Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
Acyclovir
Indication
- Antiviral agent used in the treatment of herpes simplex and varicella-zoster infections
Dosage Guidelines
Acute Herpes simplex infections:
Post Menstrual Age (PMA) | Dose |
|---|---|
Less than or equal to 32 weeks | 20 mg/kg/dose IV q12 hours |
Greater than 32 weeks | 20 mg/kg/dose IV q8 hours |
- Treat for 21 days for disseminated or CNS infections and 14 days for isolated skin, eye and mouth disease
Anti-viral suppressive therapy (to start after initial treatment of neonatal herpes simplex disease with CNS involvement):
- Use Cerner Dose Calculator to calculate mg/m2 dose
- 300 mg/m2/dose oral q8 hours for 6 months
Varicella zoster treatment:
- 10–15 mg/kg/dose IV q8 hours x 5 to 10 days; continue for at least 48 hours after appearance of last new lesion
Administration
- IV intermittent slow infusion over 60 minutes
- Maintain adequate hydration before, during and after infusion
- To make 20 mL of a 5 mg/mL solution:
- Draw up 2 mL from the 50 mg/mL vial
- Add to 18 mL D5W to make a total volume of 20 mL
- Do not refrigerate
Adverse Effects
- Phlebitis, transient elevations in serum creatinine and liver function tests, crystal nephropathy with acute tubular necrosis, neutropenia
Comments:
- Monitor liver enzymes, urea, creatinine weekly
- Monitor CBC including absolute neutrophil count twice weekly
- Contact pharmacist for dosing adjustments in renal impairment
Supplied As:
- 50 mg/mL vial (must be further diluted to a final concentration of 5 mg/mL)
- 5 mg/mL patient specific syringe, prepared by Pharmacy