ACYCLOVIR SODIUM FOR INJECTION 1g Infusion/Powder for

What is ACYCLOVIR SODIUM FOR INJECTION 1g

Acyclovir Sodium for Injection 1g is a sterile, lyophilized powder intended for intravenous infusion after reconstitution and dilution. It contains the antiviral agent acyclovir, a synthetic purine nucleoside analog with potent activity against herpesviruses.

Indications:

• Herpes Simplex Virus (HSV) Infections: Treatment of initial and recurrent mucocutaneous HSV infections in immunocompromised patients.
• Herpes Simplex Encephalitis: Management of HSV infections of the central nervous system.
• Neonatal HSV Infections: Treatment of disseminated or localized HSV infections in neonates.
• Varicella-Zoster Virus (VZV) Infections: Treatment of varicella (chickenpox) and herpes zoster (shingles) in immunocompromised individuals.

This formulation is particularly beneficial for patients unable to take oral medications or those requiring high plasma concentrations of acyclovir.

How to use ACYCLOVIR SODIUM FOR INJECTION 1g

Preparation:

• Reconstitute the 1g vial with 20 mL of sterile water for injection to obtain a solution with a concentration of 50 mg/mL.
• Shake well until the powder dissolves completely.
• Further dilute the reconstituted solution in a compatible intravenous fluid (e.g., 0.9% Sodium Chloride Injection) to achieve a final concentration not exceeding 5 mg/mL.

Administration:

• Infuse the diluted solution intravenously over at least 1 hour to minimize the risk of renal toxicity.
• Ensure adequate hydration of the patient during treatment to support renal function.
• Do not administer as a bolus injection or via intramuscular or subcutaneous routes.

Precautions:

• Monitor renal function before and during therapy, especially in patients with pre-existing renal impairment.
• Adjust dosage accordingly to prevent accumulation and toxicity.

Mode of Action ACYCLOVIR SODIUM FOR INJECTION 1g

Acyclovir exhibits antiviral activity by interfering with viral DNA synthesis. Its mechanism involves:

1. Selective Uptake: Acyclovir is preferentially taken up by virus-infected cells.
2. Phosphorylation: Viral thymidine kinase phosphorylates acyclovir to acyclovir monophosphate.
3. Further Activation: Host cell enzymes convert the monophosphate to acyclovir triphosphate.
4. Inhibition of Viral DNA Polymerase: Acyclovir triphosphate competitively inhibits viral DNA polymerase, leading to chain termination during viral DNA replication.

This selective mechanism ensures minimal impact on uninfected cells, thereby reducing host toxicity.

ACYCLOVIR SODIUM FOR INJECTION 1g Interactions ACYCLOVIR SODIUM FOR INJECTION 1g

Drug-Drug Interactions:

• Probenecid: May decrease renal clearance of acyclovir, leading to increased plasma concentrations.
• Other Nephrotoxic Agents: Concurrent use with drugs like cyclosporine or tacrolimus can enhance the risk of renal dysfunction.
• Mycophenolate Mofetil: Co-administration may increase plasma levels of both drugs.

Laboratory Test Interactions:

• No significant interference with laboratory tests has been reported.

Always review the patient's medication profile to identify potential interactions before initiating therapy.

Dosage of ACYCLOVIR SODIUM FOR INJECTION 1g

General Guidelines:

• Dosage is based on the patient's weight, renal function, and the severity of the infection.
• Administered intravenously over at least 1 hour.

Adults and Adolescents (≥12 years):

• HSV Infections: 5 mg/kg every 8 hours for 7 days.
• Herpes Encephalitis: 10 mg/kg every 8 hours for 10 days.
• VZV Infections: 10 mg/kg every 8 hours for 7 days.

Children (3 months to 12 years):

• HSV Infections: 10 mg/kg every 8 hours for 7 days.
• Herpes Encephalitis: 20 mg/kg every 8 hours for 10 days.
• VZV Infections: 20 mg/kg every 8 hours for 7 days.

Neonates (≤28 days):

• HSV Infections: 20 mg/kg every 8 hours for 21 days.

Renal Impairment:

• Dosage adjustments are necessary based on creatinine clearance levels.
• Monitor renal function closely during therapy.

Possible side effects of ACYCLOVIR SODIUM FOR INJECTION 1g

Common Adverse Effects:

• Local Reactions: Inflammation or phlebitis at the injection site.
• Gastrointestinal: Nausea, vomiting, abdominal pain.
• Neurological: Headache, dizziness.

Serious Adverse Effects:

• Renal: Elevated blood urea nitrogen (BUN) and serum creatinine, acute renal failure.
• Neurological: Agitation, hallucinations, confusion, seizures (particularly in patients with renal impairment).
• Hematologic: Thrombocytopenia, leukopenia.
• Hypersensitivity: Rash, pruritus, anaphylaxis.

Promptly report any severe or unusual symptoms to a healthcare provider.

ACYCLOVIR SODIUM FOR INJECTION 1g Contraindications ACYCLOVIR SODIUM FOR INJECTION 1g

Absolute Contraindications:

• Known hypersensitivity to acyclovir, valacyclovir, or any component of the formulation.

Relative Contraindications:

• Renal Impairment: Use with caution; dosage adjustments required.
• Neurological Disorders: History of seizures or other neurological abnormalities may increase risk of neurotoxicity.

Assess patient history thoroughly before initiating therapy.

Storage of ACYCLOVIR SODIUM FOR INJECTION 1g

Unreconstituted Vials:

• Store at controlled room temperature between 20°C to 25°C (68°F to 77°F).
• Protect from light and moisture.

Reconstituted Solution:

• Use immediately after reconstitution.
• If necessary, store at 2°C to 8°C (36°F to 46°F) for up to 24 hours.

Diluted Infusion Solution:

• Use within 24 hours when stored at 2°C to 8°C (36°F to 46°F).
• Discard any unused portion after this period.

Always adhere to institutional guidelines and manufacturer's instructions for preparation and storage.