Zovirax: instructions for use, price, reviews during pregnancy, analogues

Compound

1 tablet of Zovirax contains 200 mg of acyclovir . Additional components: povidone K30, lactose monohydrate, sodium starch glycolate, microcrystalline cellulose, magnesium stearate.
1 gram of Zovirax cream contains 50 mg of acyclovir . Auxiliary components: dimethicone, white paraffin, propylene glycol, cetostearyl alcohol, poloxamer 407, liquid paraffin, sodium lauryl sulfate, macrogol stearate, glycerol monostearate, water.
1 gram of Zovirax ointment contains 30 mg of acyclovir . Auxiliary components: white Vaseline.
1 bottle of lyophilisate for preparing Zovirax injections contains 250 mg of acyclovir . Auxiliary components: sodium hydroxide.

Release form

White, biconvex, round tablets, engraved with “GXCL3”.

5 tablets in a contour pack, 5 packs in a paper pack.

White homogeneous cream 5% for external use.

2 grams of cream in a plastic bottle with a dispenser; one bottle in a paper pack.
2, 5 or 10 grams of cream in an aluminum tube, 1 tube in a paper pack.

White, translucent, homogeneous, oily ointment, with a slight odor, containing no lumps, grains or foreign inclusions.

4.5 grams of cream in a tube with a plastic nozzle, 1 tube in a paper pack.

The lyophilisate for the preparation of injections is a white powder (hygroscopic or in the form of a sintered mass).

250 mg powder in a glass bottle, 5 bottles in a plastic tray; one tray in a cardboard box.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Antiviral drug , an artificial analogue of a purine-type nucleoside , which has the ability to inhibit the replication of herpes simplex viruses (HSV) of all types, Varicella zoster, cytomegalovirus and Epstein-Barr . Acyclovir has the most pronounced antiviral properties against the herpes virus type 1 .

The effect of the drug on viruses is highly selective. Thymidine kinase of cells infected with these viruses converts acyclovir into monophosphate , then successively into diphosphate and triphosphate under the influence of cell enzymes. The inclusion of triphosphate in the DNA and the subsequent termination of this chain blocks the copying of viral DNA .

In patients with severe immunodeficiency , prolonged or repeated courses of treatment with acyclovir can lead to the emergence of strains resistant to the drug. Many strains with reduced sensitivity to Zovirax had low concentrations of viral thymidine kinase .

Pharmacokinetics of Zovirax tablets and injections

When taken orally, the active substance is only partially absorbed from the intestine. The content in the cerebrospinal fluid is approximately half of its plasma concentration. Bounds to blood proteins to a small extent (10-33%).

The main metabolite is 9-carboxymethoxy-methylguanine . The half-life is 2.7-3.3 hours. Most of the drug is excreted by the kidneys in unchanged form. It is excreted not only through glomerular filtration, but also through tubular secretion.

In individuals with chronic renal failure, the half-life of acyclovir approaches 19.5 hours. In elderly patients, the clearance of acyclovir decreases with age, but the half-life changes slightly.

Pharmacokinetics of Zovirax ointment

After applying the eye ointment, the active substance is quickly absorbed by the periocular tissues and the corneal epithelium, after which the concentration of the drug necessary to suppress the virus is created in the fluid inside the eye. Acyclovir with this method of administration is determined in the urine in a very low concentration, which has no clinical significance.

Pharmacokinetics of Zovirax cream

With repeated use of acyclovir , systemic absorption is minimal.

Zovirax tablets 200 mg 25 pcs. In Nizhniy Novgorod

Inside

during meals, with a full glass of water.

For adults

Treatment of infections caused by the herpes simplex virus:

The recommended dose of Zovirax is 200 mg 5 times a day every 4 hours, with the exception of the period of night sleep. Usually the course of treatment is 5 days, but can be extended for severe primary infections.

In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the oral dose of Zovirax can be increased to 400 mg 5 times a day. Treatment should begin as soon as possible after infection occurs; in case of relapses, it is recommended to prescribe the drug already in the prodromal period or when the first elements of the rash appear.

Prevention of recurrence of infections caused by the herpes simplex virus.

In patients with normal immune status, the recommended dose of Zovirax is 200 mg 4 times a day (every 6 hours). For many patients, a more convenient treatment regimen is suitable - 400 mg 2 times a day (every 12 hours). In some cases, lower doses of Zovirax are effective - 200 mg 3 times a day (every 8 hours) or 2 times a day (every 12 hours). In some patients, interruption of the infection may occur when taking a total daily dose of 800 mg.

Treatment with Zovirax should be periodically interrupted for 6–12 months to identify possible changes in the course of the disease.

Prevention of infections caused by the herpes simplex virus

. In patients with immunodeficiency, the recommended dose of Zovirax is 200 mg 4 times a day (every 6 hours). In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the oral dose of Zovirax can be increased to 400 mg 5 times a day. The duration of the preventive course of therapy is determined by the length of the period when there is a risk of infection.

Treatment of chickenpox and herpes zoster:

The recommended dose of Zovirax is 800 mg 5 times a day; The drug is taken every 4 hours, with the exception of the period of night sleep. The course of treatment is 7 days. The drug should be prescribed as soon as possible after the onset of infection, because in this case, treatment is more effective.

Treatment of patients with severe immunodeficiency:

The recommended dose of Zovirax is 800 mg 4 times a day (every 6 hours). For patients who have undergone a bone marrow transplant, it is usually recommended to undergo a course of IV therapy with Zovirax for 1 month before prescribing Zovirax for oral administration. In clinical studies, the maximum duration of treatment for bone marrow transplant recipients was 6 months (from the 1st to the 7th month after transplantation). In patients with an advanced clinical picture of HIV infection, the course of treatment with Zovirax was 12 months, but there is reason to believe that longer courses of therapy may be effective in such patients.

For children

Treatment and prevention of infections caused by the herpes simplex virus in children with immunodeficiency:

from 2 years and older - the same doses as for adults;

under 2 years of age - half the dose for adults.

Treatment of chickenpox:

over 6 years old - 800 mg 4 times a day;

from 2 to 6 years - 400 mg 4 times a day;

under 2 years - 200 mg 4 times a day.

More precisely, the dose can be determined at the rate of 20 mg/kg body weight (but not more than 800 mg) 4 times a day. The course of treatment is 5 days.

There are no data on the prevention of recurrence of infections caused by the herpes simplex virus and on the treatment of herpes zoster in children with normal immunity. According to the very limited information available, the same doses of Zovirax can be used to treat children over 2 years of age with severe immunodeficiency as for the treatment of adults.

Elderly patients.

In old age, there is a decrease in the clearance of acyclovir in the body in parallel with a decrease in creatinine clearance.

Elderly patients should receive a sufficient amount of fluid while taking high doses of Zovirax orally; if they have renal failure, it is necessary to consider reducing the dose of Zovirax.

Patients with renal failure.

In patients with renal failure, oral administration of acyclovir at recommended doses for the treatment and prevention of infections caused by the herpes simplex virus does not lead to accumulation of the drug to concentrations exceeding established safe levels. However, in patients with severe renal failure (Cl creatinine <10 ml/min), the dose of Zovirax is recommended to be reduced to 200 mg 2 times a day (every 12 hours).

When treating chickenpox, herpes zoster, as well as when treating patients with severe immunodeficiency, the recommended doses of Zovirax are:

severe renal failure (Cl creatinine <10 ml/min): 800 mg 2 times a day every 12 hours;

moderate renal failure (Cl creatinine 10–25 ml/min) 800 mg 3 times a day every 8 hours.

IV, adults

. In obese patients, dosages are recommended as in adults with normal body weight.

Treatment of infections caused by HSV (except herpetic encephalitis) and FOG

— IV infusion at a dose of 5 mg/kg every 8 hours.

Treatment of FOG infections and herpetic encephalitis in immunocompromised patients

- IV infusion at a dose of 10 mg/kg every 8 hours with normal renal function.

Prevention of CMV infection during bone marrow transplantation

— IV 500 mg/m2 3 times a day with an interval of 8 hours. Duration of treatment from 5 days before transplantation and up to 30 days after transplantation.

For children

Doses for IV infusions in children aged 3 months to 12 years are calculated depending on body surface area. In newborns, doses are calculated depending on body weight. For infections caused by HSV, a dose of 10 mg/kg every 8 hours is recommended.

Treatment of infections caused by HSV (except herpetic encephalitis) and FOG

— IV infusion at a dose of 250 mg/m2 every 8 hours.

Treatment of herpes encephalitis and FOG infections in immunocompromised children

- IV infusion at a dose of 500 mg/m2 every 8 hours with normal renal function.

Prevention of CMV infection in children over 2 years of age

. Limited data suggest that children over 2 years of age who have undergone bone marrow transplantation may be given the adult dosage of Zovirax IV. In children with reduced renal function, dose adjustment is required according to the degree of renal failure.

In elderly patients

the clearance of acyclovir in the body decreases in parallel with a decrease in creatinine clearance. Particular attention should be paid to reducing doses of Zovirax in the elderly with reduced creatinine clearance.

In patients with renal failure

IV infusions of Zovirax should be administered with caution. The dose is adjusted depending on the degree of decrease in creatinine clearance:

with creatinine Cl 25–50 ml/min, the dose is 5–10 mg/kg or 500 mg/m2 every 12 hours;

with creatinine Cl 10–25 ml/min, the dose is 5–10 mg/kg or 500 mg/m2 every 24 hours;

with creatinine Cl 0 (anuria) - 10 ml/min: with continuous ambulatory peritoneal dialysis, the dose is 2.5–5 mg/kg or 250 mg/m2 every 24 hours; for hemodialysis - 2.5–5 mg/kg or 250 mg/m2 every 24 hours and after dialysis.

The course of treatment with Zovirax by intravenous infusion is usually 5 days, but may vary depending on the patient's condition and response to therapy. The duration of treatment for herpetic encephalitis and HSV infections in newborns is usually 10 days. The duration of prophylactic use of Zovirax for intravenous infusion is determined by the duration of the period when there is a risk of infection.

Preparation of solution and method of administration

The recommended dose of Zovirax should be administered as a slow IV infusion over 1 hour.

To prepare a Zovirax solution with an acyclovir concentration of 25 mg/ml, add 10 ml of water for injection or sodium chloride solution for injection (0.9%) to the ampoule with Zovirax powder and shake gently until the contents of the ampoule are completely dissolved. After dilution, the Zovirax solution can be administered as an intravenous infusion using a special infusion pump that regulates the rate of drug administration.

Another method of infusion administration is possible, when the prepared Zovirax solution is diluted further to obtain an acyclovir concentration not exceeding 5 mg/ml (0.5%). To do this, you need to add the prepared solution to the selected infusion solution (see below)

and shake well to completely mix the solutions. For children and newborns in whom minimum infusion volumes must be observed, it is recommended to add 4 ml of prepared Zovirax solution (100 mg acyclovir) to 20 ml of infusion solution.

For adults, it is recommended to use infusion solutions in 100 ml packs, even if this will give an acyclovir concentration significantly lower than 0.5%. Thus, one 100 ml infusion solution can be used for any dose of acyclovir between 250 and 500 mg (10 and 20 ml diluted solution). For doses between 500 and 1000 mg of acyclovir, a second infusion of that volume should be used.

Zovirax for IV infusion is compatible with the following infusion solutions and, when diluted with them, remains stable for 12 hours at room temperature (15 to 25 °C):

sodium chloride for intravenous infusion (0.45% and 0.9%);

sodium chloride (0.18%) and glucose (4%) for intravenous infusion;

sodium chloride (0.45%) and glucose (2.5%) for intravenous infusion;

Hartmann's solution.

Since no antibacterial preservative is included in the solutions, dissolution and dilution must be carried out completely under aseptic conditions immediately before administration of the drug, and the unused solution is destroyed.

If the solution becomes cloudy or crystals fall out, it should be destroyed.

Eye ointment:

For adults and children, a strip of ointment 10 mm long is placed in the lower conjunctival sac 5 times a day with an interval of about 4 hours. Treatment must be continued for at least 3 days after recovery.

Indications for use

Indications for use of the tablet form of the drug:

therapy for infectious lesions of Varicella zoster ( herpes zoster and chickenpox virus );
therapy for infectious lesions of the skin and mucous membranes of HSV of all types, including genital herpes in primary and recurrent forms ;
HSV infections of all types, in persons with normal immunity or immunodeficiency ;
therapy of patients with severe forms of immunodeficiency , mainly with HIV infection (with CD4+ less than 200 cells/μl with early manifestations of HIV infection and AIDS ) or after bone marrow transplantation.

Indications for use of Zovirax ointment:

keratitis caused by HSV of all types.

Indications for use of Zovirax cream:

infectious lesions of HSV of all types of skin and mucous membranes, including herpes lips.

Indications for the use of Zovirax lyophilisate for the preparation of injections:

HSV infections of all types;
prevention of infectious lesions of HSV of all types of skin and mucous membranes in persons with immunodeficiency ;
therapy for infectious lesions of Varicella zoster;
HSV infections of all types in newborns;
prevention of cytomegalovirus infection after bone marrow transplantation.

Forms of release of the drug, indications and contraindications

Zovirax is manufactured in several versions:

in tablets;
5% cream for external use;
ointments;
lyophilisate - white powder for preparing an injection solution.

Indications for use depend on the form of the drug. Tablets are prescribed to patients:

with chickenpox and herpes zoster;
infectious lesions of the mucous membrane and skin with HSV;
genital herpes - with acute or chronic course;
severe forms of immunodeficiency or after bone marrow transplantation.

The medicine is used to prevent relapse of the pathology for people with a stable immune system or immunodeficiencies.

The ointment is recommended for keratitis, and the cream is recommended for herpes infections of the skin and mucous membranes, including the lip area. Lyophilisate is recommended for therapy:

infections caused by HSV;
herpes in newborns.

Injections are used to prevent cytomegalovirus after bone marrow transplantation.

Zovirax is contraindicated:

For intravenous administration - for renal failure, dehydration, registered reactions to cytotoxic agents, neurological disorders. The product is not used to treat pregnant women.
For oral administration - for dehydration, renal failure.

Any form of release is prohibited for use in case of individual intolerance to the component composition of the medication.

Contraindications

Allergy to acyclovir or valacyclovir or components of the drug.
Contraindications for intravenous administration of the drug: renal failure, dehydration , reactions to intravenous administration of cytotoxic drugs (including in the past), neurological disorders, pregnancy.
Contraindications for oral administration of the drug: renal failure, dehydration .

Side effects

Side effects when using tablets and lyophilisate

Digestive reactions: vomiting, nausea, diarrhea and abdominal (if taken orally).
Hematopoietic reactions: leukopenia, anemia and thrombocytopenia .
Hypersensitivity reactions: rash, fever , itching, shortness of breath, angioedema , anaphylaxis , urticaria , photosensitivity, severe inflammatory reactions at the site of parenteral administration.
Reactions from the kidneys: increased concentrations of creatinine and urea in the blood. To avoid such phenomena, instead of a single-stage intravenous injection, it is necessary to prescribe a slower administration over 1 hour. Renal failure caused by intravenous administration of Zovirax is usually relieved by rehydration or reducing the dosage of the drug.
Liver reactions: temporary increase in bilirubin and liver enzymes, hepatitis and jaundice (rarely with parenteral administration).
Reactions from nervous activity: psychosis , confusion, tremor , nervous agitation, drowsiness, convulsions , hallucinations , coma , headache (if taken orally).
Other reactions: fatigue, hair loss.

Side effects when using eye ointment

Immune reactions: hypersensitivity reactions up to angioedema .
Visual reactions: punctate keratopathy (passes without consequences and does not require stopping treatment), mild temporary burning sensation, conjunctivitis , blepharitis.

Side effects when using the cream

Local reactions: temporary itching, redness, burning, peeling, tingling in the area of application.
Allergic reactions: dermatitis , Quincke's edema .

Adverse reactions

When taking tablets or injecting Zovirax, unusual body responses may occur. The list of common deviations includes:

attacks of nausea, vomiting, diarrhea, pain in the abdominal area;
anemic conditions, decreased levels of leukocytes and platelets;
dermatological rashes, obsessive itching, fever;
shortness of breath, nettle rash;
increased sensitivity to ultraviolet radiation;
inflammation at the point of injection of the solution;
anaphylactic shock and Quincke's edema;
increased concentration of urea and creatinine in the blood;
renal failure;
increased levels of bilirubin and liver enzymes;
symptoms of jaundice or hepatitis.

The reception can also affect the nervous system, manifesting itself:

confusion, psychosis;
tremor, nervous excitement;
drowsiness, hallucinations;
attacks of headache or coma.

During treatment, active hair loss and increased fatigue were recorded.

Eye ointment therapy came with its own list of side effects:

allergic reactions, up to Quincke's edema;
burning sensation in the area of application;
symptoms of blepharitis, conjunctivitis;
punctate keratopathy - signs go away on their own and do not require changes in the treatment regimen.

The use of the cream provokes temporary reactions: burning sensation, obsessive itching, tingling, peeling of the skin. May cause the development of angioedema or dermatitis.

Instructions for use of Zovirax (Method and dosage)

Zovirax tablets, instructions for use

Zovirax tablets are taken orally with 200 ml of water during meals.

When treating infectious lesions of HSV , 200 mg of the drug is prescribed every 4 hours, five times a day. The standard course of treatment is 5 days, but for severe infections it is allowed to be extended. In the presence of severe immunodeficiency or in cases of intestinal absorption disorders, the dosage of Zovirax can be increased to 400 mg while maintaining the same frequency of administration. It is recommended to begin treatment as quickly as possible after the infection develops; in case of relapses, it is recommended to take the medicine when the first symptoms appear.

To prevent relapses of HSV infections in persons with normal immunity, 200 mg of the drug is recommended four times a day at regular intervals. For many, a more convenient dosage schedule is suitable - 400 mg twice a day. In some cases, low dosages of the drug are effective - 200 mg 3-2 times a day. In some patients, the progression of infection may be interrupted when taking a total dose of 800 mg per day.

Zovirax therapy should be stopped periodically for 6–12 months in order to detect changes in the course of the infection.

HSV infections in people with immunodeficiency , 200 mg of the drug is prescribed four times a day. In the presence of severe immunodeficiency or in case of impaired absorption from the intestine, the dosage can be increased to five times 400 mg of the drug per day. The time of preventive treatment is determined by the duration of the infectious period.

When treating herpes zoster and chickenpox, a five-time dose of 800 mg of the drug per day is prescribed (except during night sleep). The duration of such treatment is one week. The drug should be prescribed as quickly as possible after the onset of infection, because in this case the therapy is most effective.

For the treatment of patients with severe forms of immunodeficiency , four doses of 800 mg of the drug per day are prescribed at regular intervals. Persons who have undergone a bone marrow transplant are usually advised to undergo a month's course of parenteral therapy with Zovirax before taking Zovirax tablets. The maximum duration of treatment after bone marrow transplantation was 6 months. In patients with advanced clinical HIV infection, the duration of treatment was 1 year.

For patients with severe forms of renal failure, the dosage of Zovirax is recommended to be reduced to 200 mg twice a day.

In the treatment of herpes zoster and chickenpox , as well as in the treatment of persons with severe immunodeficiency , standard dosages are:

severe renal failure - 800 mg twice a day;
moderate form of renal failure - 800 mg three times a day.

Zovirax eye ointment, instructions for use

Zovirax eye ointment is placed into the conjunctival sac in a 10 mm strip up to 5 times a day. It is recommended to continue treatment after recovery for at least another 3 days.

Zovirax cream, instructions for use

Zovirax cream is applied with a cotton swab or pre-washed hands to avoid reinfection of the affected areas.

A small amount of the medicine is applied to the affected and adjacent areas of the skin and mucous membranes up to 5 times a day.

The duration of treatment is usually 4 days. If there is no healing, it can be extended up to 10 days. If symptoms of the disease persist after 10 days of treatment, you should consult your doctor.

Lyophilisate Zovirax for the preparation of injections, instructions for use

The prepared solution is administered intravenously. In obese individuals, the same dosages are used as in individuals of normal weight.

For the treatment of infectious lesions of HSV and herpes zoster virus , the drug is administered intravenously three times a day at a dose of 5 mg/kg body weight.

For the treatment of infectious lesions with the herpes zoster virus and herpetic encephalitis in people with immunodeficiency , the drug is administered intravenously three times a day at a dose of 10 mg/kg body weight.

To prevent cytomegalovirus infection during bone marrow transplantation, the drug is administered intravenously three times a day at a dose of 500 mg/m2 body area. Therapy begins 5 days before transplantation and continues until 30 days after transplantation.

Pay special attention to reducing Zovirax dosages in elderly people with reduced creatinine clearance .

In people with renal failure, intravenous administration of Zovirax should be prescribed with caution. The dosage will be changed depending on the severity of the deficiency.

The course of therapy with Zovirax in the form of intravenous infusions is usually 5 days, but can be adjusted depending on the patient’s condition and response to therapy. The duration of preventive treatment is determined by the duration of the infectious-dangerous period.

Preparation of solution and method of administration

Zovirax must be administered intravenously, slowly, over 1 hour.

To prepare a solution of the drug with a concentration of the active substance of 25 mg/ml, you need to add 10 ml of water or saline solution into the ampoule with powder and shake gently until the contents are completely dissolved.

Another method of infusion administration is possible: the prepared solution is diluted further to a concentration of 5 mg/ml. To do this, add the prepared solution to one of the infusion solutions and shake to completely mix the solutions. For adults, it is recommended to use infusion solutions in 100 ml bags, despite obtaining a dilution of acyclovir of less than 0.5%. Zovirax for intravenous administration is compatible with the following solutions and remains stable for 12 hours at a temperature of 15-24 °C:

0.18% sodium chloride and 4% glucose ;
0.45% sodium chloride and 2.5% glucose ;
0.45% or 0.9% sodium chloride ;
Hartmann's solution.

Zovirax tablets 200 mg 25 pcs.

For adults, for the treatment of infections caused by the Herpes simplex virus types 1 and 2, the recommended dose of Zovirax is 200 mg 5 times a day every 4 hours (except for the period of night sleep). Usually the course of treatment is 5 days, but can be extended for severe primary infections. In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the oral dose of Zovirax can be increased to 400 mg 5 times a day. Treatment should begin as soon as possible after infection occurs; in case of relapses, it is recommended to prescribe the drug already in the prodromal period or when the first elements of the rash appear. To prevent relapses of infections caused by Herpes simplex virus types 1 and 2 in patients with normal immune status, the recommended dose of Zovirax is 200 mg 4 times a day (every 6 hours). For many patients, a more convenient treatment regimen is suitable: 400 mg 2 times a day (every 12 hours). In some cases, lower doses of Zovirax are effective: 200 mg 3 times a day (every 8 hours) or 2 times a day (every 12 hours). Treatment with Zovirax should be periodically interrupted for 6-12 months to identify possible changes in the course of the disease. To prevent infections caused by the Herpes simplex virus types 1 and 2 in patients with immunodeficiency, the recommended dose of Zovirax is 200 mg 4 times a day (every 6 hours). In case of severe immunodeficiency (for example, after bone marrow transplantation) or in case of impaired absorption from the intestine, the oral dose of Zovirax can be increased to 400 mg 5 times a day. The duration of the preventive course of therapy is determined by the duration of the period of existence of the risk of infection. For the treatment of chickenpox and herpes zoster, the recommended dose of Zovirax is 800 mg 5 times a day, the drug is taken every 4 hours, with the exception of the period of night sleep. The course of treatment is 7 days. The drug should be prescribed as soon as possible after the onset of infection, because in this case, treatment is more effective. For the treatment of patients with severe immunodeficiency, the recommended dose of Zovirax is 800 mg 4 times a day (every 6 hours). For patients who have undergone a bone marrow transplant, it is usually recommended to undergo a course of intravenous acyclovir therapy for 1 month before prescribing Zovirax orally. In clinical studies, the maximum duration of treatment for bone marrow transplant recipients was 6 months (from the 1st to the 7th month after transplantation). In patients with an advanced clinical picture of HIV infection, the course of treatment with Zovirax was 12 months, but there is reason to believe that longer courses of therapy may be effective in such patients. Treatment and prevention of infections caused by Herpes simplex viruses in children with immunodeficiency aged 2 years and older - the same doses as for adults; at the age of under 2 years - half the dose for adults. For the treatment of chickenpox in children over 6 years of age, the drug is prescribed in a single dose of 800 mg; from 2 to 6 years - 400 mg; under 2 years - 200 mg. Frequency rate 4 times/day. More accurately, a single dose can be determined at the rate of 20 mg/kg body weight (but not more than 800 mg). The course of treatment is 5 days. There are no data on the use of Zovirax for the prevention of relapses of infections caused by Herpes simplex viruses and in the treatment of herpes zoster in children with normal immunity. According to the very limited information available, the same doses of Zovirax can be used to treat children over 2 years of age with severe immunodeficiency as for treating adults. When prescribing Zovirax to elderly patients, the possibility of a decrease in acyclovir clearance in parallel with a decrease in creatinine clearance should be taken into account. If there are signs of renal failure, it is necessary to decide on reducing the dose of Zovirax. Elderly patients should receive sufficient fluids while taking Zovirax orally in high doses. In patients with renal failure, oral administration of acyclovir at recommended doses for the treatment and prevention of infections caused by Herpes simplex viruses does not lead to accumulation of the drug to concentrations exceeding established safe levels. However, in patients with CC less than 10 ml/min, the dose of Zovirax is recommended to be reduced to 200 mg 2 times a day (every 12 hours). For the treatment of chickenpox, herpes zoster, as well as for the treatment of patients with severe immunodeficiency with CC less than 10 ml/min, the recommended doses of Zovirax are 800 mg 2 times a day every 12 hours; with CC 10-25 ml/min 800 mg 3 times/day every 8 hours. Zovirax tablets can be taken with meals, since food intake does not significantly interfere with its absorption. The tablets should be taken with a full glass of water.

Overdose

There is no information about an overdose of the drug in the form of a cream or eye ointment.

Overdose of pills

With a single random oral dose of up to 20 grams, no undesirable effects are recorded.

Signs of overdose: nausea, vomiting, headache, shortness of breath, confusion, renal dysfunction, diarrhea , convulsions , lethargy , coma .

Careful observation is necessary in order to timely identify possible signs of intoxication. of hemodialysis cannot be ruled out .

Overdose with solution

Signs of overdose: increased levels of urea nitrogen and creatinine in the blood, hallucinations, renal failure , confusion, convulsions , agitation, coma .

Hemodialysis is recommended , which significantly enhances the evacuation of acyclovir from the body and is the optimal method of treatment for overdose of injectable forms of Zovirax.

Interaction

No significant drug interactions were detected when using the drug.

Acyclovir is excreted unchanged into the urine due to tubular secretion . All drugs with a similar method of elimination can increase the concentration of acyclovir in the blood.

Caution should be exercised in combining intravenous administration of Zovirax with drugs that interfere with kidney function ( Ciclosporin , Tacrolimus and others).

Dosages and methods of application

The medicine is used only externally:

Adult patients - applied every 4 hours, up to 5 times a day. Treatment should be carried out with the first appearance of symptoms of the pathology, with redness of the skin. Therapy is also allowed if papules and vesicles appear on the dermis. The duration cannot exceed 4 days; in difficult cases, an increase to 10 days is allowed.
Children - the lack of comprehensive research does not allow use by minors under 12 years of age. Therapeutic manipulations are carried out according to a standard algorithm.

To prevent transmission of infection, the patient should wash their hands with soap before applying the ointment and after treatment. Patients with renal or hepatic insufficiency do not require special dosage adjustments - the drug has insignificant systemic absorption.

Use for pregnant women is justified if the benefit to the mother exceeds the potential risk to the fetus. Studies have shown that taking acyclovir in different dosage forms did not cause congenital anomalies in children.

Restrictions on therapy are indicated only for nursing women, when using systemic agents with an active component. The choice of medication is decided by the doctor. Self-medication during pregnancy and breastfeeding is unacceptable due to the risk of allergic reactions to any medications, even previously used ones.

special instructions

Patients taking the drug orally in large doses should drink sufficient fluid.

It is possible that a burning sensation may occur immediately after applying the eye ointment, which usually goes away spontaneously.

During drug therapy, wearing contact lenses is prohibited.

In order for the therapeutic effect to be maximum, it is necessary to start using the drug already at the initial symptoms of the disease (tingling, itching, burning, redness).

If you have severe symptoms of herpes , you should definitely consult a doctor.

When treating genital herpes , it is advised to abstain from sexual intercourse or use condoms, since the use of acyclovir does not protect against contracting the disease through sexual contact.

It is not recommended to apply the cream to the mucous membranes of the mouth and eyes due to the fact that local inflammation may occur.

Patients with immunodeficiency should adhere to the recommendations of the attending physician when treating any infectious lesions.

In persons with herpetic encephalitis , taking Zovirax in large dosages, it is necessary to constantly monitor kidney function.

The finished solution of the drug has a pH of 11, so it is prohibited for oral use.

Directions and overdose

The drug is intended for the treatment of herpes, which manifests itself on the skin of the face and lips. It is not used to treat the mucous membranes of the mouth or eyes, or genital herpes. The exception is Zovirax eye ointment.

The manufacturer recommends handling with extreme caution and avoiding contact of the composition with the organs of vision. Severe symptoms of a herpetic infection on the lips require additional consultation with a local doctor.

If an opening of the lesion is present, the patient must follow precautions to prevent accidental infection of bystanders. The patient should use separate care items, and do not forget to wash their hands before and after each manipulation.

Cetyl alcohol included in the composition can provoke the occurrence of local skin reactions - contact dermatitis, etc. The propylene glycol present becomes a source of local irritation on the skin.

The drug has no significant interactions with other medications. The medicine does not affect the speed of reactions and can be used when working with moving mechanisms and when driving a car.

No pronounced consequences of an overdose of ointment have been identified. Accidental ingestion or application of large volumes of medication did not cause serious complications. The appearance of non-standard reactions to the drug requires consultation with a doctor and replacement of the previously recommended therapy regimen.

Zovirax analogs

Level 4 ATX code matches:
Aldara

Viru-Merz Serol

Zovirax Duo-Active

Acyclovir

Fenistil Pencivir

Bonafton

Atsik

Alpizarin

Herpferon

Epigen Intim

Lysozyme

Gerpevir

Kondilin

Virolex

Gevisosh

Cheaper analogues of Zovirax are listed below: Acigerpin (lip analogue), Acyclovir (cream, eye ointment, tablets), Herperax (ointment), Acyclovir Belupo (tablets, cream), Acyclovir Sandoz (tablets, cream), Acyclovir-Acri (tablets , ointment), Acyclovir-Akrikhin (tablets, ointment), Acyclostad (cream), Vivorax (cream), Virolex (cream, lyophilisate, eye ointment, tablets), Medovir (lyophilisate), Acivir (cream), Herpetad (cream), Provirsan (tablets), Zovirax Duo (cream).

For children

Zovirax tablets

Treatment and prevention of infectious lesions caused by the common herpes virus in pediatric patients with immunodeficiency :

up to the age of 2 years, use half the dosage for adults;
over 2 years of age, use adult doses described in the section “Instructions for use of Zovirax” .

For the treatment of chickenpox in children, the following dosages are used:

children under 2 years of age are prescribed 200 mg four times a day;
children 2-6 years old are prescribed 400 mg four times a day;
Children over 6 years old are prescribed 800 mg four times a day.

More accurately, the dosage can be determined based on the child’s weight: 20 mg/kg body weight four times a day. The course of therapy is 5 days.

According to the limited information currently available, adult dosages of Zovirax are permitted immunodeficiency “Instructions for use of Zovirax” ).

Zovirax eye ointment and cream

Zovirax eye ointment and cream are used by aunts according to the same scheme and in the same doses as adults (described in the section “Instructions for use of Zovirax”).

Lyophilisate for the preparation of injections

Dosages for intravenous administration in children 3 (months) - 12 (years) are calculated based on body area.

When treating infectious lesions associated with the herpes simplex virus (excluding herpetic encephalitis ) and herpes zoster virus , doses of intravenous infusions are calculated according to the scheme 250 mg/m2 three times a day.

In the treatment of infectious lesions associated with the herpes zoster virus and herpetic encephalitis in sick children with immunodeficiency doses are calculated according to the regimen of 500 mg/m2 three times a day.

It is suggested that children 2 years of age and older who have received a bone marrow transplant can be given adult doses of Zovirax.

Zovirax, 5 pcs., 250 mg, lyophilisate for solution for infusion

Inside

during meals, with a full glass of water.

For adults

Treatment of infections caused by the herpes simplex virus:

Prevention of recurrence of infections caused by the herpes simplex virus.

Treatment with Zovirax should be periodically interrupted for 6–12 months to identify possible changes in the course of the disease.

Prevention of infections caused by the herpes simplex virus

Treatment of chickenpox and herpes zoster:

Treatment of patients with severe immunodeficiency:

For children

Treatment and prevention of infections caused by the herpes simplex virus in children with immunodeficiency:

from 2 years and older - the same doses as for adults;

under 2 years of age - half the dose for adults.

Treatment of chickenpox:

over 6 years old - 800 mg 4 times a day;

from 2 to 6 years - 400 mg 4 times a day;

under 2 years - 200 mg 4 times a day.

More precisely, the dose can be determined at the rate of 20 mg/kg body weight (but not more than 800 mg) 4 times a day. The course of treatment is 5 days.

Elderly patients.

In old age, there is a decrease in the clearance of acyclovir in the body in parallel with a decrease in creatinine clearance.

Elderly patients should receive a sufficient amount of fluid while taking high doses of Zovirax orally; if they have renal failure, it is necessary to consider reducing the dose of Zovirax.

Patients with renal failure.

When treating chickenpox, herpes zoster, as well as when treating patients with severe immunodeficiency, the recommended doses of Zovirax are:

severe renal failure (Cl creatinine <10 ml/min): 800 mg 2 times a day every 12 hours;

moderate renal failure (Cl creatinine 10–25 ml/min) 800 mg 3 times a day every 8 hours.

IV, adults

. In obese patients, dosages are recommended as in adults with normal body weight.

Treatment of infections caused by HSV (except herpetic encephalitis) and FOG

— IV infusion at a dose of 5 mg/kg every 8 hours.

Treatment of FOG infections and herpetic encephalitis in immunocompromised patients

- IV infusion at a dose of 10 mg/kg every 8 hours with normal renal function.

Prevention of CMV infection during bone marrow transplantation

— IV 500 mg/m2 3 times a day with an interval of 8 hours. Duration of treatment from 5 days before transplantation and up to 30 days after transplantation.

For children

Treatment of infections caused by HSV (except herpetic encephalitis) and FOG

— IV infusion at a dose of 250 mg/m2 every 8 hours.

Treatment of herpes encephalitis and FOG infections in immunocompromised children

- IV infusion at a dose of 500 mg/m2 every 8 hours with normal renal function.

Prevention of CMV infection in children over 2 years of age

In elderly patients

In patients with renal failure

IV infusions of Zovirax should be administered with caution. The dose is adjusted depending on the degree of decrease in creatinine clearance:

with creatinine Cl 25–50 ml/min, the dose is 5–10 mg/kg or 500 mg/m2 every 12 hours;

with creatinine Cl 10–25 ml/min, the dose is 5–10 mg/kg or 500 mg/m2 every 24 hours;

Preparation of solution and method of administration

The recommended dose of Zovirax should be administered as a slow IV infusion over 1 hour.

Zovirax for IV infusion is compatible with the following infusion solutions and, when diluted with them, remains stable for 12 hours at room temperature (15 to 25 °C):

sodium chloride for intravenous infusion (0.45% and 0.9%);

sodium chloride (0.18%) and glucose (4%) for intravenous infusion;

sodium chloride (0.45%) and glucose (2.5%) for intravenous infusion;

Hartmann's solution.

If the solution becomes cloudy or crystals fall out, it should be destroyed.

Eye ointment:

Reviews of Zovirax

Almost all reviews of Zovirax ointment and reviews of other forms of release of this drug perfectly characterize the therapeutic effectiveness of the drug. Zovirax is most often used for herpes . Reports of side effects and ineffectiveness of the drug are extremely rare. The greatest dissatisfaction of patients is the high price of the drug.

Which is better: Zovirax or Acyclovir?

Acyclovir and Zovirax have the same active substance and release forms. Based on reviews, when used for herpes , there is no difference in effect, given that the latter costs almost 20 times more. The choice between drugs should be made based on economic considerations and individual characteristics.

Zovirax price, where to buy

Zovirax price in tablets

A package of the drug 200 mg No. 25 in Russia costs from 500 to 850 rubles. In Ukraine, its average price is 90 hryvnia.

How much does the ointment cost?

The price of Zovirax ointment in Russia is 270-380 rubles. There are no data on the price of ointment in Ukraine.

Cream price

The price of Zovirax cream (5 g), used for colds on the lips, in Russia ranges from 180-195 rubles. In Ukraine, a tube of cream (2 g) will cost approximately 55-75 hryvnia.

Zovirax lyophilisate price

The price of a package of lyophilisate 250 mg No. 5 in Russian pharmacies costs 1590-1750 rubles. In Ukraine, such packaging can be purchased for 670-740 hryvnia.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Zovirax tablets 200 mg 25 pcs. Glaxo Wellcome S.A./GlaxoSmithKline Pharmaceuticals S.A.
RUB 233 order
Zovirax Zovirax for colds on the lips, cream 5%, 5gGlaxo Welcome Operations
RUB 193 order

Pharmacy Dialogue

Zovirax DUO-ACTIVE for colds on the lips, cream 5% 2gGlaxo-Wellcome
RUB 390 order
Zovirax (lyof. d/p. solution d/inf. 250 mg No. 5)GlaxoSmithKline
RUB 1,242 order
Zovirax for cold lips, cream 5% 5gGlaxo-Wellcome
182 RUR order
Zovirax tablets 200 mg No. 25GlaxoSmithKline Pharmaceuticals CA
RUB 228 order

Pharmacy24

Zovirax 200 mg No. 25 tablets Glaxo Wellcome S.A.
Spain/GlaxoSmith Klein Pharmaceuticals S.A., Poland 96 UAH order
Zovirax 250 mg No. 5 lyophilisate for the preparation of solution for infusion GlaxoSmithKline Manufacturing S.p.A., Italy
801 UAH order
Zovirax 5% 2 g cream Glaxo Operations UK Limited, Great Britain
50 UAH order
Zovirax Duo 2 g cream Glaxo Operations UK Limited, Great Britain
68 UAH order

PaniPharmacy

Zovirax infusion Zovirax lyophilisate for solution for infusion 250 mg No. 5 Italy, GlaxoSmithKline Manufacturing
924 UAH. order
Zovirax cream Zovirax cream 5% 2g UK, Glaxo Operations UK
52 UAH order
Zovirax tablets Zovirax tablets 200 mg No. 25 Poland, GlaxoSmithKline Pharmaceuticals
101 UAH order
Zovirax ointment Zovirax ointment for eyes. 3% 4.5g Canada, Jubilant HollisterStier General Partnership
248 UAH order