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
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.
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