Acyclovir Injection is anti viral agent, active against herpes simplex virus and to less extent varicella-zoster virus. It Inhibits viral DNA polymerase and viral DNA replication. Resistant herpes simplex virus to aciclovir has been reported.Aciclovir Powder for Solution for Infusion is indicated for the prophylaxis and treatment of Herpes simplex infections in immunocompromised patients. It is also used for the treatment of severe initial genital herpes in the nonimmunocompromised, Herpes simplex infections in the neonate and infant up to three months of age, herpes encephalitis, and Varicella zoster infections.
There are many generic manufacturers in India who manufacture Acyclovir including Cipla, Glaxosmithkline, RPG etc.
The dose of acyclovir for infusion must be adjusted in patients with impaired renal function in order to avoid accumulation of acyclovir in the body (see Dosage in renal impairment). In patients receiving aciclovir for infusion at higher doses (e.g. for herpes encephalitis), specific care regarding renal function should be taken, particularly when patients are dehydrated or have any renal impairment. For reconstituted solutions, the shelf life is 24 hours at a temperature of 2-8°C. The storage instruction is ‘Do not store above 25°C’.
Gastrointestinal: Nausea and vomiting have been reported.
Haematological: Decreases in haematological indices (anaemia, thrombocytopenia, leucopenia).
Hypersensitivity and Skin: Rashes including photosensitivity, urticaria, pruritus, fevers and rarely dyspnoea, angioedema and anaphylaxis. Severe local inflammatory reactions sometimes leading to breakdown of the skin have occurred when formulations of aciciovir for intravenous use have been inadvertently infused into extravascular tissues.
Kidney: Rapid increases in blood urea and creatinine levels may occasionally occur in patients given aciclovir for infusion. This is believed to be related to peak plasma levels and the state of hydration of the patient. To avoid this effect the drug should not be given as an intravenous bolus injection but by slow infusion over a one hour period. Adequate hydration of the patient should be maintained. Renal impairment developing during treatment with aciclovir for infusion usually responds rapidly to rehydration of the patient and/or dosage reduction or withdrawal of the drug. Progression to acute renal failure, however, can occur in exceptional cases.
Liver: Reversible increases in bilirubin and liver-related enzymes. Hepatitis and jaundice have been reported on very rare occasions.