- Stock: Out Of Stock
- Brand: Aristopharma
- Product ID: Acyclovir
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Acyvir 500mg IV Infusion — Acyclovir
Generic Name: Acyclovir 500mg (for IV Infusion)
Manufacturer: Beximco Pharmaceuticals Ltd.
Drug Class: Antiviral — Nucleoside Analogue
Dosage Form: Powder/Concentrate for IV Infusion
Prescription Status: Prescription Only (Rx) — Hospital/Specialist Use
Mechanism of Action
Acyclovir is selectively activated by herpes virus thymidine kinase (TK) to acyclovir monophosphate, then phosphorylated by cellular enzymes to the active acyclovir triphosphate. This inhibits viral DNA polymerase and terminates viral DNA chain elongation. The 500mg vial is the higher-strength IV formulation, used for patients requiring higher weight-based dosing (e.g. 10mg/kg in encephalitis or immunocompromised patients over 50kg) where fewer vials are needed.
Indications (IV Formulation)
- Herpes simplex encephalitis (HSE) — life-threatening; requires high-dose IV therapy
- Severe or disseminated herpes zoster in immunocompromised patients
- Severe primary genital herpes simplex
- Varicella (chickenpox) in immunocompromised or high-risk adults
- HSV infections when oral route is unavailable or inadequate
- Herpes simplex keratitis with systemic involvement
Dosage and Administration
| Indication | Adult Dose | Duration |
|---|---|---|
| Herpes simplex encephalitis | 10mg/kg IV every 8 hours | 14–21 days |
| Severe herpes zoster (immunocompromised) | 10mg/kg IV every 8 hours | 7–10 days |
| Varicella (immunocompromised) | 10mg/kg IV every 8 hours | 7 days |
| Renal impairment (eGFR 25–50) | Standard dose every 12 hours | As clinically indicated |
| Renal impairment (eGFR <10) | 50% of dose every 24 hours | — |
Preparation: Reconstitute 500mg vial in 10ml water for injection. Dilute further in 0.9% NaCl to ≤5mg/ml. Infuse over at least 1 hour. Maintain adequate hydration — urine output must be monitored throughout therapy to prevent nephrotoxicity.
Special Considerations in Diabetes
- Diabetes impairs immune function — higher risk of severe and prolonged herpetic infections
- Diabetic nephropathy patients require careful renal monitoring and dose adjustment
- Avoid glucose-containing diluents in poorly controlled diabetics — use 0.9% NaCl; monitor blood glucose during IV therapy
- Herpes zoster increases post-herpetic neuralgia risk in diabetics — early aggressive IV treatment is particularly important
- Consider co-prescribing corticosteroids for zoster (under specialist guidance) to reduce neuralgia risk
Contraindications
- Hypersensitivity to acyclovir or valacyclovir
- Rapid IV bolus injection — must always be infused slowly over ≥1 hour
Drug Interactions
| Drug / Class | Effect |
|---|---|
| Probenecid / Cimetidine | Reduce acyclovir clearance — increased plasma levels |
| Nephrotoxic agents | Additive nephrotoxicity — avoid concurrent use if possible |
| Mycophenolate mofetil | Compete for tubular secretion — monitor both drug levels |
Side Effects
| System | Side Effects |
|---|---|
| Renal | Crystalluria, creatinine rise, acute kidney injury (if inadequate hydration) |
| Neurological | Encephalopathy, tremor, agitation (rare; risk increased in renal failure) |
| Local | Phlebitis, pain at injection site; tissue damage if extravasation |
| GI | Nausea, vomiting |
| Haematological | Anaemia, leucopenia (uncommon) |
Storage
Store below 25°C. Protect from light. Reconstituted solution: use within 12 hours. Do not refrigerate after reconstitution.
Medical Disclaimer
The information provided here is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Acyvir 500mg IV Infusion must only be administered under the direct supervision of a qualified physician in a clinical or hospital setting. Maintain adequate hydration throughout treatment. DiabetesStore.com.bd does not endorse self-medication.
