Acivir (Acyclovir)
Also sold as: Acivir, Zovirax, Acyclo, Ocuvir (eye)
Pregnancy
Cat B
Lactation
Safe
Schedule
H
Forms
Tablet 200/400/800mg +4
Indications
- Herpes zoster (shingles)
- Genital herpes (HSV-2)
- Orolabial herpes
- Varicella (chickenpox) — within 24h
- HSV encephalitis
- Prophylaxis in immunocompromised
Adult Dosing
Herpes zoster
800 mg PO 5 times/day × 7-10 days; start within 72h
Genital herpes (initial)
400 mg PO TDS × 7-10 days
Suppression
400 mg PO BD
HSV encephalitis (IV)
10 mg/kg IV every 8h × 14-21 days
Pediatric Dosing
Best within 24h of rash
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 50 | Standard |
| CrCl 25-50 | Standard dose, every 12h instead of 8h |
| CrCl 10-25 | Standard dose, every 24h |
| CrCl < 10 | Half dose every 24h |
Pregnancy & Lactation
Pregnancy: Category B
Used safely in pregnancy
Lactation: Safe
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Probenecid | Increased acyclovir levels | Moderate |
| Nephrotoxic drugs | Additive nephrotoxicity | Moderate |
| Mycophenolate | Increased levels of both | Moderate |
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Side Effects
Common
- Nausea
- Diarrhea
- Headache
- Local irritation (topical)
Serious / Discontinue If
- Acute kidney injury (especially IV high-dose, dehydration)
- Crystal nephropathy
- Neurotoxicity (lethargy, confusion — esp in CKD)
- TTP/HUS (rare)
Contraindications
- Hypersensitivity to acyclovir/valacyclovir
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Acivir 800 | Cipla | 5 tab ₹65 |
| Zovirax 800 | GSK | 5 tab ₹185 |
| Acivir Cream 5% | Cipla | 5g ₹45 |
Monitoring Required
- Renal function for IV high-dose
Patient Counseling Points
- Start within 72h of rash for best effect
- Maintain hydration
- Complete full course
- Topical for early oral lesions
Stop Googling drug references mid-consultation
EasyClinic auto-flags Acivir interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
References
- BNF
- Lexicomp
- Indian National Formulary
- Specialty society guidelines