Acyclovir (Zovirax)

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General information

Class/mechanism: Antiviral; synthetic purine nucleoside analog which interacts with the viral thymidine kinase (TK) encoded by herpes simplex virus types 1 and 2 (HSV-1 & HSV-2) and the varicella-zoster virus (VZV). Thymidine kinase converts acyclovir to acyclovir monophosphate, which is eventually converted via phosphorylation into acyclovir triphosphate. Acyclovir triphosphate inhibits the replication of viral DNA by prematurely terminating the replicating DNA strand since acyclovir has no 3' end; competitively inhibiting viral DNA polymerase; and inactivating viral DNA polymerase. Acyclovir has greater activity against HSV compared to VZV because of more robust phosphorylation by the HSV viral thymidine kinase.[1][2]
Route: PO, IV, topical
Extravasation: no information

For conciseness and simplicity, currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, UpToDate Lexidrug, Medscape, or the prescribing information.[1]

Diseases for which it is used

No known antineoplastic properties. Widely used to prevent HSV and VZV reactivation in immunocompromised hosts receiving chemotherapy.

Patient drug information

Also known as

  • Generic names: aciclovir, ACV, acycloguanosine
  • Brand names:
Acic Acivir Acivirax Acylete Apo-acyclovir Avorax Axcel
Cusiviral Cyclovax Cyclovir Declovir Dravyr Hepirax Herpevex
Herpex Herzovir Klovireks-l Lovir Medovir Pharmaniaga Saforax
Vacrax Vicide Virax Virest Virless Virox Virucid
Virupos Xovir Zevin Zirax Zoral Zorax Zoraxin
Zoviax Zovir Zovirax