800 mg every 4 hours orally, 5 times daily for 7 to 10 days.
200 mg every 4 hours, 5 times daily for 10 days.
400 mg 2 times daily for up to 12 months, followed by re-evaluation. Alternative regimens have included doses ranging from 200 mg 3 times daily to 200 mg 5 times daily.
The frequency and severity of episodes of untreated genital herpes may change over time. After 1 year of therapy, the frequency and severity of the patient’s genital herpes infection should be re-evaluated to assess the need for continuation of therapy with acyclovir.
200 mg every 4 hours, 5 times daily for 5 days. Therapy should be initiated at the earliest sign or symptom (prodrome) of recurrence.
20 mg/kg per dose orally 4 times daily (80 mg/kg/day) for 5 days. Children over 40 kg should receive the adult dose for chickenpox.
800 mg 4 times daily for 5 days.
Intravenous acyclovir is indicated for the treatment of varicella-zoster infections in immunocompromised patients.
When therapy is indicated, it should be initiated at the earliest sign or symptom of chickenpox. There is no information about the efficacy of therapy initiated more than 24 hours after onset of signs and symptoms.
In patients with renal impairment, the dose of acyclovir should be modified as shown in Table 3:
Table 3. Dosage Modification for Renal Impairment
Creatinine
Adjusted Dosage Regimen
Normal Dosage
Regimen
Clearance
(mL/min/1.73 m2)
Dose
(mg)
Dosing Interval
200 mg every 4 hours
>10
200
every 4 hours, 5x daily
0-10
200
every 12 hours
400 mg every 12 hours
>10
0-10
400
200
every 12 hours
every 12 hours
800 mg every 4 hours
>25
800
every 4 hours, 5x daily
10-25
800
every 8 hours
0-10
800
every 12 hours
For patients who require hemodialysis, the mean plasma half-life of acyclovir during hemodialysis is approximately 5 hours. This results in a 60% decrease in plasma concentrations following a 6-hour dialysis period. Therefore, the patient’s dosing schedule should be adjusted so that an additional dose is administered after each dialysis.
No supplemental dose appears to be necessary after adjustment of the dosing interval.
