Acyclovir (Acyclovir) - Summary

ACYCLOVIR SUMMARY

ACYCLOVIR INJECTION
FOR INTRAVENOUS INFUSION ONLY
R_x only

Acyclovir is a synthetic nucleoside analogue active against herpesviruses. Each capsule, for oral administration, contains 200 mg of acyclovir.

Herpes Zoster Infections

Acyclovir is indicated for the acute treatment of herpes zoster (shingles).

Genital Herpes

Acyclovir is indicated for the treatment of initial episodes and the management of recurrent episodes of genital herpes.

Chickenpox

Acyclovir is indicated for the treatment of chickenpox (varicella).

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NEWS HIGHLIGHTS

Published Studies Related to Acyclovir

Improvement in healing and reduction in HIV shedding with episodic acyclovir therapy as part of syndromic management among men: a randomized, controlled trial. [2009.10.01]
BACKGROUND: It is uncertain whether episodic acyclovir will enhance ulcer healing if delivered at primary health care settings, because there is often a delay in treatment initiation... CONCLUSIONS: Addition of acyclovir to syndromic management will improve healing of genital ulcers and may potentially reduce HIV transmission in combination with other interventions.

Five-year follow-up on the effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis. [2009.09]
PURPOSE: To investigate the long-term effect of oral acyclovir administered during the first 6 months after penetrating keratoplasty (PK) for herpetic eye disease (HED)... CONCLUSION: The results of our study suggest that oral acyclovir prescribed during the first 6 months after PK for HED protects against clinically evident HED recurrences during the first 5 years following PK.

Impact of acyclovir on genital and plasma HIV-1 RNA, genital herpes simplex virus type 2 DNA, and ulcer healing among HIV-1-infected African women with herpes ulcers: a randomized placebo-controlled trial. [2009.07.15]
BACKGROUND: Little is known about the impact of episodic treatment of herpes on human immunodeficiency virus type 1 (HIV-1)... CONCLUSION: Episodic therapy for herpes reduced the quantity of cervicovaginal HSV-2 DNA and slightly improved ulcer healing, but it did not decrease genital and plasma HIV-1 RNA loads. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT00158483 .

Valacyclovir and topical clobetasol gel for the episodic treatment of herpes labialis: a patient-initiated, double-blind, placebo-controlled pilot trial. [2009.03]
BACKGROUND: Treatment of herpes simplex labialis (HSL) has been associated with modest benefits. This difficulty results from the rapid resolution of the disease accomplished by the immune system, which narrows the window of therapeutic opportunity. The immune response is also responsible for important clinical manifestations, including oedema and pain. The dual role of immune responses (protection, pathology) is well recognized in other infectious diseases. The addition of corticosteroids to antimicrobial agents has been associated with improvement in some of these diseases. OBJECTIVE: We evaluated the combination of oral valacyclovir plus topical clobetasol compared to placebo for recurrent HSL... CONCLUSIONS: This pilot study supports the addition of topical corticosteroids to an oral antiviral agent for the treatment of HSL. Larger studies need to confirm the safety and efficacy of this approach.

Double blind trial of adjunctive valacyclovir in individuals with schizophrenia who are seropositive for cytomegalovirus. [2009.02]
CONCLUSIONS: The study did not demonstrate benefit of adjunctive valacyclovir for schizophrenia individuals with persistent symptoms who are CMV seropositive.

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Clinical Trials Related to Acyclovir

Double-Blind Placebo-Controlled Study Comparing the Combination of 15% SP-303 Gel With Acyclovir Versus Acyclovir Alone for the Treatment of Recurrent Herpes Simplex Virus (HSV) Infections in Subjects With Acquired Immunodeficiency Syndrome (AIDS) [Completed]
To evaluate the safety of topically applied SP-303 gel and to compare the efficacy of SP-303 gel in combination with acyclovir, relative to acyclovir alone, for the treatment of recurrent Herpes Simplex Virus (HSV) 1 and 2 infections, affecting the genital, perianal and neighboring areas, in patients with AIDS.

A Randomized Controlled Trial of Acyclovir Among HIV and HSV-2 Co-Infected Women, Chiang Rai, Thailand [Completed]
Herpes infection is an important co-factor in HIV transmission. A recent meta-analysis demonstrated that HSV infection contributed to a 2-fold increased risk of HIV transmission. Suppressive therapy with acyclovir has been a method proposed to reduce HIV transmission. We are conducting a randomized controlled cross-over trial to evaluate the effect of acyclovir suppressive therapy on HIV genital shedding in women co-infected with HIV-1 and Herpes Simplex Virus Type-2 (HSV-2) in Thailand.

Iontophoretic Application of Acyclovir Cream to Treat Recurrent Herpes Labialis [Completed]
Currently approved drugs for the treatment of herpes labialis (cold sores) exhibit low levels of efficacy due to the limited ability of the drugs to penetrate the skin to the site where the herpes virus is replicating. Iontophoresis uses electric current to enhance the delivery of drugs through the skin. This trial is testing a new iontophoretic device for the delivery of acyclovir cream to treat cold sores.

Comparison of Brovavir Versus Acyclovir in the Treatment of Herpes in HIV-Infected Patients [Completed]
To compare the efficacy of oral sorivudine (brovavir) and oral acyclovir for the treatment of localized herpes zoster in HIV-infected patients.

HIV-infected patients are at high risk for herpesvirus infections, including varicella-zoster virus ( VZV ) infections, also called shingles. Acyclovir, an approved drug, is widely used to treat VZV infections in the HIV population. Since no data from controlled studies are available to define the role of antiviral therapy for VZV infections in HIV-infected patients, a study is needed to test the relative efficacy of brovavir, an experimental antiviral drug, versus that of acyclovir.

Acyclovir for Herpes Infections Involving the Central Nervous System in Neonates [Active, not recruiting]
The purpose of this study is to test whether long term treatment with acyclovir given orally (by mouth) improves the outcome for infants with herpes simplex virus infection of the brain or spinal cord (known as the central nervous system [CNS]). Infants with herpes viral infection of the CNS that has or has not spread to other parts of the body will be enrolled in this study. All participants will receive treatment in a hospital for 21 days with acyclovir, given intravenously (by a needle inserted into a vein). Participants will then be divided into two groups: those with CNS disease that has or has not spread to the skin, and those whose viral infection has spread and involves the CNS. Both groups will be randomly assigned to receive either oral acyclovir or inactive substance for 6 months. Infants in the US and Canada will participate for 5 years. A physical exam, hearing exam, eye exam, and an evaluation of the nervous system will be performed throughout the study.

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PATIENT REVIEWS / RATINGS / COMMENTS

Acyclovir review by 26 year old female patient
		Rating
Overall rating:
Effectiveness:		Considerably Effective
Side effects:		Mild Side Effects
		Treatment Info
Condition / reason:		cold sores
Dosage & duration:		400 mg taken twice a day for the period of 1 year
Other conditions:		NA
Other drugs taken:		NA
		Reported Results
Benefits:		My whole lip used to swell up and I would get over a dozen little pockets of fluid that would merge into one giant blister. Now, cold sores appear 1/2 as often as before - down to every other month at most. One or two little pockets of fluid usually appear without the unsightly swelling. The cold sore is dried up within 24 hrs. They became unnoticeable to everyone.
Side effects:		I had to take it with food or I would get a little upset stomach.
Comments:		I have been taking Acyclovir daily for 1 year so far and will continue as long as my doctor allows me to.

Acyclovir review by 31 year old female patient
		Rating
Overall rating:
Effectiveness:		Considerably Effective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		HSV 2
Dosage & duration:		400mg taken 2-3x daily for the period of 2 months
Other conditions:		none
Other drugs taken:		daily vitamins
		Reported Results
Benefits:		Since this was an initial diagnosis of HSV 2 I do not know how effective it was as I have nothing to compare it to. It is supposed to keep HSV 2 from erupting on the skin's surface or if it already has, it is supposed to reduce the duration of the lesions.
Side effects:		I experienced very noticeable hair loss when washing my hair. It seemed to go away after about 2 weeks, but this could also be when I lowered my daily total dose from 1200mg to 800mg. When I again started taking 1200mg total per day, my hair loss seems to have returned.
Comments:		I was prescribed acyclovir for an initial diagnosis of HSV 2. Initially one is supposed to take it 400mg 3x daily for 10 days. I then chose to continue taking acyclovir as part of a "suppressive therapy" regimen. At this time the dosing decreased to 400mg 2x daily.

Acyclovir review by 43 year old female patient
		Rating
Overall rating:
Effectiveness:		Moderately Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		herpes
Dosage & duration:		don't know (dosage frequency: daily) for the period of probably a year
Other conditions:		none
Other drugs taken:		none
		Reported Results
Benefits:		This drug did not completely eliminate outbreaks. While it may have diminished length and extent of outbreak, still had more than expected. Decided not to take any longer and had better results taking Olive Leaf extract daily
Side effects:		none
Comments:		prescribed as a daily preventive for herpes outbreak.