Aciherp

Aciherp

  • Active Ingredient: Acyclovir
  • 800 mg, 400 mg, 200 mg
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What is Aciherp?

The active ingredient of Aciherp brand is acyclovir. Acyclovir is an antiviral drug. It slows the growth and spread of the herpes virus in the body. Acyclovir will not cure herpes, but it can lessen the symptoms of the infection. The inhibitory activity of acyclovir is highly selective due to its affinity for the enzyme thymidine kinase (TK) encoded by HSV and VZV. This viral enzyme converts acyclovir into acyclovir monophosphate, a nucleotide analogue. The monophosphate is further converted into diphosphate by cellular guanylate kinase and into triphosphate by a number of cellular enzymes. In vitro, acyclovir triphosphate stops replication of herpes viral DNA. This is accomplished in 3 ways: 1) competitive inhibition of viral DNA polymerase, 2) incorporation into and termination of the growing viral DNA chain, and 3) inactivation of the viral DNA polymerase. The greater antiviral activity of acyclovir against HSV compared with VZV is due to its more efficient phosphorylation by the viral TK.

Used for

Aciherp is used to treat diseases such as: Cold Sores, Herpes Simplex, Herpes Simplex - Congenital, Herpes Simplex Encephalitis, Herpes Simplex, Mucocutaneous/Immunocompetent Host, Herpes Simplex, Mucocutaneous/Immunocompromised Host, Herpes Simplex, Suppression, Herpes Zoster, Infectious Mononucleosis, Mononucleosis, Ramsay Hunt Syndrome, Varicella-Zoster.

Side Effect

Possible side effects of Aciherp include: changes in vision; decreased frequency of urination or amount of urine; Burning, prickling, or tingling sensations; decreased consciousness; blood in urine or stools; large hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs; trembling; clumsiness.

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Aciherp Interactions

Some drugs may affect the way Aciherp works, and Aciherp may affect other drugs you are taking.

It's very important to let your doctor know about all drugs you are taking, including any over-the-counter herbs or supplements.

Drugs that may interact with Aciherp include:

  • Several medications used to treat bacterial or fungal infections, including amphotericin B (Fungizone) and several antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex) and tobramycin (Tobi, Nebcin)
  • Over-the-counter pain relievers (Advil, Motrin, Aleve)
  • Medications used to treat HIV/AIDS, such as zidovudine (Retrovir, AZT)

There were no signs of toxicosis in Charles River CD (Sprague-Dawley) rats (100 rats/sex/dose group) given Aciherp by oral gavage at 50, 150 and 450 mg/kg in a lifetime oral carcinogenicity study. Mean plasma levels obtained in high-dose males 1.5 hours after dosing at various sampling times during the study were as follows: 1.54, 1.63, 1.39, 1.60 and 1.70 μg/mL (6.84, 7.26, 6.17, 7.10 and 7.56 μM) at days 7, 90, 209, 369 and 771, respectively. Corresponding mean values for the high-dose females were 1.76, 2.38, 2.12, 1.71 and 1.81 μg/mL (7.82, 10.58, 9.44, 7.62 and 8.03 μM) at days 7, 90, 209, 369 and 852, respectively.

Values for clinical laboratory tests including hematology, clinical chemistry, urinalysis, body weight, food consumption and ophthalmoscopy were all within normal ranges. There were no drug-induced gross or microscopic lesions and there was no evidence that Aciherp affected survival, temporal patterns of tumor incidence or tumor counts for benign or malignant neoplasms.

Most of the relatively few rats found dead or moribund during the first 52 weeks of this study suffered dosing accidents as evidenced by postmortem findings of esophageal perforation causing pleural effusion, pneumonia, or mediastinitis.

Charles River CD (Sprague-Dawley) rats were given suspensions of Aciherp by gavage. There were 50 male and 50 female rats at each of the following dose levels: 0, 50, 150 and 450 mg/kg. After 30 and 52 weeks of treatment, 10 male and 10 female rats from each group were necropsied. The remaining rats were dosed each day until natural mortality decreased a group size to approximately 20% of the number of animals of that sex present in the test groups when the study was started. All remaining rats were killed and necropsied when the 20% cut-off point was reached. This was during week 110 for the male rats and week 122 for the female rats. Tissues from control rats and those in the high-dose group were evaluated by light microscopy. Tissues from rats in the low and mid-dose groups having masses, nodules or unusual lesions were also examined by light microscopy. Fixed tissues from rats that were found dead during the first 52 weeks of the study were also evaluated by light microscopy.

No signs of toxicosis were observed. Plasma samples were collected 1.5 hours after dosing on days 7, 90, 209, 369, 771 (males only) and 852 (females only). Mean plasma levels found in high-dose males (450 mg/kg/day) at the times indicated above were as follows: 1.54, 1.63, 1.39, 1.60 and 1.70 μg/mL (6.84, 7.26, 6.17, 7.10 and 7.56 μM). Corresponding mean plasma levels for the high-dose females for the corresponding time periods were 1.76, 2.38, 2.12, 1.71 and 1.81 μg/mL (7.82, 10.58, 9.44, 7.62 and 8.03 μM). Plasma levels in both males and females at all dose levels after one year of treatment were generally comparable to plasma levels obtained at earlier samplings. Values for laboratory tests including hematology, clinical chemistry and ophthalmoscopy were all within the normal range. There were no drug-induced gross or microscopic lesions and there was no evidence that Aciherp affected survival.

What Other Drugs Interact with Aciherp (Zovirax)?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of this medicine or any drug before seeking medical advice from your doctor, healthcare provider or pharmacist first. To do so may result in serious consequences or side effects.

Sun sensitivity

Aciherp can make your skin more sensitive to the sun. This increases your risk of sunburn. Avoid the sun if you can. If you can't, be sure to wear protective clothing and apply sunscreen.

Q: What is Aciherp?

A: Aciherp (Zovirax) is an antiviral medication indicated for the acute treatment of herpes zoster (shingles), the treatment of initial episodes and the management of recurrent episodes of genital herpes and the treatment of chickenpox. Aciherp is only approved, by the U.S. Food and Drug Administration (FDA), for the treatment of chickenpox in the pediatric population 2 year of age and older. The safety and effectiveness of oral Aciherp in the pediatric population, younger than 2 years of age, has not been established. The dosage and administration of oral Aciherp depends upon the indication for use and age of the patient. Aciherp can be administered with or without food. Aciherp is the generic equivalent of Zovirax and is currently available, for oral administration, in capsule and tablet form and as a suspension for patients who have difficulty swallowing pills. Treatment with Aciherp should be initiated as soon as possible after the first appearance of symptoms, such as tingling, burning or blisters. Patients being treated with Aciherp are advised to stay adequately hydrated and take each dose with a full glass of water to protect the kidneys. The most frequently reported adverse reactions differed among clinical trials of Aciherp depending on the indication for use. During clinical trials of treatment with Aciherp, the most frequently reported adverse reactions included nausea, vomiting, diarrhea, malaise and headache. For the treatment of shingles, there is no information regarding initiation of treatment more than 72 hours following the onset of rash. Patients should initiate treatment as soon as possible after diagnosis. For the treatment of chickenpox, information gathered during clinical studies reflects initiation of treatment within 24 hours following rash. There is no information available regarding the effectiveness of treatment initiated after 24 hours. Patients should be advised that Aciherp is not a cure for genital herpes and there is no available research regarding whether Aciherp will prevent the transmission of the virus to other individuals.

Serious Interactions of Aciherp include:

  • amphotericin B deoxycholate
  • bacitracin
  • cidofovir
  • neomycin PO
  • oral probenecid
  • talimogene laherparepvec

Aciherp has moderate interactions with at least 28 different drugs.Aciherp has mild interactions with at least 65 different drugs.This document does not contain all possible interactions from the use of this medication. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Which drugs or supplements interact with Aciherp?

Aciherp may decrease levels of phenytoin (Dilantin) or valproic acid (Depakote, Depakote ER). Probenecid (Benemid) may increase Aciherp serum levels by decreasing renal excretion of Aciherp. Aciherp may increase serum levels of theophylline (Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin).

Combining Aciherp with cidofovir (Vistide), amphotericin B (Fungizone) or other drugs that reduce kidney function may increase harmful effects on the kidney.

What Is Aciherp (Zovirax) and How Does It Work?

Aciherp is approved by the Food and Drug Administration as a prescription drug that is commonly used as a topical, injectable, and oral treatment for genital herpes and cold sores. Herpes refers to a group of viruses that cause a variety of herpes infections including genital herpes, shingles, chicken pox (also chickenpox), cold sores, and encephalitis (inflammation of the brain). Herpes viral infections are very common. Genital herpes refers to a sexually transmitted disease (STD) that any sexually active person can contract and transmit.

Shingles and chicken pox are common skin conditions.Shingles and chicken pox are skin infections which are both caused by the herpes virus. They are not caused by the same virus that causes cold sores or genital herpes.

Many people who suffer from shingles or chicken pox (chickenpox) infection will experience symptoms such as a rash, often with pain, which is treatable with this drug.

Genital herpes is an STD caused by two types of viruses: herpes simplex type 1 and herpes simplex type 2. Most people with genital herpes do not know they have it. Still, symptoms often appear days to weeks after exposure. Symptoms of genital herpes generally include:

  • Flu-like symptoms such as fever, body aches, or swollen glands
  • Blisters, sores, or rash in the genital area with or without pain, itching, tingling
  • Blisters that pop open, causing painful sores.

Aciherp may also help treat pain associated with an outbreak of genital herpes after the sores heal.

There is no cure for herpes, however, this prescription is a treatment that helps to decrease and ease symptoms of herpes infections.

Aciherp is am antiviral drug that belongs to a class of medications called "antivirals," or "antiviral medications."

Your doctor may prescribe this drug as a treatment to relieve symptoms of your infection.

This medication is similar to the drug valAciherp (Valtrex), which is another medication that may also be prescribed for herpes infections.

This drug may cause serious side effects or mild side effects. This includes side effects that may affect the liver. Side effects that affect the skin as well as allergic reactions have occurred.

Aciherp is the generic equivalent of Zovirax.

The quantitative relationship between the in vitro susceptibility of herpes simplex virus (HSV) and varicella-zoster viruses (VZV) to Aciherp and the clinical response to therapy has not been established in man, and virus sensitivity testing has not been standardized. Sensitivity testing results, expressed as the concentration of drug required to inhibit by 50% the growth of virus in cell culture (ID50), vary greatly depending upon the particular assay used, the cell type employed, and the laboratory performing the test. The ID50 of Aciherp against HSV-1 isolates may range from 0.02 μg/mL (plaque reduction in Vero cells) to 5.9-13.5 μg/mL (plaque reduction in green monkey kidney cells). The ID50 against HSV-2 ranges from 0.01 to 9.9 μg/mL (plaque reduction in Vero and GMK cells, respectively).

Using a dye-uptake method in Vero cells, which gives ID50 values approximately 5 to 10-fold higher than plaque reduction assays, 1,417 HSV isolates (553 HSV-1 and 864 HSV-2) from approximately 500 patients were examined over a 5-year period. These assays found that 90% of HSV-1 isolates were sensitive to ≤ 0.9 μg/mL Aciherp and 50% of all isolates were sensitive to ≤ 0.2 μg/mL Aciherp. For HSV-2 isolates, 90% were sensitive to ≤ 2.2 μg/mL and 50% of all isolates were sensitive to ≤ 0.7 μg/mL of Aciherp. Isolates with significantly diminished sensitivity were found in 44 patients. It must be emphasized that neither the patients nor the isolates were randomly selected and, therefore, do not represent the general population. Most of the less sensitive HSV clinical isolates have been relatively deficient in the viral thymidine kinase (TK). Strains with alterations in viral TK or viral DNA polymerase have also been reported.

The ID50 against VZV ranges from 0.17-1.53 μg/mL (yield reduction, human foreskin fibroblasts) to 1.85-3.98 μg/mL (foci reduction, human embryo fibroblasts ). Reproduction of EBV genome is suppressed by 50% in superinfected Raji cells or P3HR-1 lymphoblastoid cells by 1.5 μg/mL Aciherp. Cytomegalovirus (CMV) is relatively resistant to Aciherp with ID50 values ranging from 2.3-17.6 μg/mL (plaque reduction, HEF cells) to 1.82-56.8 μg/mL (DNA hybridization, HEF cells). The latent state of the genome of any of the human herpesviruses is not known to be sensitive to Aciherp.

More common side effects

Some of the more common side effects of Aciherp oral tablet include:

Dosage Forms, Composition And Packaging

Suspension: Each teaspoonful (5 mL) of ZOVIRAX® Suspension contains 200 mg Aciherp and the non-medicinal ingredients banana flavour, cellulose, glycerin, methylparaben, propylparaben, sorbitol, vanillin, and water.

Tablets: Each ZOVIRAX® 200 Tablet contains 200 mg Aciherp and the non-medicinal ingredients cellulose, indigotine, lactose, magnesium stearate, povidone, and sodium starch glycolate.

ZOVIRAX® Suspension is available in bottles of 125 mL* and 475 mL. Each teaspoonful (5 mL) of off-white, banana-flavoured suspension contains 200 mg Aciherp.

*125 mL bottle not available in Canada

ZOVIRAX® 200 Tablets are available in bottles of 100 tablets. Each blue, shield-shaped, bevel-edged, compressed tablet contains 200 mg Aciherp, and is imprinted with “ZOVIRAX” on one side and a triangle on the reverse.

GlaxoSmithKline Inc., 7333 Mississauga Road, Mississauga, Ontario, L5N 6L4 1-800-387-7374. Revised: November 10, 2014

Summary

Aciherp (Zovirax) is an antiviral drug prescribed to treat genital herpes, shingles, and chickenpox. Side effects drug interactions, dosing, storage, and pregnancy safety information should be reviewed prior to taking this medication.

Q: I am in stage 1 of multiple myeloma. I was diagnosed nearly 3 years ago. The last 3 summers I have had attacks of shingles, the 1st year I took 1000 mg of Aciherp daily and avoided the painful stage. Last year I missed the spots as they were on my back and suffered greatly for 2 to 3 months and I am still taking 1000 mg Aciherp per day. Each time I stop the medication the fever returns for a couple of days followed by the first few spots. I am on my 5th lot of Aciherp, starting with 1000 mg per day, increasing to 2,400 per day and 2 weeks ago was prescribed 4000 mg per day for 21 days. I have managed 10 days at this level but there are so many side effects, including kidney pain, so I have reduced to 3 tablets of 800 mg each. I feel less "in a fog" and slightly better already but am afraid when I stop the shingles will return. I am concerned about the side effects. Can you give me advice please? The side effects are basically 90% of the ones mentioned on the leaflet in the box of 800 mg tablets at 5 per day.

A: Shingles is a painful rash that is caused by the same virus (varicella virus) that causes the chickenpox. Only people who were infected with the virus and got chickenpox can get shingles. Unfortunately, people with weakened immune systems, from other diseases like cancer or treatments like chemotherapy, are at much greater risk of developing shingles. Drugs like Aciherp (Zovirax) work to reduce the ability of the virus to multiply and spread in the body. Aciherp has been shown to reduce the duration of infection and the severity of symptoms, but it relies on an individual's immune system to attack the virus. The drug itself does not kill the virus and that is likely the reason you continue to have symptoms and relapses. It is possible that some of the painful effects you are experiencing are the result of complications of shingles. One of these complications is called postherpetic neuralgia, which is the painful, tingling, and stinging pain at the site of the initial rash. There are medications that are used to help treat the pain associated with the nerve damage of shingles. These drugs include the anticonvulsants, such as Neurontin (gabapentin), Lyrica (pregabalin), and Tegretol (carbamazepine) and tricyclic antidepressants like Elavil (amitriptyline). For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Michelle McDermott, PharmD


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