Tablets: 200 mg, 400 mg, 800 mg
Suspension: 200 mg/5ml, 400 mg/5ml
Injection: 25 mg/ml (250mg, 500mg 1g vials)
Herpes simplex: 200–400 mg orally five times a day for 5 days or (or 5 mg/kg IV 8 hourly in more serious infection) duration of treatment adjusted according to response.
Prophylaxis of herpes simplex infections: 200–400 mg orally twice a day continuously.
Herpes zoster: 800 mg orally five times a day for 7–10 days (or 10 mg/kg IV 8 hourly) duration of treatment adjusted according to response. Following clinical improvement IV therapy may be switched to oral therapy.
Herpes encephalitis: 10 mg/kg IV three times a day for 7–14 days (Unlicensed 15 mg/kg IV three times a day)
Progressive outer retinal necrosis (PORN): 10 mg/kg IV three times a day with foscarnet 90 mg/kg IV twice a day.
Acute retinal necrosis: Aciclovir followed by oral valaciclovir
Renal toxicity (particularly at high doses), watch patient for signs of dehydration and give additional fluids during IV administration, or high dose oral administration, neurological reactions (dizziness, confusional states, hallucinations), somnolence (usually in patients with renal impairment), skin rash, abnormal LFTs, nausea
Probenecid increases the half life and bioavailability of aciclovir, however not thought to warrant dose adjustment
GFR >10: 800 mg every 8 hours
GFR <10: 800 mg every 12 hours
GFR 25–50: 5–10 mg/kg every 12 hours
GFR 10–25: 5–10 mg/kg every 24 hours
GFR <10: 2.5–5 mg/kg every 24 hours
Caution when used in conjunction with other drugs which are renally excreted
Use with caution in patients with serious hepatic dysfunction
It is recommended that the state of hydration and the creatinine clearance should be evaluated before the administration of high dosages of aciclovir, especially in patients with reduced body mass.
Ensure infusion is administered as a slow IV infusion over a minimum of 1 hour.