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(C) Vancouver
General Hospital.
This monograph may not be reproduced without permission.
For further information, please contact a Pharmacist. |
NAME OF DRUG
acyclovir sodium
CLASSIFICATION
Antiviral Agent
ALTERNATE NAME
ZOVIRAX
INDICATIONS
- treatment of mucocutaneous and disseminated infections caused by herpes simplex virus
(HSV) types 1 and 2, varicella zoster (VZ) and Epstein Barr Virus (EBV)
- prophylaxis of HSV and cytomegalovirus (CMV) infection in immunocompromised patients
RECONSTITUTION AND STABILITY
- stable at room temperature
COMPATIBILITY
- compatible with commonly used IV solutions
- compatible via Y-site with amikacin, aminophylline,
ampicillin, cefamandole, cefazolin, cefotaxime, ceftazidime, ceftizoxime,
ceftriaxone, cefuroxime, clindamycin, cotrimoxazole, dimenhydrinate,
diphenhydramine, erythromycin, fluconazole, gentamicin, heparin,
hydrocortisone, hydromorphone, imipenem, lorazepam, magnesium sulphate,
methylprednisolone, metoclopramide, metronidazole, MVI, penicillin G,
potassium chloride, ranitidine, sodium bicarbonate, tobramycin, vancomycin
ROUTES OF ADMINISTRATION
- IV intermittent ONLY - over 1 hour
- concentration not to exceed 10mg/mL
VH & HSC ADMINISTRATION POLICY
A - Not to be administered by the direct IV route.
DOSAGE
- BMT HSV Prophylaxis: 5 mg/kg IV q12h
- Solid Organ Transplant CMV Prophylaxis: 10mg/kg q8h IV
- HSV Infection: 5 mg/kg (250 mg/m2) IV every 8 hours for 7 days
- Herpes encephalitis, Herpes ophthalmitis, VZ: 10-15 mg/kg (500 mg/m2)
IV every 8 hours for 7-14 days
NOTE: Reduce dosage in patients with impaired renal function: Contact Pharmacy for
guidelines
POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION
- phlebitis at the injection site
- rapid intravenous injection may result in precipitation of acyclovir crystals in the
renal tubules
IMPORTANT IMPLICATIONS
- rash, urticaria, diaphoresis, hematuria, encephalopathic changes and nausea may occur
- an increase in serum creatinine and decreased creatinine clearance may occur in patients
who are poorly hydrated, who are receiving concomitant nephrotoxic drugs, who have
pre-existing renal damage and in whom the dose was administered over less than 10 minutes
- following 6-hour hemodialysis period, there is 60% decrease in plasma concentration of
acyclovir
Revised Dec 2006