{"id":1607,"date":"2023-06-25T17:27:16","date_gmt":"2023-06-25T17:27:16","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/aciclovir-iv\/"},"modified":"2023-06-25T19:57:35","modified_gmt":"2023-06-25T19:57:35","slug":"aciclovir-iv","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/aciclovir-iv\/","title":{"rendered":"Aciclovir IV"},"content":{"rendered":"

<\/p>\n

Aciclovir IV<\/h1>\n

CLINICAL USE<\/h3>\n

Antiviral agent:Herpes simplex and herpes zoster infection<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n
  • Herpes simplex treatment: normal or immunocompromised 5 mg\/kg every 8 hours<\/li>\n
  • Recurrent varicella zoster infection: normal immune status 5 mg\/kg every 8 hours<\/li>\n
  • Primary and recurrent varicella zoster infection: immunocompromised 10 mg\/kg every 8 hours<\/li>\n
  • Herpes simplex encephalitis: normal or immunocompromised 10 mg\/kg every 8 hours<\/li>\n

    PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           :225.2<\/li>\n
  • %Protein binding                           :9\u201333<\/li>\n
  • %Excreted unchanged in urine     : 40\u201370<\/li>\n
  • Volume of distribution (L\/kg)       :0.7<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :2.9\/19.5 (dialysis: 5.7)
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n

    25\u201350 5\u201310 mg\/kg every 12 hours10\u201325 5\u201310 mg\/kg every 24 hours (some units use 3.5\u20137 mg\/kg every 24 hours)<\/li>\n

  • <10           : 2.5\u20135 mg\/kg every 24 hours
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Not dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HD                     :Dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HDF\/high flux   :Dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • CAV\/VVHD      :Dialysed. Dose as in GFR=10\u201325 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Ciclosporin: reports of increased and decreased ciclosporin levels. Some editors report no experience of interaction locally; possibly increased risk of nephrotoxicity<\/li>\n
  • Higher plasma levels of aciclovir and mycophenolate mofetil with concomitant administrationTacrolimus: possibly increased risk of nephrotoxicity
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    Sodium chloride 0.9% or water for injection; 10 mL to each 250 mg vial; 20 mL to 500 mg vial (Resulting solution contains 25 mg\/mL)<\/p>\n

    Route<\/h4>\n

    IV<\/p>\n

    Rate of Administration<\/h4>\n

    1 hour; can worsen renal impairment if injected too rapidly!<\/p>\n

    Comments<\/h4>\n<\/li>\n
  • Reconstituted solution may be further diluted to concentrations not greater than 5 mg\/mL<\/li>\n
  • Use 100 mL infusion bags for doses of 250\u2013500 mg; use 2 \u00d7 100 mL bags for 500\u20131000 mg<\/li>\n
  • Compatible with sodium chloride 0.9% and glucose 5%<\/li>\n
  • DO NOT REFRIGERATE<\/li>\n
  • Do not use turbid or crystal-containing solutions<\/li>\n
  • Reconstituted solution very alkaline (pH 11)
    \n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • Aciclovir clearance in CAVHD is approximately equivalent to urea clearance, i.e. lower clearance than in intermittent haemodialysis<\/li>\n
  • Monitor aciclovir levels in critically ill patients. Reports of neurological toxicity at maximum recommended doses<\/li>\n
  • Renal impairment developing during treatment with aciclovir usually responds rapidly to rehydration of the patient, and\/or dosage reduction or withdrawal of the drug. Adequate hydration of the patient should be maintained<\/li>\n
  • Plasma aciclovir concentration is reduced by 60% during haemodialysis<\/li>\n","protected":false},"excerpt":{"rendered":"

    Aciclovir IV CLINICAL USE Antiviral agent:Herpes simplex and herpes zoster<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1607","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1607","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1607"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1607\/revisions"}],"predecessor-version":[{"id":1678,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1607\/revisions\/1678"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1607"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1607"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1607"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}