Zovirax: Effective Antiviral Treatment for Herpes Infections
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Synonyms | |||
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Zovirax (acyclovir) is a leading antiviral medication specifically formulated to manage and treat infections caused by the herpes viruses. As a nucleoside analogue DNA polymerase inhibitor, it targets viral replication with precision, offering both therapeutic and suppressive benefits. This prescription medication is a cornerstone in dermatological and infectious disease practice, trusted by healthcare professionals for its well-established efficacy and safety profile. It is available in multiple formulations, including oral tablets, topical cream, and intravenous solutions, to address a spectrum of clinical needs from episodic treatment to long-term suppression.
Features
- Active ingredient: Acyclovir 200mg, 400mg, 800mg (tablets); 5% w/w (cream)
- Mechanism: Selective inhibition of viral DNA polymerase
- Formulations: Oral tablets, topical cream, intravenous infusion
- Bioavailability: Approximately 15-30% (oral); minimal systemic absorption (topical)
- Half-life: 2.5-3.3 hours in adults with normal renal function
- Excretion: Primarily renal via glomerular filtration and tubular secretion
Benefits
- Reduces the duration and severity of acute herpes simplex and herpes zoster outbreaks
- Decreases the frequency of recurrent episodes with prophylactic use
- Accelerates healing of lesions and crusting in cutaneous applications
- Lowers risk of viral transmission to susceptible individuals during suppression therapy
- Minimizes systemic complications in immunocompromised patients
- Well-tolerated profile with extensive clinical documentation spanning decades
Common use
Zovirax is indicated for the treatment of initial and recurrent episodes of herpes simplex virus (HSV) infections, including genital herpes, herpes labialis (cold sores), and herpes keratitis. It is also approved for the management of varicella-zoster virus (VZV) infections (chickenpox and shingles) in both immunocompetent and immunocompromised patients. Additionally, it is used prophylactically to prevent recurrent HSV infections in immunocompromised individuals, such as those undergoing chemotherapy or organ transplantation, and in patients with frequent recurrences.
Dosage and direction
Oral Tablets:
- Herpes Simplex (initial): 200mg every 4 hours (5 times daily) for 10 days
- Herpes Simplex (recurrent): 200mg every 4 hours (5 times daily) for 5 days
- Chronic Suppression: 400mg twice daily or 200mg three times daily
- Herpes Zoster: 800mg every 4 hours (5 times daily) for 7-10 days
Topical Cream:
- Apply sufficient quantity to cover affected area 5 times daily at approximately 4-hour intervals
- Treatment should begin as early as possible following onset of signs and symptoms
Intravenous:
- 5-10mg/kg every 8 hours for 7-10 days (dose adjusted for renal function)
All dosing must be individualized based on renal function, immunologic status, and specific viral indication. Administration with food may minimize gastrointestinal discomfort.
Precautions
Maintain adequate hydration during treatment to prevent crystalluria and nephrotoxicity. Use with caution in elderly patients and those with pre-existing renal impairment; dosage adjustment is required for creatinine clearance below 50mL/min. Monitor renal function during intravenous therapy. Topical application should avoid mucous membranes and ocular surfaces. Not a cure for herpes infections; does not eliminate latent virus or prevent transmission through sexual contact. Caution advised in patients with neurological abnormalities or history of seizures.
Contraindications
Hypersensitivity to acyclovir, valacyclovir, or any component of the formulation. Intravenous administration contraindicated in patients with known intolerance to intravenous acyclovir. Topical formulation should not be used in immunocompromised patients for prophylaxis against recurrent infections.
Possible side effect
Common: Nausea (2-5%), vomiting, diarrhea, headache (2-5%), dizziness, skin rash Less common: Elevated liver enzymes, fatigue, musculoskeletal pain, paresthesia Rare but serious: Acute renal failure, neurotoxicity (agitation, confusion, hallucinations, seizures), thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS), anaphylaxis Topical: Transient burning/stinging at application site, pruritus, dryness, flaking
Drug interaction
Probenecid: Significantly increases acyclovir plasma concentration and half-life Nephrotoxic agents (aminoglycosides, cyclosporine, IV pentamidine): Increased risk of renal toxicity Zidovudine: May cause increased drowsiness or lethargy Mycophenolate mofetil: Potential additive effects on immunosuppression Monitoring required when co-administering with medications that affect renal tubular secretion
Missed dose
Take the missed dose as soon as remembered, unless it is almost time for the next scheduled dose. Do not double the dose to make up for the missed one. For topical formulation, apply as soon as remembered and resume regular schedule. Maintaining consistent dosing is crucial for therapeutic efficacy, particularly in suppression therapy.
Overdose
Symptoms: Agitation, coma, seizures, lethargy, elevated BUN and serum creatinine, renal failure Management: Supportive care with maintenance of adequate hydration. Hemodialysis significantly enhances acyclovir removal (approximately 60% reduction in plasma concentrations). Contact poison control center or emergency department immediately for guidance.
Storage
Store at controlled room temperature (15-30°C/59-86°F). Keep oral tablets in tightly closed container. Protect from moisture and light. Topical cream should not be refrigerated. Keep all formulations out of reach of children. Do not use beyond expiration date printed on packaging.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Zovirax is a prescription medication requiring professional medical supervision. Individual response to therapy may vary. Consult a healthcare provider for proper diagnosis, treatment recommendations, and monitoring. Not all uses, precautions, or interactions may be listed here. Report any adverse reactions to your physician and appropriate regulatory authorities.
Reviews
“Zovirax has been a practice staple for over three decades. Its predictable efficacy in managing HSV outbreaks, particularly in immunocompromised patients, remains unmatched. The oral formulation provides excellent bioavailability for systemic treatment, while the topical cream offers targeted action with minimal systemic exposure.” - Dr. Eleanor Vance, Infectious Disease Specialist
“In dermatological practice, we find Zovirax cream significantly reduces healing time for recurrent herpes labialis when applied at prodromal symptoms. The safety profile is particularly favorable compared to newer antivirals, making it suitable for long-term suppression in appropriate patients.” - Dr. Marcus Thorne, Dermatologist
“While generally well-tolerated, clinicians must remain vigilant about renal function monitoring, especially in elderly patients and those receiving concurrent nephrotoxic medications. The dosage adjustment guidelines for renal impairment are well-established and should be strictly followed.” - Pharmaceutical Care Specialist, Johns Hopkins Hospital