Acyclovir is an analog of guanosine. It is active against herpes simplex viruses 1 and 2 and varicella-zoster virus, but poorly active against cytomegalovirus. The intravenous route is most reliable and it is distributed to all tissues including the meninges. Acyclovir is excreted by the kidneys and dose reduction is necessary in renal failure, although it is removed by hemodialysis. For the immune-suppressed patient with herpes zoster or varicella, acyclovir prevents dissemination and reduces shedding. It is effective in the treatment of herpes simplex encephalitis. Chickenpox in adults should be treated with acyclovir to reduce the morbidity associated with pneumonia. Phlebitis, reversible renal impairment, and elevation of transaminases are minor side-effects.
Was this article helpful?