The drug is used only in a hospital.
Adults
In patients with obesity, doses are recommended, as in adults with normal body weight.
Treatment of infections caused by herpes simplex viruses (HSV, with the exception of herpetic encephalitis) and the virus of chicken pox and herpes zoster (VZV)
Intravenous infusions at a dose of 5 mg / kg body weight every 8 hours.
Treatment and prevention of infections caused by HSV, VZV, and herpetic encephalitis in patients with immunodeficiency
Intravenous infusions at a dose of 10 mg / kg body weight every 8 hours with normal kidney function.
Prevention of CMV infection in bone marrow transplantation
500 mg / m2 surface of the body intravenously 3 times a day with an interval of 8 hours.
Duration of treatment from 5 days to transplantation and up to 30 days after transplantation.
Special patient groups
Children
Doses of the drug
Acyclovir in children aged 3 months to 12 years is calculated depending on the body surface area.
In newborn doses are calculated depending on the body weight. For infections caused by HSV, a dose of 10 mg / kg is recommended every 8 hours.
Treatment of infections caused by HSV (other than herpetic encephalitis) and VZV
Intravenous infusions in a dose of 250 mg / m2 every 8 hours.
Treatment of herpetic encephalitis and VZV infections in children with immunodeficiency
Intravenous infusions in a dose of 500 mg / m2 every 8 hours with normal kidney function.
Prevention of CMV infection in children older than 2 years
Limited data suggest that children older than 2 years who have undergone bone marrow transplantation may be assigned an adult dose of the drug Acyclovir.
Children with reduced renal function require a dose adjustment in accordance with the degree of renal failure.
| Creatinine clearance (ml / min / 1.73 m3) | % of recommended dose | Multiplicity introduction of |
| >50 | 100 | 4 times a day |
| 25-50 | 100 | 2 times a day |
| 10-25 | 100 | 1 time per day |
| 0-10 | 50 | 1 time per day |
Elderly patients
In the elderly, the clearance of acyclovir in the body decreases along with the decrease in creatinine clearance. In elderly patients with reduced clearance of creatinine, a dose reduction should be considered.
Patients with renal insufficiency
Intravenous infusion of the drug Acyclovir should be administered with caution in patients with renal insufficiency. The following scheme of correction of doses is proposed depending on the degree of decrease in creatinine clearance:
| Creatinine clearance | Doses |
| 25-50 ml / min | 5-10 mg / ml every 12 hours |
| 10-25 ml / min | 5-10 mg / ml every 24 hours |
| 0 (anuria) - 10 ml / min | With continuous ambulatory peritoneal dialysis 5-10 mg / ml every 12 hours. With hemodialysis 5-10 mg / ml every 24 hours and after dialysis. |
Course of drug treatment Acyclovir in the form of intravenous infusion is usually 5 days, but may vary depending on the patient's condition and response to therapy. The duration of treatment for herpetic encephalitis and HSV infections in newborns is usually 10 days.
Duration of preventive use of the drug Acyclovir for intravenous infusion is determined by the duration of the period when there is a risk of infection.
Preparation of solution and method of administration
The recommended dose of the drug Acyclovir should be administered as a slow intravenous infusion for 1 hour.
10 ml of dilution solution are used (water for injection or a solution of sodium chloride for injection (0.9%)) for the preparation of the drug solution Acyclovir with a content of 1 ml of the resulting solution of 25 mg of acyclovir. The recommended volume of dilution solution must be added to the powder bottle of the preparation Acyclovir, shake gently until the contents of the vial completely dissolve.
After dilution, the drug solution Acyclovir can be administered in the form of intravenous infusions with the help of a special infusion pump that regulates the rate of administration of the drug.
Another method of infusion administration is possible, when the prepared solution is diluted further to obtain an acyclovir concentration not exceeding 5 mg / ml (0.5%).
To do this, add the prepared solution to the selected infusion solution, which is recommended below, and shake well until the solutions are completely mixed.
For children and newborns who need to enter minimal infusion volumes, it is recommended to add 4 ml of the prepared drug solution Acyclovir (100 mg of acyclovir) to 20 ml of the solvent.
For adults, it is recommended to use infusion solutions in packs of 100 ml, even if it gives the concentration of acyclovir significantly below 0.5%. Thus, one 100 ml infusion solution can be used for any dose of acyclovir between 250 mg and 500 mg (10 and 20 ml diluted solution). For doses between 500 and 1000 mg of acyclovir, another solution for infusion of this volume (100 ml) should be used.
Acyclovir, is compatible with the following infusion solutions and remains diluted with them for 12 hours at room temperature (15-25 ° C):
- Sodium chloride for intravenous infusions (0.45% and 0.9%);
- Sodium chloride (0.18%) and dextrose (4%) for intravenous infusions;
- Sodium chloride (0.45%) and dextrose (2.5%) for intravenous infusions;
- Hartman's solution.
When preparing the solution Acyclovir for infusions, as indicated above, the concentration of acyclovir is not more than 0.5%.
Dissolution and dilution should be carried out completely in aseptic conditions immediately prior to administration of the preparation. Unused solution is disposed of.If the solution is cloudy or the crystals fall out, it must be destroyed.