drink alcohol during treatment, even in small doses, because the drug acts on the nervous system and can cause constant drowsiness in combination with alcoholic beverages. Moreover, this can negatively affect visual acuity.

Prevention of herpes with Acyclovir - relapses, then it is necessary to take the drug 200 mg 4 times a day after a clear period of time, for example after 6 hours. Or you can drink 400 mg, but then 2 times a day, for example in the morning and evening, so that there is a 12-hour break. Such prevention will help to avoid relapses and generally any negative consequences and complications after the disease.

For prevention, you should not only take medicine, but also monitor your own hygiene, use individual household items, and avoid people who show signs of herpes.

List of contraindications

The use of all dosage forms of the drug "Acyclovir" is contraindicated in the presence of high sensitivity to the components of its composition. Absolute contraindications for taking pills are:

• lactose intolerance;
• lack of lactase;
• glucose or galactose malabsorption;
• age less than 3 years;
• lactation.

Relative contraindications:

• neurological reactions to the use of cytotoxic pharmacological agents (including in the presence of a complicated medical history);
• renal dysfunction;
• large dosages, especially against the background of severe dehydration;
• pregnancy period;
• elderly age.

Relative contraindications for ointments and creams for topical use include pregnancy and lactation. In this case, the medication is used strictly under the supervision of a doctor.

It is better to familiarize yourself with the contraindications of Acyclovir and side effects in advance.

For eye ointment, an absolute contraindication for use is during breastfeeding. During pregnancy, eye ointment can be used only on the recommendation of a doctor and under his supervision.

For the infusion solution, the main contraindication is lactation; the list of relative restrictions includes:

• dehydration of the body;
• kidney or liver failure;
• neurological disorders;
• complex forms of hypoxia;
• electrolyte disturbances;
• reactions to the use of cytotoxic medications (including history);
• combination therapy with medications that can impair renal function, in particular with tacrolimus, cyclosporine (monitoring of renal function is necessary);
• complex treatment with mycophenolate mofetil (an immunosuppressive drug used in organ transplantation);
• pregnancy period.

To avoid side effects from Acyclovir in children and adults, it is important to strictly follow the instructions.

Interaction with other drugs

"Acyclovir" is not recommended for use in parallel with medications that have identical pharmacological effects, since they can increase the concentration of the active component of the same name in plasma.

When using Cymedin and Probenecid in the treatment process, it should be taken into account that these drugs can reduce the rate of elimination of Aciclovir from the body by 30%.

If Cyclosporine or other medications with neurotoxic properties are used in parallel with this drug, the risk of developing a neurotoxic or nephrotoxic effect will increase.

Ointment, cream, tablets Acyclovir: reviews

Acyclovir is one of the first antiviral drugs. Of course, this is not the best and somewhat outdated drug, but it will work well in children, as well as in adults who have not received long-term regular treatment with acyclovir in the past, and whose immunity is not weakened. In these cases, one can expect the absence of resistance of the herpes virus to treatment with acyclovir (24stoma.ru).

In addition, for Acyclovir tablets, reviews will be good only if you start taking them early (the same applies to ointment and cream forms). Clinical studies have shown that the best treatment results are achieved when patients begin to use acyclovir either in the prodromal period, or in the first 12 hours from the onset of herpetic eruptions.

It makes sense to start using acyclovir cream or ointment only during the first 48 hours from the moment of illness, until the herpetic blisters burst (after this point, use will no longer speed up recovery). As for tablets with acyclovir, you can start using them no later than 72 hours, but you need to keep in mind that the later you start taking this period, the less effective the treatment will be.

The main disadvantages of the drug Acyclovir are:

1) Low bioavailability of the drug - it is only about 20% of the amount taken. In this regard, Acyclovir must be taken 5 times a day, which is not very convenient (this applies to both tablet forms and forms in the form of an ointment or cream).

2) Poor penetration into the skin - products in the form of ointments or creams for external use have a significant drawback, which is that acyclovir does not penetrate very well through the most superficial layer of the skin (the stratum corneum of the epidermis). This certainly reduces the effectiveness of the drug. Some manufacturers, in order to increase the permeability of acyclovir, add propylene glycol to the cream.

3) Low tropism of acyclovir to the virus - acyclovir equally penetrates both healthy and cells infected with the herpes virus. If there is a viral thymidine kinase (enzyme) in the cell, acyclovir is activated and blocks the reproduction of the virus. However, the problem is that acyclovir has low tropism for viral thymidine kinase, so it may not find it in infected cells. Accordingly, in this case it simply does not convert into the active form of acyclovir-3-phosphate, which blocks the reproduction of the herpes virus.

4) Resistance to the drug - compared to all other modern antiviral drugs - resistance to the herpes virus most often occurs to acyclovir. According to statistics, in people with weakened immune systems, resistance occurs in 7-10% of cases, and in some groups of patients it even reaches 27% of cases. Resistance occurs especially often in individuals who have repeatedly taken acyclovir, as well as in patients with weakened immune systems.

5) Intracellular half-life - acyclovir has a very short intracellular half-life (about 1 hour), which leads to a complete cessation of blocking viral replication - immediately after taking the drug. For example, the antiviral drug Penciclovir has a longer intracellular half-life (up to 20 hours), which provides an acceptable antiviral effect for up to 2 days after discontinuation of the drug.

Below you will find information about modern analogues of Acyclovir.

Analogs

The main analogues of the drug "Acyclovir" for the active substance are the following drugs:

• "Herperax".
• "Vivorax".
• "Acyclostad".
• "Virolex".
• "Sagging."

Analogues according to the mechanism of therapeutic action are:

• "Rebetol."
• "Ribavirin".
• "Walcyte."
• "Trivorin."
• "Virazol".
• "Arviron".
• "Valtrex".
• "Valacyclovir."
• "Vacirex."
• "Valogard".
• "Ribavin."
• "Vairova".
• "Famvir."
• "Medovir."
• "Zovirax".
• "Minaker."
• "Ribapeg."
• "Valvir."

Signs of overdose

The most common signs of overdose are: agitation, coma, seizures, lethargy. If the concentration of the main substance is higher than the solubility in the renal tubules, its precipitation may occur. If side effects from Acyclovir develop, symptomatic treatment is prescribed. In case of an overdose of the infusion solution, the concentration of creatinine, urea and blood nitrogen increases, and renal failure occurs. Neurological symptoms include agitation, confusion, hallucinations, convulsions, and coma. In this case, hemodialysis is prescribed.

How to store the drug, and what is its shelf life?

The shelf life for both tablets and ointment is 3 years. Once the tube is opened, the ointment can be used for a month.

Ointment forms should be stored at temperatures ranging from +15° to +25°C.

Tablets should be kept in places shielded from sunlight and protected from moisture.

Keep away from children!

Plisov Vladimir, medical observer

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( 174 votes, average: 4.56 out of 5)

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Description of the drug

Acyclovir is an antiviral agent that has a positive effect on the herpes virus, which affects the mucous membranes and epidermis of humans.

The pharmaceutical drug is available in the form of a whitish or yellowish ointment, packaged in aluminum and laminate tubes. Acyclovir for herpes is used only externally. To treat herpes on the skin, a 5% ointment is produced, and for the treatment of the eyes - 3%.

The mechanism of action of the ointment is quite complex, but to put it simply, the active substance of the ointment interacts with viral enzymes and interrupts its further reproduction. The ointment is quickly absorbed by the skin if it is not covered with a crust. Prevents the reappearance of rashes by curing existing ones.

Compound

The drug in the form of an ointment contains the active substance acyclovir. Among the auxiliary components, chicken oil, emulsifier No. 1, propylene glycol, nipagin, nipazole and purified water should be noted. It should be noted that the drug is available both in the form of an injection solution and in the form of tablets for internal use.

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Valacyclovir or Acyclovir?

Valaciclovir is an antiviral drug developed later than Acyclovir based on its composition. Both of these drugs are similar in action, but there are some differences. The goal of developing Valaciclovir is to improve the absorption of the drug and accelerate the antiherpetic effect. A special enzyme has been added to the drug to achieve faster results.

You need to take Valaciclovir less often, its absorption is higher, it is just as easily tolerated, and the contraindications are the same. The medicine is available exclusively in tablets. Decide which drug you should choose after consulting your doctor. You may need a different form of antiviral.

Release form and composition

Before you start studying the instructions for using Acyclovir tablets, you should understand the basic information. The drug is produced in a cardboard box, inside of which there are two contoured cell packaging - each of them contains 10 white tablets.

The active ingredient is acyclovir. The composition also contains auxiliary components - calcium stearate, milk sugar, medium molecular weight polyvinylpyrrolidone, as well as aerosil and potato starch.

By the way, each Acyclovir tablet (photo of the drug is shown above) contains either 200 mg of the active substance or 400 mg. When purchasing tablets, you need to take this fact into account.

Main characteristics of Acyclovir ointment

Acyclovir in the form of an ointment or cream, according to the instructions, is an external antiviral agent, the main characteristics of which are indicated in the table.

Properties	Characteristics of Acyclovir for external use
Compound	Acyclovir, propylene glycol, emulsifiers
Release form	Cream or ointment 2.5%, 3%, 5%, 2, 5 and 10 g per tube
Mechanism of action	Incorporates into viral DNA and stops virus replication
What viruses does it disparage?	Herpes type 1 and 2, less active in chickenpox, herpes zoster, Epstein Barr virus infection
Does it penetrate through the skin into the blood?	Minimum amount of ointment for intact skin and moderate amount for inflamed skin
Best before date	3 years
How to store	In a cardboard package, in a tightly closed tube at a temperature not exceeding 25 degrees
What is the price	From 30 to 146 rubles depending on the form of release
Is it possible to overdose	It is impossible, even if you apply the entire tube externally or accidentally take it internally, since the maximum amount of 50 mg of acyclovir in it is lower than its single dose.
Drug interactions	No negative reactions were detected, the effect of the ointment is enhanced by taking acyclovir and immune stimulants in tablets or injections

Analogues of Acyclovir® tablets

As already mentioned at the beginning of the article, quite a lot of antiviral drugs based on acyclovir are produced. Pharmacy chains offer the following structural substitutes for the original:

• Acyclovir-AKOS®
• Zovirax®
• Acyclovir-Acri®
• Acyclovir-Belupo®
• Virolex®
• Ciclovir®
• Acyclovir-Sandoz®
• Acyclovir-Akrikhin®
• Cyclovax®
• Acyclostad®
• Vivorax®
• Supraviran®
• Herperax®
• Provirsan®
• Lizavir®
• Cycloviral-SEDICO®
• Citivir®

In the case of Acyclovir®, it is simply impractical to look for cheaper analogues. It is the original domestic drug that is the most affordable in pharmacies, while imported substitutes can cost several times more.

Treatment of smallpox and lichen

In this case, the use of Acyclovir is carried out according to a special scheme. As a rule, the course lasts 7 days. The patient has to take tablets every 4 hours - 800 mg 5 times a day.

If treatment is prescribed to a patient with immunodeficiency, then, most likely, the drug will be prescribed in a lyophilisate dosage form. This will make it possible to carry out infusion therapy.

It is necessary to start taking the drug as early as possible - immediately after the appearance of the rash. Early measures taken lead to greater effectiveness of treatment.

Treatment for chickenpox should begin within 24 hours of the onset of obvious symptoms.

What about individual dosage? For children, the following schemes are usually recommended:

• 4 times a day 800 mg. If the child is over 6 years old.
• 4 times a day 400 mg. If the child is between 3 and 6 years of age.

But in general, the instructions for Acyclovir tablets recommend calculating the exact dosage. It can be determined by performing a calculation - 20 mg of the drug per 1 kg of body weight. However, the dosage should still not exceed 800 mg. And in any case, the children's course of treatment lasts 5 days.

But with the greatest caution, the dosage of Acyclovir is calculated for elderly patients. Because they are more likely to have kidney failure

And, if the doctor nevertheless approved the use of the drug by an elderly patient, he needs to maintain adequate water balance.

What is Acyclovir

"Acyclovir" is a synthetic analogue of an acyclic purine nucleoside (a component of DNA). The main function of the drug is the antiviral effect that Acyclovir selectively exhibits against herpes viruses. It invades the cell (in which the virus has already “inhabited”), binds to its enzymes and disrupts the DNA of the virus, which prevents its reproduction. At the same time, the drug has virtually no effect on the cells of the infection carrier. On sale there is a drug with additions in the names - “Akri”, “Stada”, “Akos”. This is the same product, but from different manufacturers and in different forms of release. Thus, “Acyclovir 200 Stada” (we will look at the instructions and analogues of the drug today) is a German product, the price of which is significantly lower than the Russian and Ukrainian ones. Of course, this is a big plus.

Acyclovir (200 mg tablets, instructions below) prevents the development of visceral complications. The drug also has an immunomodulatory effect. It is strong immunity that suppresses intracellular viruses and prevents them from manifesting themselves.

“Acyclovir-Acos” (200 mg tablets), the instructions for which we are reviewing today, are only partially absorbed into the gastrointestinal tract. Most of it is excreted unchanged in the urine. In case of renal failure, the half-life increases several times.

Side effects

In general, this drug is well tolerated and the occurrence of adverse reactions is practically not observed, since the active substances do not enter the systemic circulation. Side effects are manifested by allergic manifestations and can be expressed in the form of skin rash, itching, urticaria and swelling. In extremely rare cases, the development of angioedema is observed (expressed in swelling of the skin and subcutaneous tissue, most often localized in the face or genitals). If side effects occur, use of the drug must be stopped. This is indicated in the instructions for use for Acyclovir cream. For children, it must be prescribed by a doctor.

Acyclovir: price for 2019

The price of the drug acyclovir in 2019 did not increase compared to previous years, which is most likely due to high competition between manufacturers, as well as the appearance in pharmacies of a large number of more modern and effective analogues of acyclovir. The highest price is the original Acyclovir from GlaxoSmithKline (UK), sold under the Zovirax brand.

Ointment and cream Acyclovir 5% –

• Acyclovir Acri ointment (Russia) 5 g – from 40 rub.
• Acyclovir Sandoz cream 5 g – from 150 rub.
• Zovirax cream (UK) 5 g – from 190 rub.
• Zovirax Duo-Active cream (2 g) – from 290 rub.

Acyclovir eye ointment –

• Acyclovir 3% (Sintez, Russia) – from 116 rubles.
• Zovirax 3% (UK) – from 270 rub.

Acyclovir tablets: price

• Zovirax 200 mg (25 tablets) – from 550 rub.
• Acyclovir Acri 200 mg (20 tablets) – from 70 rub.
• Acyclovir Forte 400 mg (20 tablets) – from 170 rub.
• Acyclovir Acri 400 mg (20 tablets) – from 260 rub.

Acyclovir for intravenous administration -

• Zovirax (5 bottles of 250 mg) – from 1550 rubles.

Mechanism of action of Acyclovir

The effectiveness of the drug on the spread of the virus is due to the selective mechanism of action specifically on the affected cells. The pharmacological effect is explained by the absence of viral thymidine kinase (an enzyme involved in DNA formation) in uninfected cells. Once in the body, the active drug is phosphorylated under the influence of pathogenic enzymes and converted into acycloguanosine triphosphate, i.e. a compound that inhibits viral DNA. The concentration of the substance reaches its maximum after 1.5-2 hours.

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Contraindications of the drug

It is strictly unacceptable for patients under three years of age to take Acyclovir and if the body is individually immune to the components of the composition.

Use with caution and only at the discretion of the doctor in therapy during pregnancy and breastfeeding. It is important to consider that the active ingredient of the drug can penetrate into breast milk in high concentrations and accumulate in it. If alternative therapy does not have the desired effect, you should refrain from breastfeeding while taking pills during treatment.

The drug should be used under constant medical supervision in patients:

• with dehydration;
• with renal failure;
• with severe liver pathologies.

In a special group are elderly patients. It is recommended to prescribe the minimum dosage of the drug in treatment.