200 mg Tablet: Each tablet contains Acyclovir USP 200 mg. Acerux® 400 Tablet: Each tablet contains Acyclovir USP 400 mg. Acerux® 800 Tablet: Each tablet contains Acyclovir USP 800 mg. Acerux® 70 ml Suspension: Each 5 ml suspension contains Acyclovir USP 200 mg. Acerux® 250 mg Injection: Each vial contains Acyclovir USP 274 mg equivalent to Acyclovir 250 mg. Acerux® 500 mg Injection: Each vial contains Acyclovir USP 448.85 mg equivalent to Acyclovir 500 mg.
Acyclovir (Acerux®) is a synthetic pure derivative. It exerts its antiviral effect on Herpes simplex viruses (HSV) and Varicella Zoster (VZV) virus by interfering with DNA synthesis and inhibiting viral replication. In cells infected with virus, the antiviral activity of Acyclovir appears to depend principally on the intracellular conversion of the ring-2 DNA. Herpes simplex (HSV-2 and VZV) thymidine kinase converts acyclovir to the acyclovir monophosphate, which is then converted to the diphosphate by cellular glyoxuric kinase, and finally to the triphosphate by phosphoglycerate kinase, phosphoenolpyruvate carboxykinase, and pyruvate kinase. acyclovir triphosphate competitively inhibits viral DNA polymerase and competes with the natural deoxyguanosine triphosphate, for incorporation into viral DNA. Once incorporated, acyclovir triphosphate inhibits DNA synthesis by acting as a chain terminator.
Pharmacokinetics Acyclovir is poorly water soluble and has poor oral bioavailability (15-30%). Intravenous administration is necessary if high concentrations are required. When orally administered, peak plasma concentration occurs after 1-2 hours. Acyclovir has a high distribution rate; protein binding is reported to range from 9 to 33%. The elimination half-life is approximately 3 hours. It is renal excreted.
Acerux® is indicated for the treatment of viral infections due to Herpes simplex virus (type I & II) and Varicella zoster virus (herpes zoster & chicken pox). It is also indicated for the treatment of Herpes simplex virus infections of the skin and mucous membranes including initial and recurrent genital herpes and herpes labialis.
Acerux® is also indicated for the prophylaxis of Herpes simplex infections in immunocompromised patients.
Acerux® and 70 ml Suspension: Treatment of initial herpes simplex: 200 mg 4 times daily usually for 5 days. For immunocompromised patients: 200 mg 4 times daily for 5 days. Treatment of varicella (chicken pox): 200 mg 4 times daily for 5 days. Treatment of herpes simplex: 200 mg 4 times daily for 5 days. Treatment of varicella (chicken pox): 200 mg 4 times daily for 5 days. Treatment of herpes simplex: 200 mg 4 times daily for 5 days. Treatment of varicella (chicken pox): 200 mg 4 times daily for 5 days. Treatment of herpes simplex: 200 mg 4 times daily for 5 days. Treatment of varicella (chicken pox): 200 mg 4 times daily for 5 days. Treatment of herpes simplex: 200 mg 4 times daily for 5 days. Treatment of varicella (chicken pox): 200 mg 4 times daily for 5 days.
Prevention of occurrence of herpes simplex:
200 mg 4 times daily or 400 mg twice daily possibly reduced to 200 mg 2 or 3 times daily and interrupted every 6-12 months. Children under 2 years: Half of the dose. Children over 2 years: Adult dose. Prophylactic treatment of herpes simplex in the immunocompromised patients: 200 to 400 mg 4 times daily. Children under 2 years: Adult dose. Children over 2 years: Adult dose. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Children under 2 years: Adult dose. Children over 2 years: Adult dose. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily. Treatment of varicella (chicken pox): Adult and children over 4 kg: 800 mg 4 times daily.
Probenecid reduces Acyclovir excretion and so increases plasma concentration and risk of toxicity. Over dosage: Overdose symptoms may include seizure (convulsions), hallucinations, and urinating less than usual or not at all.
Pregnancy Category B: Acyclovir should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. Caution should be exercised when it is administered to a nursing mother.
Acyclovir should be administered with caution in patients with renal impairment and doses should be adjusted according to creatinine clearance. Monitor neutrophil count at least twice weekly in neonates.
Store in a cool (Below 25 C temperature) and dry place protected from light.