How old is acyclovir

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. If you're not feeling better after you finish your prescribed course of aciclovir, tell your doctor. If your genital herpes sore is not better after 5 days, you can use the cream for another 5 days. If the infection gets worse at any time or the sore still has not healed after 10 days, speak to your doctor.

If your cold sore has not healed after 4 days, you can carry on using the cold sore cream for another 5 days. If your cold sore still has not healed after this or it gets worse at any time, stop using the cream and speak to your doctor. Some people feel dizzy when taking aciclovir tablets or liquid. This may make it more difficult to concentrate and react. If you have been prescribed aciclovir for genital herpes, do not have sex until all your sores or blisters have healed.

Aciclovir will not stop your contraception working. This includes the combined pill and emergency contraception. But if aciclovir makes you get sick or have severe diarrhoea 6 to 8 watery poos in 24 hours for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Find out what to do if you're on the pill and you're being sick or have diarrhoea. Page last reviewed: 8 July Next review due: 8 July Aciclovir including Zovirax On this page About aciclovir Key facts Who can and cannot take aciclovir How and when to take it Side effects How to cope with side effects Pregnancy and breastfeeding Cautions with other medicines Common questions.

About aciclovir Aciclovir or acyclovir is an antiviral medicine. It treats infections caused by the herpes virus herpes simplex , including: cold sores genital herpes Your doctor may prescribe aciclovir to prevent you getting these infections if you have had them before or you have a weak immune system.

It's sometimes given by injection, but this is usually only done in hospital. Start taking aciclovir as soon as you get the first signs of infection. For most infections, you should start to feel better after taking aciclovir for a few days. Common side effects include headaches, dizziness, and feeling or being sick.

Wash your hands before and after using the cream. Brand names include Zovirax, Cymex Ultra and Virasorb. Aciclovir can be taken by most adults and children.

Aciclovir is not suitable for some people. To make sure aciclovir is safe for you, tell your doctor if you: have had an allergic reaction to aciclovir or any other medicine in the past have kidney problems are over 65 years old are pregnant, trying to get pregnant or breastfeeding If your immune system is weakened for example, if you have HIV or AIDS, or you have had a bone marrow transplant , talk to your doctor about the best type of aciclovir for you.

They may recommend tablets rather than the cream. A cold sore usually starts with a tingling, itching or burning feeling.

Aciclovir tablets and liquid Doses will vary, depending on why you're taking aciclovir. A single dose is generally between mg and mg, and may be lower for children. If you take aciclovir: 4 times a day — you could take it first thing in the morning, at midday, in the late afternoon and at bedtime 5 times a day — for example, you could take it at 7am, 11am, 3pm, 7pm and 11pm You can take aciclovir with or without food.

Cream for cold sores Wash your hands before and after using the cream. Do not put aciclovir cream in your mouth, eyes or vagina. Cream for genital herpes Wash your hands before and after using the cream. What if I forget a dose of aciclovir?

Never have 2 doses at the same time. Never have an extra dose to make up for a forgotten one. If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicines. What if I take or use too much?

Talk to your doctor or pharmacist if you're worried that you have had too much aciclovir. Many people have no side effects at all, or only minor ones. Common side effects tablets and liquid These common side effects happen in more than 1 in 10 people who take aciclovir tablets or liquid.

Keep taking the medicine, but talk to your doctor or pharmacist, if these side effects bother you or do not go away: headaches feeling dizzy feeling or being sick nausea or vomiting diarrhoea skin being sensitive to sunlight Common side effects cream The cold sore cream is generally very safe and less than 1 in people experience any side effects. Keep using the medicine, but talk to your doctor or pharmacist, if these uncommon side effects bother you or do not go away: burning or stinging for a short time after applying the cream itchy, dry or flaky skin Serious allergic reaction In rare cases, aciclovir can cause a serious allergic reaction anaphylaxis.

These are not all the side effects of aciclovir. For a full list, see the leaflet inside your medicines packet. Information: You can report any suspected side effect using the Yellow Card safety scheme. Visit Yellow Card for further information.

Acyclovir Zovirax is approved for the acute management of varicella in children and adults. When acyclovir is given within the first 24 hours of the onset of rash in children, constitutional symptoms and pruritus are diminished. The number of lesions and the time until crusting are also reduced. Defervescence occurs more quickly on average in treated children day 1 versus day 2.

However, by the third day, all treated children and 75 percent of untreated children are afebrile. Currently, no data indicate that treating varicella with acyclovir hastens the return of children to school or parents to work; the rate of development of complications has not been diminished by active therapy. Adverse effects attributable to acyclovir are uncommon. Gastrointestinal problems occur infrequently. The immune response following varicella is not affected by acyclovir therapy.

No effect has been shown on the subsequent development of varicella zoster in children treated with acyclovir. The dosage of oral acyclovir is 20 mg per kg per dose, four times a day, up to mg per dose. Acyclovir therapy is not indicated in pregnant women or in infants less than two years of age. Acyclovir also has been used to prevent the development of chickenpox following household exposure.

In one unblinded, nonrandomized study, 5 exposed children were given acyclovir starting seven to nine days following exposure and continuing for seven days. Varicella developed in 16 percent of treated children, compared with percent of untreated children. Seroconversion, a marker of subclinical infection, occurred in 85 percent of the children receiving acyclovir. A second study 6 also found that acyclovir prophylaxis, given in the second week following exposure, allowed seroconversion without the development of symptoms.

This protection did not occur in all of the study subjects, so it is still not known whether acyclovir is a suitable alternative to varicella zoster immune globulin for postexposure protection.

The American Academy of Pediatrics 7 AAP recommends against the routine use of acyclovir in cases of uncomplicated varicella in otherwise healthy children. It recommends acyclovir treatment for susceptible nonpregnant adolescents. Acyclovir therapy also may be considered in children over 12 months of age who are receiving long-term salicylate therapy because of the risk of Reye's syndrome , in those with chronic pulmonary or skin problems, and in those receiving aerosolized corticosteroids.

However, the benefits of therapy in these groups has not been proved. Immunocompromised children, including those receiving oral corticosteroids in dosages of 2 or more mg per kg per day, should receive intravenous acyclovir to prevent or treat disseminated varicella.

The dosage is mg per m 2 every eight hours. In children less than 12 months of age, the dosage is 30 mg per kg per day in three divided doses. Therapy is continued for seven to 10 days. Two other antiviral agents, famciclovir Famvir and valacyclovir Valtrex , are available for the treatment of herpes zoster and recurrent genital herpes.

Neither of these agents is labeled for use in the treatment of varicella in children, and no studies have evaluated the use of these agents in children with zoster. In summary, acyclovir therapy can slightly decrease the severity and duration of acute varicella. To be effective, therapy must be started within 24 hours of the onset of rash, which may be difficult. Its effect on the subsequent development of zoster is not known.

With the marketing of the varicella vaccine, few children should require treatment of acute varicella infection. Herpes simplex virus is also responsible for eye infections in children and for lesions on the distal parts of fingers herpetic whitlow and at other sites. The most dramatic results of the use of antiviral therapy in healthy children have been seen with the use of acyclovir in the treatment of herpes simplex gingivostomatitis.

A recent trial 9 of 72 children receiving acyclovir, 15 mg per kg five times a day for seven days, showed a marked benefit with treatment compared with placebo. Intraoral lesions cleared significantly more quickly four days versus 10 days with the use of acyclovir. Other signs and symptoms disappeared significantly more quickly with treatment: fever one versus three days , eating difficulties four versus seven days , drinking difficulties three versus six days and the presence of lesions around the mouth zero versus five and one-half days.

A much greater concern is herpes simplex virus infection in newborn infants. The virus is most frequently transmitted to infants from the mother during vaginal delivery or, sometimes, via ascending infection. Transmission is much more likely to occur during a vaginal birth in a mother who is having a first episode of genital herpes.

In such cases, the rate of transmission may be 33 to 50 percent. Unfortunately, in most cases, infected neonates are born to women in whom neither the history nor the physical examination suggests active infection. Herpes simplex infection in newborns can range from a local infection of the skin, eyes and mouth to a generalized systemic infection or a localized infection of the central nervous system.

Neonatal meningitis is extremely rare: A recently published survey 10 of all causes of neonatal meningitis in England and Wales during the years to found only 10 cases that were due to herpes simplex virus among 26, reported cases.

For this reason, the AAP 8 p does not recommend empiric treatment of infants born to mothers with active primary or recurrent genital herpes infections unless cultures are positive or manifestations of herpes simplex virus infection occur. Infants with documented herpes simplex virus infections, whether localized, systemic or involving the central nervous system, should be treated with acyclovir.

The usual dosage is 30 mg per kg per day, given intravenously in three divided doses. Patients should receive treatment for at least 14 days and up to 21 days. Ribavirin Virazole has been approved since the early s for the treatment of respiratory syncytial virus infection. It is administered as an aerosol, generally via an oxygen tent, head box or mask, using a specific small-particle aerosol generator. Initial dosing consists of continuous inhalation, 12 to 20 hours per day for four to five days.

The drug also may be given in high dosages for two hours three times a day. Recent research about the effectiveness of ribavirin has contradicted previous findings. We compared HSV recurrence in both groups during the 2 periods. Recurrences were classified as 1 of the following: blepharoconjunctivitis, epithelial keratitis, stromal keratitis, or iritis.

Statistical analysis was performed by using the Kaplan-Meier method with the purpose of comparing the recurrence-free survival time to recurrence between the 2 groups in period 2. Eighteen patients were included in group 1 and 22 patients in group 2. The demographic characteristics of both groups were similar Table 1. One patient had epithelial keratitis group 2 , and 9 patients had stromal keratitis 6 patients in group 1 and 3 patients in group 2.

The types of recurrence are described in Table 2. In this study, we evaluated ocular recurrence of HSV after 12 months of treatment with oral acyclovir. Follow-up was similar in both groups. In the control group group 1 , the patients received acyclovir for at least 12 months and then discontinued treatment.

In group 2, the patients continued taking acyclovir for more than 12 months. Rate of recurrence and time to recurrence were both statistically significant between the 2 groups. There was no significant difference between the 2 groups regarding sex, age, and rate of recurrence in period 1, when both groups were using acyclovir. There are many articles concerning the use of oral acyclovir to prevent recurrence of ocular HSV.

However, the Herpetic Eye Disease Study analyzed the use of acyclovir for only 12 months, which was followed by 6 months of observation.

During this period, there was no significant difference in the ocular HSV recurrence rate in the 2 groups. There are few data in the literature regarding the use of oral acyclovir for more than 12 months for ocular purposes. Colin et al 16 and Simon and Pavan-Langston 4 studied the use of oral acyclovir for more than 12 months for prevention of herpetic keratitis recurrence.

Results of both studies showed benefit in prophylactic treatment with acyclovir. However, the authors looked only at epithelial recurrences, and they also included patients who had undergone penetrating keratoplasty. Lairson et al 17 reported recently that long-term treatment with oral acyclovir is not cost-effective, and the decision to maintain the treatment for a long time must be based on the specific case.

We suggest prolonged treatment for patients with virulent HSV-related ocular disease, such as keratouveitis with inflammatory glaucoma or moderate central scarring, in which 1 additional HSV episode could severely affect vision. Additionally, some patients in our study preferred to continue taking acyclovir because the number of episodes of fever blisters decreased.

There are some limitations to our study. It is a retrospective study with a limited number of patients, and there is variability in follow-up. This difference, combined with the fact that the patients had the option to either stop or continue the treatment after 12 months, may have led to a selection bias. Group 1 might have been more likely to discontinue treatment because the drug was less effective for them.

Nevertheless, we conclude that the use of oral acyclovir for more than 12 months provides substantial additional prevention against recurrence of ocular HSV. Our data suggest that long-term oral acyclovir use remains effective in decreasing the number of recurrences beyond 12 months.

More studies, ideally prospective, are necessary to confirm our results. Corresponding author: Elisabeth J. Submitted for publication March 6, ; final revision received June 27, ; accepted July 2, Our website uses cookies to enhance your experience.

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