Product Overview
Structure
1 tablet contains:
active substance:
acyclovir 200 mg.
pharmachologic effect
Farmgroup:
antiviral agent.
Farm action:
An antiviral drug is a synthetic analogue of thymidine nucleoside.
In infected cells containing viral thymidine kinase, phosphorylation and conversion to acyclovir monophosphate occurs. Under the influence of acyclovir guanylate cyclase, monophosphate is converted into diphosphate and, under the action of several cellular enzymes, into triphosphate. High selectivity and low toxicity to humans are due to the lack of the necessary enzyme for the formation of acyclovir triphosphate in intact cells of the macroorganism.
Acyclovir triphosphate, "integrating" into the DNA synthesized by the virus, blocks the reproduction of the virus. The specificity and very high selectivity of the action is also due to its predominant accumulation in cells affected by the herpes virus.
Highly active against Herpes simplex virus type 1 and 2; chickenpox virus and herpes zoster (Varicella zoster); Epstein-Barr virus (types of viruses are listed in ascending order of magnitude of IPC acyclovir).
Moderately active against CMV.
With herpes, it prevents the formation of new elements of the rash, reduces the likelihood of skin dissemination and visceral complications, accelerates the formation of crusts, and reduces pain in the acute phase of herpes zoster. It has an immunostimulating effect.
Indications
Treatment of primary and recurrent severe genital herpes (including in patients with impaired immunity) - inside and parenteral;
prevention of often recurring (6 or more cases per year) genital herpes (including in patients with impaired immunity) - inside;
treatment of primary and recurrent herpes simplex with damage to the skin and mucous membranes caused by Herpes simplex virus type 1 and 2, in patients with impaired immunity - by mouth, parenterally;
prevention of herpes simplex in patients with impaired immunity (including after transplantation and taking immunosuppressive drugs, HIV-infected patients, with chemotherapy) - inside;
encephalitis caused by Herpes simplex type 1 and type 2 virus - parenterally;
treatment of herpes zoster caused by the Varicella zoster virus in adults - by mouth; in patients with impaired immunity and with generalized herpes zoster in patients with undisturbed immunity - parenterally;
prevention of herpes zoster caused by the Varicella zoster virus after the initial period of use of acyclovir for parenteral use in all patients with impaired immunity (including after transplantation and when taking immunosuppressive drugs, HIV-infected patients, during chemotherapy) - by mouth;
herpes zoster with eye damage - inside, parenteral;
generalized infection in newborns caused by the Herpes simplex virus - parenterally;
chickenpox in patients with undisturbed immunity within 24 hours after the appearance of a typical rash - inside, in patients with impaired immunity - parenterally.
Pregnancy and lactation
Contraindications
Hypersensitivity (including to valaciclovir), children's age up to 3 years (for solid LF).
Carefully. Pregnancy, lactation.
Side effects
rarely - increased levels of urea and creatinine in the blood;
fever, lymphadenopathy, peripheral edema, visual impairment, myalgia, alopecia.
Interaction
With simultaneous use with probenecid, the average half-life increases and the clearance of acyclovir decreases.
With concomitant use with nephrotoxic drugs, the risk of developing renal dysfunction increases.
How to take, course of administration and dosage
In patients with impaired renal function, dose adjustment and dosing regimen are necessary depending on the size of creatinine clearance and the type of infection. For the treatment of Herpes simplex infection, when creatinine clearance is less than 10 ml / min, the daily dose should be reduced to 400 mg, dividing it into 2 doses (with intervals between them of at least 12 hours, i.e. 200 mg 2 times day).
In the treatment of infections caused by Varicella zoster, and in the treatment of patients with severe immunodeficiency - patients with creatinine clearance of 10-25 ml / min are prescribed 800 mg 3 times a day with an interval of 8 hours, with creatinine clearance of less than 10 ml / min - 800 mg 2 times a day with an interval of 12 hours
Overdose
It was reported about the ingestion of 20 g of acyclovir. Symptoms: agitation, coma, cramps, lethargy. Precipitation of acyclovir in the renal tubules is possible if its concentration exceeds solubility in the renal tubules (2.5 mg / ml).
Overdose with parenteral administration (for bolus administration, or use in high doses, or in patients whose water-electrolyte balance was not properly controlled): increased urea nitrogen, hypercreatininemia, impaired renal function, lethargy, convulsions, coma.
Treatment: maintenance of vital functions, hemodialysis.
Special instructions
With caution, Acyclovir should be prescribed to patients with impaired renal function, elderly patients due to an increase in the half-life of acyclovir.
When using the drug, it is necessary to ensure the flow of a sufficient amount of fluid.
The effectiveness of the treatment with the use of the ointment will be the higher the sooner it is started.
In patients with immunodeficiency with repeated repeated courses of treatment, the formation of resistance of viruses to acyclovir sometimes occurs.
When taking the drug, kidney function (blood urea and blood plasma creatinine) should be monitored.
Release form
tablets