▶BY INTRAVENOUS INFUSION
▶Neonate: 10 – 20 mg/kg every 8 hours for at least 7 days.▶Child 1–2 months: 10 – 20 mg/kg every 8 hours for at least
7 days
▶Child 3 months–11 years: 250 mg/m^2 every 8 hours
usually for 5 days
▶Child 12–17 years: 5 mg/kg every 8 hours usually for
5 days
Varicella zoster (chickenpox), treatment in
immunocompromised|Herpes zoster (shingles),
treatment in immunocompromised
▶BY INTRAVENOUS INFUSION
▶Child 3 months–11 years: 500 mg/m^2 every 8 hours
usually for 5 days
▶Child 12–17 years: 10 mg/kg every 8 hours usually for
5 days
Herpes zoster (shingles), treatment in
immunocompromised
▶BY MOUTH
▶Child 1–23 months: 200 mg 4 times a day continued for
2 days after crusting of lesions
▶Child 2–5 years: 400 mg 4 times a day continued for
2 days after crusting of lesions
▶Child 6–11 years: 800 mg 4 times a day continued for
2 days after crusting of lesions
▶Child 12–17 years: 800 mg 5 times a day continued for
2 days after crusting of lesions
Herpes zoster, treatment in encephalitis|Varicella zoster,
treatment in encephalitis
▶BY INTRAVENOUS INFUSION
▶Neonate: 10 – 20 mg/kg every 8 hours given for
10 – 14 days in encephalitis, possibly longer if also
immunocompromised.▶Child 1–2 months: 10 – 20 mg/kg every 8 hours given for
10 – 14 days in encephalitis, possibly longer if also
immunocompromised
▶Child 3 months–11 years: 500 mg/m^2 every 8 hours given
for 10 – 14 days in encephalitis, possibly longer if also
immunocompromised
▶Child 12–17 years: 10 mg/kg every 8 hours given for
10 – 14 days in encephalitis, possibly longer if also
immunocompromised
Varicella zoster (chickenpox), attenuation of infection if
varicella–zoster immunoglobulin not indicated
▶BY MOUTH
▶Child: 10 mg/kg 4 times a day for 7 days, to be started
1 week after exposure
Varicella zoster (chickenpox), prophylaxis after delivery
▶BY INTRAVENOUS INFUSION
▶Neonate: 10 mg/kg every 8 hours continued until
serological tests confirm absence of virus.DOSESATEXTREMESOFBODY-WEIGHT
▶With intravenous useTo avoid excessive dosage in obese
patients parenteral dose should be calculated on the
basis of ideal weight for height.lUNLICENSED USE
▶With oral useTablets and suspension not licensed for
suppression of herpes simplex or for treatment of herpes
zoster in children (age range not specified by
manufacturer).
Aciclovir doses in BNF may differ from those in product
literature. Attenuation of chickenpox is an unlicensed
indication.
▶With intravenous useIntravenous infusion not licensed for
herpes zoster in children under 18 years.
lCAUTIONSMaintain adequate hydration (especially with
infusion or high doses)
lINTERACTIONS→Appendix 1 : aciclovir
lSIDE-EFFECTS
▶Common or very commonAbdominal pain.diarrhoea.
dizziness.fatigue.fever.headache.nausea.
photosensitivity reaction.skin reactions.vomiting
▶UncommonAnaemia.leucopenia.thrombocytopenia
▶Rare or very rareAcute kidney injury.agitation.alopecia.
angioedema.ataxia.coma.confusion.drowsiness.
dysarthria.dyspnoea.encephalopathy.hallucination.
hepatic disorders.inflammation localised.psychosis.
renal impairment.renal pain.seizure.tremor
▶Frequency not knownCrystalluria
lPREGNANCYNot known to be harmful—manufacturers
advise use only when potential benefit outweighs risk.
lBREAST FEEDINGSignificant amount in milk after systemic
administration—not known to be harmful but
manufacturer advises caution.
lRENAL IMPAIRMENTRisk of neurological reactions
increased. Maintain adequate hydration (especially during
renal impairment).
Dose adjustments▶With intravenous useUsenormal
intravenous doseevery 12 hours if estimated glomerular
filtration rate 25 – 50 mL/minute/ 1. 73 m^2 (every 24 hours if
estimated glomerularfiltration rate
10 – 25 mL/minute/ 1. 73 m^2. Consult product literature for
intravenous dose if estimated glomerularfiltration rate
less than 10 mL/minute/ 1. 73 m^2.
▶With oral useForherpes zoster, use normal oral dose every
8 hours if estimated glomerularfiltration rate
10 – 25 mL/minute/ 1. 73 m^2 (every 12 hours if estimated
glomerularfiltration rate less than 10 mL/minute/ 1. 73 m^2.
Forherpes simplex, use normal dose every 12 hours if
estimated glomerularfiltration rate less than
10 mL/minute/ 1. 73 m^2.
lDIRECTIONS FOR ADMINISTRATIONForintravenous
infusion, reconstitute to 25 mg/mL with Water for
Injections or Sodium Chloride 0. 9 % then dilute to
concentration of 5 mg/mL with Sodium Chloride 0. 9 %or
Sodium Chloride and Glucose and give over 1 hour;
alternatively, may be administered in a concentration of
25 mg/mL using a suitable infusion pump and central
venous access and given over 1 hour.
lPRESCRIBING AND DISPENSING INFORMATIONFlavours of
oral liquid preparations may include banana, or orange.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Aciclovir (oral) for viral infections
http://www.medicinesforchildren.org.uk/aciclovir-for-viral-infections
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Aciclovir Tablets 200 mg or 800 mg may be prescribed.
Aciclovir Oral Suspension 200 mg/ 5 mL may be prescribed.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Tablet
CAUTIONARY AND ADVISORY LABELS 9
▶Aciclovir (Non-proprietary)
Aciclovir 200 mgAciclovir 200 mg tablets| 25 tabletP£ 10. 00
DT = £ 0. 83
Aciclovir 400 mgAciclovir 400 mg tablets| 56 tabletP£ 15. 00
DT = £ 2. 39
Aciclovir 800 mgAciclovir 800 mg tablets| 35 tabletP£ 20. 00
DT = £ 2. 88
Dispersible tablet
CAUTIONARY AND ADVISORY LABELS 9
▶Aciclovir (Non-proprietary)
Aciclovir 200 mgAciclovir 200 mg dispersible tablets|
25 tabletP£ 0. 86 DT = £ 0. 86
Aciclovir 400 mgAciclovir 400 mg dispersible tablets|
56 tabletP£ 20. 00 DT = £ 11. 98BNFC 2018 – 2019 Herpesvirus infections 405
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