Aciclovir (Sandoz)

What it is used for

Adults; Treatment of first episode (primary or nonprimary) genital herpes and the management of recurrent episodes of genital herpes in certain patients. Treatment of acute attacks of Herpes zoster (shingles) when the duration of rash is less than 72 hours. The management of patients with advanced symptomatic HIV disease (CD4+ counts <150 x 10 6l). genital herpes initial episodes. the duration of viral shedding is reduced very significantly; pain and time to healing are also reduced. promptness initiation therapy or patient's prior exposure simplex virus mayinfluence degree benefit from therapy. intravenous aciclovir should be considered in patients whom prostration, cns involvement inability take oral medication requires hospitalisation more aggressive management. does not prevent establishment latency episodes.,recurrent suppression. with frequent recurrences, suppressive prevents reduces frequency severity recurrences a high proportion patients. abortive episodes (prodromal symptoms without vesicle formation) occasional breakthrough may, however, continue occur during appropriate for attacks mild, last short periods infrequently (e.g. lessfrequently than once month). effective only period intake has no residual beneficial effect. it eradicate body pool. following cessation therapy, onset their frequency, remain generally unaffected. some experience increased first episode risk inducing resistance potential long-term adverse effects (see precautions, carcinogenesis, mutagenesis impairment fertility) weighed carefullybefore initiating asymptomatic cases known shed frequency. at present limited data available on extent receiving therefore, if tablets being used prenatal use pregnancy), assumed that ceased. pregnancy managed according considerations normally applicable herpes. view complex variable natural history herpes, interrupted periodically ascertain whether disease undergone spontaneous change dosage administration). intermittent treatment. certain patients, short-term treatment effective. although average would derive benefits such treatment, minority who have experienced severe, prolonged recurrent complicated by eczema, burns or immunosuppression may experience more appreciable benefits. In those patients, intermittent treatment may be more appropriate than suppressive therapy when recurrences are infrequent. Herpes zoster. In controlled trials aciclovir tablets were shown to reduce acute pain and rash progression in adult patients of all ages with herpes zoster in whom the duration of rash was less than 72 hours. Aciclovir tablets appeared to be relatively less effective in younger adults, in whom Herpes zoster is generally a milder disease. In ophthalmic zoster, oral aciclovir has been shown to reduce the incidence of stromal keratitis and both the incidence and severity of anterior uveitis, but not other ocular complications or acute pain. Note. In immunocompetent patients with very severe Herpes zoster, immunocompromised patients, or in patients with impaired absorption from the gut, consideration should be given to intravenous dosing. Advanced symptomatic HIV disease. Studies have shown that oral aciclovir reduced mortality in patients with advanced HIV disease (CD4+ count < 150 x 10 6/L). In addition, oral aciclovir provided effective prophylaxis for herpes virus disease. No significant effect was seen on the prophylaxis of cytomegalovirus (CMV) disease or Epstein-Barr virus (EBV) disease.