Acyclovir is non-retroviral anti-viral drug which targets virus DNA synthesis and therefore blocking DNA replication of Herpes viruses which include Herpes simplex virus-1 (HSV-1), Herpes simplex virus-2 (HSV-2), Varicella zoster virus (VZV), Epstein Barr virus (EBV), and cytomegalovirus (CMV).
It is also used to treat infections such as genital herpes, chickenpox, shingles, cold sores. This medicine will not fully cure herpes related infection but instead heals the symptoms caused to the infection.
We will dive into understanding various aspects of Acyclovir 400 tablet’s activity, uses, dosage, side effects, precautions and many more.
Overview Acyclovir 400 Tablet
- Genital Herpes simplex: It is caused by Type 2 virus, it can be treated by different routes of acyclovir administration depending upon the stage of infection. Late and severe cases require oral therapy, on the other hand, early stage cases can be treated with topical application. It provides symptomatic relief and fastens lesions healing.
- Mucocutaneous II simplex: This viral disease affects lips and gums. This was treated with a cream application providing some relief and oral tablet for spreading lesions to be taken for 10 days.
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- H. simplex encephalitis (type I virus): At early stage it can be treated with Acyclovir, delay in treatment increases the chances of mortality and neurological defects.
- Varicella-Zoster virus (Chicken pox): This condition is treated with Acyclovir in those patients who are immune-compromised or at the high risk of complications. If given for 7 days with 400mg during incubation period, helps to abort chicken pox.
- Herper Zoster (Shingles): Acyclovir does treat Herpes infection but instead helps to relieve the body from symptoms like painful rashes and helps in faster healing of lesions. It also helps slow recovery of Post-herpetic neuralgia, but does not heal wholly.
Precautions and Contraindications
- Kidney disease: Patient should clearly mention any kidney disease, renal impairment, or weak immune system as dosage adjustments are required to prevent side effects related to kidney function. Drink plenty of water if on this medicine.
- Pregnancy or Breastfeeding: There are chances of passing drugs to infants during pregnancy or childbirth, so one should report it to the doctor for dose adjustments as required.
Herpes infection spreads from mother to child during both scenarios so it should be treated on time, so seek a physician for help. - Allergies: Individuals with hypersensitivity to acyclovir should avoid its use. It might cause difficulty breathing, skin rashes, fast heartbeat, skin flushing, swelling over face.
If a patient experiences any of these events, they should consult a doctor on immediate basis and stop using drugs.
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- Liver infection: Patients should be cautious if suffering from live infection or increase in liver enzymes. Consult a physician before starting medicine.
Acyclovir is a deoxiguanosine analogue which converts into active metabolite “Acyclovir triphosphate” by interacting with virus specific enzyme called “Herpes virus specific thymidine kinase” and “cellular kinases”.
This active metabolite works in 2 different ways:
- Inhibits herpes DNA polymerase activity competitively
- Gets incorporated into viral DNA and terminates lengthening of viral DNA strand which further stops DNA polymerase irreversibly
Disease Interactions
- Renal dysfunction
- Neurotoxicity
- Hemodialysis
- Dehydration
- Liver problems
Side-effects of Acyclovir 400 Tablet
Some individuals might experience mild side effects caused b Acyclovir like gastrointestinal disturbances and other effects mentioned below:
- Headache
- Dizziness
- Nausea
- Fever
- Fatigue
- Stomach pain
- Diarrhea
- Skin rash
- Photophobia
- Menstrual abnormalities
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- Difficulty in sleeping
- Flushing or skin redness
- Mouth ulcers
- Sore throat
- Sweating
- Taste disturbances
- Thirst
- Swelling under skin and also around face, eye, and neck
- Urticaria
- Vomiting
- Some CNS effects reported
Serious adverse effects
- Blood in urine
- Chest pain and palpitations
- Decrease in red blood cells (RBC) and white blood cells (WBC)
- Alopecia (hair loss)
- Kidney problems such as decreased urination, renal impairment, crystalluria, acute renal failure
- Alteration in liver enzymes- bilirubin
- Liver inflammation
- Hypotension
- Lymph node swelling
- Mental health impairment like aggression, agitation, confusion, depression, hallucinations, psychotic symptoms
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- Seizures and convulsions
- Serious skin infections like Steven Johnson’s syndrome or toxic epidermal necrolysis
- Angioedema or anaphylaxis
- Tissue necrosis
- Shortness of breath
- Peripheral edema
- Tremors
- In rare situations it leads to coma or brain damage
- Eye inflammation
The side effects caused by Acyclovir are temporary and might go away after a few days of consuming it or after discontinuation of Acyclovir.
Long term side effects reported are very rare, and if occurs might require other medications for treatment.
Composition of Acyclovir 400 Tablet
Major drug interactions include drug
- Cidofovir
- Diatrizoate
- Everolimus
- Fezolinetant
- Inotersen
- odamide
- Iodipamide
- Iodixanol
- iopamidol
- iopromide
- iothalamate
- ioversol
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- ioxaglate
- ioxilan
- Metrizamide
- Tacrolimus
- Temsirolimus
- Tenofovir
- Tizanidine
- Varicella virus vaccine
- Zoster vaccine live
Moderate drug interactions include:
- Adefovir
- Bacitracin
- Balsalazide
- Capreomycin
- Ceftazidime
- Cladribine
- Clofarabine
- Cyclosporine
- Dimethyl furamate
- Entecavir
- Ethotin
- Fosphenytoin
- Givosiran
- Ifosfamide
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- Lithium
- Meperidine
- Mephenytoin
- Mesalamine
- Olsalazine
- Polymyxin B
- Phenytoin
- Ramelteon
- Sulfasalazine
- Telavancin
- Trospium
- Vancomycin
- Voclosporin
Mild drug interactions include:
- Aminophyline
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- Memantine
- Mycofenolate mofetil
- Mycophenolic acid
- Oxtriphylline
- Probenicid
- Theophylline
- Zidovudine
Safety Advice for Acyclovir 400 Tablet
- Adhere to the dosage regimen provided by the physician.
- Stay hydrated to avoid kidney related side effects
Regular check-up is required to monitor efficacy of the treatment and also to address any concerns if reported.
