for herpes encephalitis), specific care regarding renal function should be taken, particularly when patients are dehydrated or have any renal impairment.Reconstituted aciclovir for infusion has a pH of approximately 11.0 and should not be administered by mouth.Aciclovir for infusion contains no antimicrobial preservative.
The pH has been adjusted with sodium hydroxide and if necessary, hydrochloric acid to fall in the range of 10.7 to 11.7. The registry findings have not shown an increase in the number of birth defects amongst aciclovir exposed subjects compared with the general population, and any birth defects showed no uniqueness or consistent pattern to suggest a common cause.There is no information on the effect of aciclovir on human female fertility. Renal impairment developing during treatment with aciclovir for infusion usually responds rapidly to rehydration of the patient and/or dosage reduction or withdrawal of the drug. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made.
Concomitant use of other nephrotoxic drugs, pre-existing renal disease, and dehydration make further renal impairment with acyclovir more likely. Aciclovir triphosphate interferes with the viral DNA polymerase and inhibits viral DNA replication with resultant chain termination following its incorporation into the viral DNA.In adults, the terminal plasma half-life of aciclovir after administration of aciclovir for9-carboxymethoxymethylguanine is the only significant metabolite of aciclovir and accounts for 10 to 15% of the dose excreted in the urine. Testicular atrophy and aspermatogenesis were observed in rats and dogs at higher dose levels.Acyclovir administered during organogenesis was not teratogenic in the mouse (450 mg/kg/day, PO), rabbit (50 mg/kg/day, SC and IV), or rat (50 mg/kg/day, SC).These exposures resulted in plasma levels the same as, 4 and 9, and 1 and 2 times, respectively, human levels. There are no adequate and well-controlled studies in pregnant women. Aciclovir 250mg for infusion should be reconstituted using 10ml of either Water for Injections PhEur or Sodium Chloride Intravenous Infusion BP (0.9% w/v) to provide a solution containing 25mg aciclovir per ml.From the calculated dose, determine the appropriate number and strength of vials to be used. Select one or more newsletters to continue.
Thus one 100 ml infusion bag may be used for any dose between 250 mg It is a sterile, aqueous solution for intravenous infusion, containing 50 mg acyclovir per mL in Water for Injection, USP. Any drugs administered concurrently that compete with this mechanism may increase aciclovir plasma concentrations. Probenecid and cimetidine increase the AUC of aciclovir by this mechanism, and reduce aciclovir renal clearance. When aciclovir is given one hour after 1g of probenecid the terminal half-life and the area under the plasma concentration time curve, are extended by 18% and 40% respectively.In adults, mean steady state peak plasma concentrations (CThe terminal plasma half-life in these patients was 3.8 hours. Nausea and/or vomiting occurred in approximately 7% of the patients (the majority occurring in nonhospitalized patients who received 10 mg/kg). Aciclovir for infusion is indicated for the prophylaxis of Herpes simplex infections in immunocompromised patients. In the elderly, total body clearance falls with increasing age and is associated with decreases in creatinine clearance although there is little change in the terminal plasma half-life.In patients with chronic renal failure the mean terminal half-life was found to be 19.5 hours. For most events, suitable data for estimating incidence were not available. Patients should be observed closely for signs of toxicity.Aciclovir is a synthetic purine nucleoside analogue with The inhibitory activity of aciclovir for HSV-1, HSV-2, VZV and EBV is highly selective.
At physiologic pH, acyclovir exists as the un-ionized form with a molecular weight of 225.21 and a maximum solubility of 2.5 mg/mL in water at 37°C.