Acyclovir

C difficile risk
None
Oral Bioavailability
Moderate

Spectrum Of Activity

Dosing

CrCl >50 mL/minCrCl 30-50 mL/minCrCl 10-29 mL/minCrCl <10 mL/min800mg PO QID, or 5-10 mg/kg IV Q8h800mg PO QID, or 5-10 mg/kg IV Q12h800mg PO QID, or 5-10 mg/kg IV Q24h200mg PO Q12h, or 2.5-5 mg/kg Q24h

200mg PO Q12h, or 2.5-5 mg/kg IV Q24h (doses given on HD days should be given after HD)

5-10 mg/kg PO/IV Q24h

Serious Infections (e.g. CNS and Disseminated Zoster) 10mg/kg IV q8h

Shingles 800mg PO 5 times per day

Prophylaxis dosing varies by indication

General Information

Therapy for herpesviral infections (HSV and VZV) including encephalitis.

Prophylaxis of herpesviral infections if recurrent disease or immunocompromised.

Follow SCr as appropriate.

Check urine for crystals if AKI suspected.

  • GI upset

  • Phlebitis

  • Increased SCr

  • AKI from crystal nephropathy

Mycophenolate can increase the acyclovir concentration.

May diminish efficacy of zoster or varicella vaccine.

For oral indications, valacyclovir is the pro-drug, which is more bioavailable with more convenient dosing.

Antimicrobial class: Antiviral. Nucleoside analogue.

Pregnancy category: B

Average serum half life: 3 hours

CSF penetration: Therapeutic

Urine penetration: Therapeutic