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How it is administered
Acyclovir is available in several forms, including oral tablets (200 mg, 400 mg, 800 mg), capsules (200 mg), topical cream and ointment (5%), and intravenous formulations (not covered in the provided labels). For blood cancer patients, oral and topical forms are most commonly used for prevention and treatment of viral infections.
Oral acyclovir is typically taken with or without food, as directed by your doctor. Topical forms are applied directly to the affected skin area. Dosage and duration depend on the condition being treated and individual patient factors such as kidney function.
How it works
Acyclovir is an antiviral medication that works by interfering with the replication of herpes viruses, including herpes simplex virus (HSV) and varicella-zoster virus (VZV). It is a synthetic nucleoside analogue, which means it mimics the building blocks of viral DNA. When the virus tries to replicate, acyclovir is incorporated into the viral DNA, causing premature chain termination and stopping the virus from multiplying.
This selective action is due to acyclovir's affinity for the viral enzyme thymidine kinase, which activates the drug primarily in infected cells. This helps limit the spread of the virus while minimizing effects on healthy cells. In patients with blood cancers, who may have weakened immune systems, acyclovir can help prevent or treat viral infections that could otherwise become severe.
Common side effects
- Nausea
- Vomiting
- Diarrhea
- Headache
- Malaise (feeling unwell)
- Dizziness
- Abdominal pain
- Skin reactions (with topical forms): burning, stinging, itching, or rash
- Rare but serious: kidney problems, confusion, hallucinations (especially in elderly or those with kidney impairment)
- Blood-related: anemia, leukopenia (low white blood cells), thrombocytopenia (low platelets)
Who Should take it
Acyclovir is indicated for the treatment of herpes zoster (shingles), initial and recurrent episodes of genital herpes, and chickenpox (varicella). In the context of blood cancer, acyclovir is especially important for immunocompromised patients who are at higher risk for severe herpesvirus infections.
Patients undergoing chemotherapy or stem cell transplantation may be prescribed acyclovir to prevent or treat herpes simplex or varicella-zoster infections. It is also used in immunocompromised patients with non-life-threatening mucocutaneous HSV infections. The decision to use acyclovir should be made by your healthcare provider based on your individual risk factors and medical history.
Who should not take it
Acyclovir should not be used by patients who have had a hypersensitivity reaction to acyclovir or valacyclovir. If you have experienced allergic reactions such as rash, swelling, or difficulty breathing after taking these medications, you should avoid acyclovir.
Caution is advised in patients with kidney impairment, as acyclovir is eliminated by the kidneys and dose adjustments may be necessary. Elderly patients and those with underlying renal impairment are at higher risk for side effects and may require lower doses. Always inform your healthcare provider of your full medical history before starting acyclovir.
Commonly used with
In blood cancer patients, acyclovir may be used alongside other antiviral medications, antifungals, or antibiotics as part of infection prophylaxis or treatment regimens. It is often given with chemotherapy or immunosuppressive therapies to prevent viral reactivation.
Acyclovir may also be used with medications like probenecid, which can increase acyclovir levels in the body by reducing its elimination, though this combination is not routine and should be managed by a healthcare provider.
Commonly tested with
Acyclovir is often studied in combination with other antiviral agents (such as famciclovir, penciclovir, or foscarnet) for resistant or severe infections. In clinical trials involving blood cancer patients, it is commonly tested as part of infection prevention protocols, sometimes alongside antifungal or antibacterial agents.
It is also tested in the context of stem cell or bone marrow transplantation, where it may be combined with other supportive care medications.
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