ACYCLOVIR CREAM 5% 5G
ACYCLOVIR CREAM 5% 5G
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Mechanism of action
Antiviral drug, a synthetic analog of acyclic purine nucleoside, which has a highly selective effect on herpes viruses. Inside viral infected cells, viral thymidine kinase undergoes a series of consecutive transformations of Acyclovir into mono-, di-, and acyclovir triphosphate. Acyclovir triphosphate is inserted into the viral DNA chain and blocks its synthesis through competitive inhibition of viral DNA polymerase. In vitro, acyclovir is active against Herpes simplex type 1 and 2, Varicella zoster; higher concentrations are required to inhibit Epstein-Barr virus. In vivo acyclovir is therapeutically and prophylactically effective primarily in viral infections caused by Herpes simplex.
Indications and usage
- treatment of infections of the skin and mucous membranes caused by Herpes simplex type 1 and 2, both primary and secondary, including genital herpes;
- prevention of exacerbations of recurrent infections caused by the virus Herpes simplex type 1 and 2 in patients with normal immune status;
- prevention of primary and recurrent infections caused by the Herpes simplex type 1 and 2 virus in patients with immunodeficiency;
- as part of complex therapy in patients with severe immunodeficiency: in HIV infection (AIDS stage, early clinical manifestations and detailed clinical picture) and in patients undergoing bone marrow transplantation;
- treatment of primary and recurrent infections caused by the virus Varicella zoster (chickenpox, shingles).
- hypersensitivity to acyclovir, ganciclovir or drug components;
- lactation period (breastfeeding).
With caution, you should prescribe the drug for dehydration, renal failure, neurological disorders, including in the anamnesis.
Dosing regimen set individually depending on the severity of the disease.
In the treatment of infections of the skin and mucous membranes caused by the virus Herpes simplex type 1 and 2, adults and children over 2 years old, the drug is prescribed 200 mg 5 times / day for 5 days at intervals of 4 hours during the day and with an interval of 8 hours at night. In more severe cases, the disease may increase the course of treatment.
As part of complex therapy for severe immunodeficiency, including with a developed clinical picture of HIV infection (including early clinical manifestations of HIV infection and the AIDS stage), after bone marrow implantation, 400 mg is prescribed 5 times / day.
For the prevention of recurrence of infections caused by the Herpes simplex type 1 and 2 virus, patients with a normal immune status and with a relapse of the disease are prescribed 200 mg 4 times / day every 6 hours.
For the prevention of infections caused by the virus Herpes simplex type 1 and 2, adults and children over 2 years old with immunodeficiency, the drug is prescribed 200 mg 4 times / day every 6 hours, the maximum dose is 400 mg 5 times / day.
In the treatment of infections caused by the Varicella zoster virus, adults are prescribed 800 mg 5 times / day at intervals of 4 hours during the day and at intervals of 8 hours at night. Duration of treatment is 7-10 days. Children over 2 years old are prescribed 20 mg / kg of body weight 4 times / day for 5 days, children weighing more than 40 kg are prescribed the drug in the same dosage as adults.
In the treatment of herpes zoster (Herpes zoster), adults are prescribed 800 mg 4 times / day every 6 hours for 5 days. Children over 6 years old - 800 mg 4 times a day; 2-6 years - 400 mg 4 times a day; under 2 years old - 200 mg 4 times a day. More precisely, the dose can be determined at the rate of 20 mg / kg, but not more than 800 mg 4 times / day. The course of treatment is 5 days.
In patients with pronounced impaired renal function (CC <10 ml / min) in the treatment and prevention of infections caused by the Herpes simplex virus, the drug is prescribed 200 mg 2 times / day at intervals of 12 hours.
In the treatment of infections caused by the Varicella zoster virus, in patients with CC <10 ml / min, the drug is prescribed 800 mg 2 times / day at 12-hour intervals; at CC from 10 to 25 ml / min - 800 mg 3 times / day at intervals of 8 hours.
The drug should be taken during or immediately after a meal and drink plenty of water.
Ointment / cream is applied to the affected surface 5 times / day (after 4 hours). The duration of treatment is 5-10 days.
On the part of the digestive system: in isolated cases - abdominal pain, nausea, vomiting, diarrhea; rarely, transient increases in liver enzymes, hyperbilirubinemia.
On the part of the blood system: rarely - leukopenia, erythropenia.
From the side of the central nervous system: rarely - headache, weakness; in some cases - tremor, dizziness, fatigue, drowsiness, hallucinations.
Allergic reactions: skin rash; rarely - allergic dermatitis (when applying the ointment).
Local reactions: when applying the ointment it is possible - redness, itching, peeling, burning or tingling.
Other: rarely - alopecia, fever, increased levels of urea and creatinine.
Pregnancy and breastfeeding
Use of the drug during pregnancy is possible only in the case when the intended benefit to the mother outweighs the potential risk to the fetus.
Acyclovir penetrates the placental barrier and accumulates in breast milk. If you need to take acyclovir during lactation requires interruption of breastfeeding.
Precautions should be prescribed the drug to patients with impaired renal function, elderly patients in connection with an increase in the half-life of acyclovir.
When using the drug it is necessary to ensure the supply of a sufficient amount of liquid.
The ointment is not recommended to be applied to the mucous membranes of the mouth, eyes, genitals, because possible development of pronounced local inflammation.
The effectiveness of treatment when applying the ointment will be the higher, the earlier it is started.
In patients with immunodeficiency with repeated repeated courses of treatment, viruses are sometimes resistant to acyclovir.
When taking the drug should monitor kidney function (blood urea and plasma creatinine).
With simultaneous use with probenecid, the average half-life increases and the clearance of acyclovir decreases.
When taken simultaneously with nephrotoxic drugs increases the risk of developing renal dysfunction.
The external use of Acyclovir revealed no interaction with other drugs.
The drug in the form of pills should be stored in a dry, dark place, out of reach of children, at a temperature not exceeding 25 ° C. List B.
The drug in the form of ointment should be stored in a dry, dark place at a temperature of from 8 ° to 15 ° C.
Shelf life: Table. - 3 years
ointment / cream - 2 years.
The drug in the form of pills is available by prescription.
The drug in the form of ointment is approved for use as a means of non-prescription.