Healthy adult men and women with recurrent genital herpes simplex virus type 2 HSV-2 infection were recruited at the University of Washington Virology Research Clinic Seattle. The trial was randomized, double blind, and placebo controlled. Patients who met the entry criteria were randomized in a 1: The same medication was dispensed for the first and second recurrence during the study. This study design was chosen so that the mean of the results from both recurrences could be used as a unit of analysis.
This allowed us to recruit fewer patients than would have been required had each person been observed through only 1 recurrence. For each episode, each participant was given 3 doses of study medication and a diary card. Subjects were asked to start use of the study medication as soon as possible, but not more than 12 h after the first signs or symptoms of a genital herpes recurrence, and to return to the clinic within 24 h.
At that time, herpes recurrence was confirmed by means of a clinical examination and viral culture, and the remaining 3 doses of medication were dispensed.
Patients returned to the clinic for subsequent evaluations on days 2, 3, 5, and 7 after starting treatment, and then every other day thereafter until the lesions healed. Patients were instructed on how to obtain samples for viral culture twice per day, at home, any morning or evening they were not seen in the clinic, and at the initiation of therapy. The times at which samples were obtained for viral cultures, medications were taken, and that lesions healed and symptoms resolved were noted on the diary card.
These events have been chosen for inclusion due to either their seriousness, frequency of reporting, potential causal connection to acyclovir, or a combination of these factors. Anaphylaxis, angioedema, fever, headache, pain, peripheral edema.
Aggressive behavior, agitation, ataxia, coma, confusion, decreased consciousness, delirium, dizziness, dysarthria, encephalopathy, hallucinations, paresthesia, psychosis, seizure, somnolence, tremors. Diarrhea, gastrointestinal distress, nausea. Anemia, leukocytoclastic vasculitis, leukopenia, lymphadenopathy, thrombocytopenia.
Hepatobiliary Tract and Pancreas: Elevated liver function tests, hepatitis, hyperbilirubinemia, jaundice. Alopecia, erythema multiforme, photosensitive rash, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria. Adverse events that have been reported in association with overdosage include agitation, coma, seizures, and lethargy.
Precipitation of acyclovir in renal tubules may occur when the solubility 2. Overdosage has been reported following bolus injections or inappropriately high doses and in patients whose fluid and electrolyte balance were not properly monitored. This has resulted in elevated BUN and serum creatinine and subsequent renal failure. Chronic Suppressive Therapy for Recurrent Disease: For prevention of recurrent outbreaks of genital herpes infections: Adults and children 12 years of age and older— to mg two to five times a day for five days or up to twelve months, depending on how often your outbreaks of infection occur.
For treatment of chickenpox: Adults and children who weigh over 88 pounds 40 kilograms — mg four times a day for five days. Children 2 years of age and older and weighing 88 pounds 40 kilograms or less—Dose is based on body weight and must be determined by the doctor. The usual dose is 20 mg per kilogram kg of body weight, up to mg, four times a day for five days.
Children up to 2 years of age—Use and dose must be determined by the doctor. For treatment of shingles: Acyclovir may be taken without regard to food and should be taken exactly as instructed by a health care provider.
I am in stage 1 of multiple myeloma. I was diagnosed nearly 3 years ago. The last 3 summers I have had attacks of shingles, the 1st year I took mg of acyclovir daily and avoided the painful stage. Last year I missed the spots as they were on my back and suffered greatly for 2 to 3 months and I am still taking mg acyclovir per day. Each time I stop the medication the fever returns for a couple of days followed by the first few spots. I am on my 5th lot of acyclovir, starting with mg per day, increasing to 2, per day and 2 weeks ago was prescribed mg per day for 21 days.
I have managed 10 days at this level but there are so many side effects, including kidney pain, so I have reduced to 3 tablets of mg each. I feel less "in a fog" and slightly better already but am afraid when I stop the shingles will return.
I am concerned about the side effects. Can you give me advice please? Shingles is a painful rash that is caused by the same virus varicella virus that causes the chickenpox. Only people who were infected with the virus and got chickenpox can get shingles.
Unfortunately, people with weakened immune systems, from other diseases like cancer or treatments like chemotherapy, are at much greater risk of developing shingles. Drugs like acyclovir Zovirax work to reduce the ability of the virus to multiply and spread in the body.
Acyclovir has been shown to reduce the duration of infection and the severity of symptoms, but it relies on an individual's immune system to attack the virus. The drug itself does not kill the virus and that is likely the reason you continue to have symptoms and relapses. It is possible that some of the painful effects you are experiencing are the result of complications of shingles.
One of these complications is called postherpetic neuralgia, which is the painful, tingling, and stinging pain at the site of the initial rash. There are medications that are used to help treat the pain associated with the nerve damage of shingles. These drugs include the anticonvulsants, such as Neurontin gabapentin , Lyrica pregabalin , and Tegretol carbamazepine and tricyclic antidepressants like Elavil amitriptyline. Does acyclovir affect kidney disease? Acyclovir Zovirax is used to decrease pain and speed the healing of sores or blisters in people who have varicella chickenpox , herpes zoster shingles; a rash that can occur in people who have had chickenpox in the past , and first-time or repeat outbreaks of genital herpes a herpes virus infection that causes sores to form around the genitals and rectum from time to time.
Read More I had an outbreak genitally and after that had nearly continuous cold sores on my mouth and nose. I was treated with acyclovir , mg 4 times a day and that didn't really work. I am now taking mg Valtrex once a day. This is working somewhat well, but I am having some breakthrough symptoms around the time of ovulation.
I am extremely worried that my herpes is becoming resistant. Here are my questions: Effect of renal failure on the pharmacokinetics of acyclovir. Unexpected accumulation of acyclovir in breast milk with estimation of infant exposure. Obstet Gynecol ; 69 3 Pt 2: Recurrent genital herpes and suppressive oral acyclovir therapy. Relation between clinical outcome and in-vitro drug sensitivity. Sensitivity of HSV genital isolates after oral acyclovir.
Double-blind, placebo-controlled trial comparing long-term suppressive with short-term oral acyclovir therapy for management of recurrent genital herpes. Spectrum of sensitivity of acyclovir of herpes simplex virus clinical isolates. A colorimetric assay for the measurement of the sensitivity of herpes simplex viruses to antiviral agents.
Antiviral Res ; 3 4: In vitro sensitivity to acyclovir in genital herpes simplex viruses from acyclovir-treated patients. Double-blind placebo-controlled trial of oral acyclovir in first-episode genital herpes simplex virus infection. JAMA ; 9: Long-term acyclovir suppression of frequently recurring genital herpes simplex virus infection. A multicenter double-blind trial. JAMA ; 2: Prolonged continuous versus intermittent oral acyclovir treatment in normal adults with frequently recurring genital herpes simplex virus infection.
Acyclovir in human breast milk. Am J Obstet Gynecol ; 3 Pt 1: Prophylactic oral acyclovir in recurrent genital herpes. Lancet ; 2 Morton P, Thomson AN. Oral acyclovir in the treatment of herpes zoster in general practice. N Z Med J ; Relation of cytohistopathology of genital herpesvirus infection to cervical anaplasia. Cancer Res ; 33 6: Efficacy of oral acyclovir in the treatment of initial and recurrent genital herpes.
The in vitro acyclovir sensitivity of herpesvirus shed by patients receiving suppressive oral therapy.
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