Aciclovir
General Information
Formulary antimicrobial: Use in accordance with Trust guidelines
Dosing in obesity
For intravenous administration: Use adjusted body weight. Take renal function into account when deciding dosing.
Renal and hepatic impairment
Renal impairment
Intravenous aciclovir
|
eGFR (mL/min/1.73m2) |
IV Dose |
|
More than 50 |
Dose as in normal renal function |
|
25-50 |
5-10mg/kg BD |
|
10-25 |
5-10mg/kg OD |
|
Less than 10 |
2.5-5mg/kg OD |
|
HD/HDF |
2.5-5mg/kg OD Dialysed: give after dialysis |
|
APD/CAPD |
2.5-5mg/kg OD Not dialysed |
Oral aciclovir
|
eGFR (mL/min/1.73m2) |
Herpes simplex virus (HSV) |
Varicella zoster virus (VZV) |
|
More than 25 |
No adjustment |
|
|
10-25 |
200mg po TDS-QDS |
800mg po BD-TDS |
|
Less than 10 |
200mg po BD |
400mg-800mg po BD |
|
HD/HDF |
As for eGFR less than 10 Dialysed: give after dialysis |
|
|
APD/CAPD |
As for eGFR less than 10 Not dialysed |
|
Hepatic impairment
No dose adjustment required
Pregnancy and breastfeeding
Pregnancy
Use only when potential benefits outweigh the risks.
Breastfeeding
Discuss with pharmacy.
Additional information
- Ensure patients on IV aciclovir and high dose oral aciclovir are adequately hydrated to minimise risk of renal impairment.
References
- Aurobindo Pharma - Milpharm Ltd. Aciclovir 800mg tablets Summary of product characteristics: Electronic Medicines Compendium [Internet]. Last revision of the text: 2/7/24. Available from: https://www.medicines.org.uk/emc/product/11674/smpc Accessed 13/3/25
- Rosemont Pharmaceuticals Limited. Aciclovir 400mg/5ml Oral Suspension Summary of product characteristics: Electronic Medicines Compendium [Internet]. Last revision of the text: 17/6/23. Available from: https://www.medicines.org.uk/emc/product/77/smpc Accessed 13/3/25
- GlaxoSmithKline UK. Zovirax IV 500mg Summary of product characteristics: Electronic Medicines Compendium [Internet]. Last revision of the text:23/10/24. Available from: https://www.medicines.org.uk/emc/product/7595/smpc Accessed 13/3/25
- The Renal Drug Database. Aciclovir oral [Internet]. Last revision of the text: 10/5/23. Available from: https://www.renaldrugdatabase.com/s/article/ACICLOVIR-ORAL Accessed 13/3/25
- The Renal Drug Database. Aciclovir IV [Internet]. Last revision of the text: 10/5/23. Available from: https://www.renaldrugdatabase.com/s/article/ACICLOVIR-IV Accessed 13/3/25
- UK Clinical Pharmacy Association. Drug dosing in extremes of body weight in critically ill patients, 1st edition [Internet]. 2013 [cited 2024 Aug 13]. Available from: https://ukclinicalpharmacy.org/wp-content/uploads/2023/06/Drug-dosing-extreme-body-weight-2013-1Ed.pdf.
- Black D. Obesity Dosing Adjustments - Sanford Web Guide [Internet]. 2024 [cited 2024 Aug 13]. Available from: https://web.sanfordguide.com/en/comparisons-1/drug-usage-dosing/obesity-dosing-adjustments
- Saag M. Acyclovir- Sanford Web Guide [Internet]. 2024 [cited 2024 Aug 13]. Available from: https://web.sanfordguide.com/en/drug-information/antiviral-agents/herpesvirus/acyclovir
- Briggs GG, Freeman RK, Towers CV, Forinash AB. Briggs Drugs in Pregnancy and Lactation. 12th ed. Wolters Kluwer Health; 2021.
- Hale TW, Krutsch K. Hale’s Medications & Mothers’ Milk. 2023 ed. Springer Publishing Company; 2023.
- UK Teratology Information Service. Use of aciclovir/valaciclovir in pregnancy [Internet]. 2023 [cited 2024 Aug 13]. Available from: https://www.medicinesinpregnancy.org/