Acyvir intravenous infusion is indicated for the treatment of-
- Acute clinical manifestations of Herpes simplex virus in immunocompromised patients
- Severe primary or non-primary genital herpes in immune competent patients
- Varicella zoster virus infection in immunocompromised patients
- Herpes zoster (shingles) in immune competent patients who show very severe acute local or systemic manifestations of the disease
- Herpes simplex encephalitis
—Dosage & Administration
- Herpes simplex infection: For normal or immunocompromised immune status: 5 mg/kg every 8 hours
- Very severe Herpes zoster infection (shingles): For normal immune status: 5 mg/kg every 8 hours
- Varicella zoster infection: For immunocompromised immune status: 10 mg/kg every 8 hours
- Herpes simplex encephalitis: For normal or immunocompromised immune status: 10 mg/kg every 8 hours
It is recommended that Acyclovir IV Injection for Intravenous Infusion should be administered for five to seven days in the treatment of most infections and for at least ten days in the treatment of Herpes simplex encephalitis.
Acyclovir IV Injection after reconstitution may be injected directly into a vein over one hour by a controlled-rate infusion pump or be further diluted for administration by infusion. For intravenous infusion each vial of Acyclovir IV Injection should be reconstituted and then, wholly or in part according to the dosage required, added to and mixed with at least 50 mL-100 ml infusion solution. A maximum of 250 mg & 500 mg of Acyclovir may be added to 50 ml & 100 ml infusion solution respectively. After addition of Acyclovir IV Injection to an infusion solution the mixture should be shaken to ensure thorough mixing. Acyclovir IV Injection when diluted in accordance with the above schedule will give an Acyclovir concentration not greater than 0.5% w/v.
Acyclovir IV Injection is known to be compatible with the following infusion fluids and stable for up to 12 hours at room temperature (below 25?C) when diluted to a concentration not greater than 0.5% w/v Acyclovir.
Sodium Chloride Intravenous Infusion BP (0.45% and 0.9% w/v)
Sodium Chloride (0.18% w/v) and Glucose (4% w/v) Intravenous Infusion
Sodium Chloride (0.45% w/v) and Glucose (2.5% w/v) Intravenous Infusion
Compound Sodium Lactate Intravenous Infusion BP (Hartmann’s Solution)
Acyclovir IV Injection for Intravenous Infusion contains no preservative. Reconstitution and dilution should therefore be carried out immediately before use and any unused solution should be discarded. The solution should not be refrigerated.
*Each dose should be administered by slow intravenous infusion over a one-hour period.
—Use in Special Populations
Pediatric use: The dose of Acyvir IV injection in children aged 1-12 years should be calculated on the basis of body surface area. Children in this age group with Herpes simplex infections (except Herpes simplex encephalitis) or Varicella zoster infections should be given Acyvir IV Infusion in doses of 250 mg/m2 (equivalent to 5 mg/kg in adults). Immunocompromised children in this age group with Varicella zoster virus infection or with Herpes simplex encephalitis should be given Acyvir IV Infusion in doses of 500 mg/m2 (equivalent to 10 mg/kg in adults). Children with impaired renal function require an appropriately modified dose, according to the degree of impairment.
Geriatric use: No data are available on this age group. However, as creatinine clearance is often low in the elderly, special attention should be given to dosage reduction.
In patients with renal impairment: Acyvir should be administered with caution since the drug is excreted through the kidneys. The following modifications in dosage are suggested:
CrCl: 25-50 ml/min: 5 or 10 mg/kg every 12 hours
CrCl: 10-25 ml/min: 5 or 10 mg/kg every 24 hours
CrCl: 0-10 ml/min: 2.5 or 5 mg/kg every 24 hours and after dialysis.