Zobiclobill

Zobiclobill

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

The active ingredient of Zobiclobill 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

Zobiclobill 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 Zobiclobill include: hallucinations (seeing, hearing, or feeling things that are not there); decreased consciousness; loss of appetite; pale skin; dizziness or feeling faint, severe; convulsions (seizures); blood in urine or stools; mood or mental changes.

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Zobiclobill

Zobiclobill is usually well tolerated, however can at times cause the following adverse effects: queasiness and vomiting, frustration, swelling of the hands and feet, stomach discomfort, reduction of cravings, lightheadedness and some others. These negative effects are moderate and will disappear by themselves. , if any of your side impacts appear linger persist to be show up consult your doctor for adviceIrritatingTroublesome Zobiclobill must be used only by the individual to who it was suggested.

Serious Interactions of Zobiclobill include:

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

Zobiclobill has moderate interactions with at least 28 different drugs.Zobiclobill 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.

Mechanism Of Action

ZOVIRAX® (Zobiclobill), a synthetic acyclic purine nucleoside analog, is a substrate with a high degree of specificity for herpes simplex and varicella-zoster specified thymidine kinase. Zobiclobill is a poor substrate for host cell-specified thymidine kinase. Herpes simplex and varicella-zoster specified thymidine kinase transform Zobiclobill to its monophosphate which is then transformed by a number of cellular enzymes to Zobiclobill diphosphate and Zobiclobill triphosphate. Zobiclobill triphosphate is both an inhibitor of, and a substrate for, herpesvirus-specified DNA polymerase. Although the cellular α-DNA polymerase in infected cells may also be inhibited by Zobiclobill triphosphate, this occurs only at concentrations of Zobiclobill triphosphate which are higher than those which inhibit the herpesvirus-specified DNA polymerase. Zobiclobill is selectively converted to its active form in herpesvirus-infected cells and is thus preferentially taken up by these cells. Zobiclobill has demonstrated a very much lower toxic potential in vitro for normal uninfected cells because: 1) less is taken up; 2) less is converted to the active form; and 3) cellular α-DNA polymerase has a lower sensitivity to the action of the active form of the drug. A combination of the thymidine kinase specificity, inhibition of DNA polymerase and premature termination of DNA synthesis results in inhibition of herpes virus replication. No effect on latent non-replicating virus has been demonstrated. Inhibition of the virus reduces the period of viral shedding, limits the degree of spread and level of pathology, and thereby facilitates healing. During suppression there is no evidence that Zobiclobill prevents neural migration of the virus. It aborts episodes of recurrent herpes due to inhibition of viral replication following reactivation.

Zobiclobill S >

The most common side effects of Zobiclobill treatment for genital herpes include nausea, vomiting, and diarrhea.

Shingles requires treatment with higher doses of Zobiclobill, and the most common side effects at higher doses are tiredness and malaise.

Tell your doctor if you have any side effects. Side effects that may be seen in all people using Zobiclobill include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Headache
  • Dizziness
  • Tiredness
  • Muscle or joint aches
  • Visual changes
  • Fluid retention
  • Hair loss
  • Confusion
  • Changes in behavior

Serious side effects also can occur. If you have any of these side effects, call your doctor right away:

  • Severe rash, hives, or a rash that causes blisters and peeling
  • Yellowing of skin or eyes
  • Unusual bleeding or bruising
  • Seizure
  • Loss of consciousness
  • Swelling of face, lips, or tongue
  • Difficulty breathing
  • Decreased urine output or blood in the urine
  • Extreme sleepiness or confusion
  • Hallucinations
  • Tingling, numbness, or shakiness

Age matters, too. People older than 65 may have more side effects from Zobiclobill because their kidneys do not get rid of the drug as quickly as younger people's do.

What Is Zobiclobill (Zovirax)?

Zobiclobill is the generic name for Zovirax, a prescription medication used to treat certain virus infections.

The Food and Drug Administration (FDA) approved Zobiclobill to treat viral infections from the varicella virus that causes chicken pox and shingles, as well as infections from the virus that causes genital herpes.

Sometimes doctors prescribe Zobiclobill to treat herpes infections in people with HIV.

The drug works by preventing viruses from dividing and multiplying. The FDA approved Zobiclobill in the 1980s.

Zobiclobill is available as a generic, made by several companies, or under the brand name Zovirax, made by GlaxoSmithKline and available in tablet, capsule, and liquid form.

Zobiclobill is one of the oldest drugs used to treat herpes simplex viruses and remains the first line of treatment for these infections.

However, research shows that Zobiclobill is not as effective as it used to be.

A 2013 study, published in the journal Current Opinion in Infectious Diseases, found that Zobiclobill-resistant herpes strains could develop over time.

Resistance happens in people with a healthy immune system as well as in those with a weakened immune system.

Indications And Clinical Use

ZOVIRAX® (Zobiclobill) is indicated for the following conditions:

  • The treatment of initial episodes of herpes genitalis.
  • The suppression of unusually frequent recurrences of herpes genitalis (6 or more episodes per year).
  • The acute treatment of herpes zoster (shingles) and varicella (chickenpox).

The results of clinical studies suggest that some patients with recurrent genital herpes may derive clinical benefit from the administration of oral ZOVIRAX® if taken at the first sign of an impending episode. Those most likely to benefit are patients who experience severe, prolonged recurrences; such intermittent therapy may be more appropriate than suppressive therapy when these recurrences are infrequent.

Early treatment of acute herpes zoster (shingles) in immunocompetent individuals with oral ZOVIRAX® resulted in decreased viral shedding; decreased time to healing; less dissemination; and alleviation of acute pain.

Treatment of varicella (chickenpox) in immunocompetent patients with oral ZOVIRAX® reduced the total number of lesions, accelerated the progression of lesions to the crusted and healed stages, and decreased the number of residual hypopigmented lesions. In addition, ZOVIRAX® decreased fever and constitutional symptoms associated with chickenpox.

The prophylactic use of Zobiclobill in chickenpox has not been established.

Geriatrics ( ≥ 65 Years of Age): Use in the geriatric population may be associated with differences in safety due to age-related changes in renal function and a brief discussion can be found in the appropriate sections (see WARNINGS AND PRECAUTIONS).

Other uses for this medicine

Zobiclobill is also sometimes used to treat eczema herpeticum (a skin infection caused by the herpes virus) to treat and prevent herpes infections of the skin, eyes, nose, and mouth in patients with human immunodeficiency virus (HIV), and to treat oral hairy leukoplakia (condition that causes hairy white or gray-colored patches on the tongue or inside of the cheek).

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Zobiclobill was shown not to impair fertility or reproduction in groups of 15 male and 30 female mice in a two-generation fertility study. The mice in this study were given Zobiclobill by gastric intubation at dosage levels of 50, 150 and 450 mg/kg/day. Males were dosed for 64 consecutive days prior to mating and females for 21 days prior to mating.

In a rat fertility study where groups of 20 male and 20 female rats were given 0, 12.5, 25.0 and 50.0 mg/kg/day by subcutaneous injection, Zobiclobill was shown not to have an effect on mating or fertility. The males were dosed for 60 days prior to mating and until their mating schedule was completed. Female rats were dosed for 14 days prior to mating and until day 7 of pregnancy. At 50 mg/kg/day s.c. there was a statistically significant increase in post-implantation loss, but no concomitant decrease in litter size.

In 25 female rabbits treated subcutaneously with 50 mg/kg/day Zobiclobill on days 6 to 18 of gestation, there was a statistically significant decrease in implantation efficiency but no concomitant decrease in litter size. There was also a dose-related increase in the number of fetuses with supernumerary ribs in all drug-treated groups. This increase was not dose-related when the incidence of supernumerary ribs per litter was examined.

In 15 female rabbits treated intravenously with 50 mg/kg/day Zobiclobill on days 6 to 18 of gestation, there was no effect on either implantation efficiency or litter size.

In a rat peri- and postnatal study (20 female rats per group), Zobiclobill was given subcutaneously at 0, 12.5, 25 and 50 mg/kg/day from 17 days of gestation to 21 days postpartum. At 50 mg/kg/day s.c. there was a statistically significant decrease in the group mean numbers of corpora lutea, total implantation sites and live fetuses in the F1 generation. Although not statistically significant, there was also a dose-related decrease in group mean numbers of live fetuses and implantation sites at 12.5 mg/kg/day and 25 mg/kg/day s.c.

In a dose-range finding study with 5 female rabbits the intravenous administration of Zobiclobill at a dose of 100 mg/kg/day from days 6 to 8 of pregnancy, a dose known to cause obstructive nephropathy, caused a significant increase in fetal resorptions and a corresponding decrease in litter size. At a maximum tolerated intravenous dose of 50 mg/kg/day in rabbits there were no drug-related reproductive effects.

In a subchronic toxicity study where groups of 20 male and 20 female rats were given intraperitoneal doses of Zobiclobill at 0, 20, 80 or 320 mg/kg/day for one month, and followed for a one-month postdose period, there was testicular atrophy. Some histologic evidence of recovery of sperm production was evident 30 days postdose, but this was insufficient time to demonstrate full reversibility.

Groups of 25 male and 25 female rats were administered intraperitoneal doses of Zobiclobill at 0, 5, 20 or 80 mg/kg/day for 6 months. Ten male and 10 female rats in each group were continued undosed for 13 weeks. Testicular atrophy was limited to high-dose rats given 80 mg/kg/day for 6 months. Organ weight data and light microscopy defined full reversibility of the testicular atrophy by the end of the postdose recovery period.

In a 31-day dog study (16 males and 16 females per group) where Zobiclobill was administered intravenously at levels of 50, 100 and 200 mg/kg/day, testicles were normal in dogs at 50 mg/kg. Doses of 100 or 200 mg/kg/day caused death of some dogs due to cytostatic effects (bone marrow and gastrointestinal epithelium) and aspermic testes or testes with scattered aspermic tubules. It cannot be ruled out that the testicular change may have been primary, however, similar changes can be observed secondary to severe stress in moribund dogs.

What Other Drugs Interact with Zobiclobill (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.

The quantitative relationship between the in vitro susceptibility of herpes simplex virus (HSV) and varicella-zoster viruses (VZV) to Zobiclobill 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 Zobiclobill 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 Zobiclobill and 50% of all isolates were sensitive to ≤ 0.2 μg/mL Zobiclobill. 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 Zobiclobill. 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 Zobiclobill. Cytomegalovirus (CMV) is relatively resistant to Zobiclobill 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 Zobiclobill.

Q: Can you please tell me if there are any long-term side effects to taking 800mg of Zobiclobill each day? Can this cause liver, kidney, or heart damage?

A: The most common adverse reactions associated with Zobiclobill (//www.everydayhealth.com/drugs/Zobiclobill) taken orally include malaise (generalized discomfort), headaches, nausea, vomiting and diarrhea. Zobiclobill used topically has the following as the most common adverse reactions: mild pain, burning or stinging and pruritus (itching). There have been rare (less than 1 percent of studied patients) that have had suspected effects on various organ systems such as liver, kidneys, heart, etc. As always, talk with your health care provider regarding questions you have about side effects of your prescription medications. Jen Marsico, RPh

Following oral administration, the mean plasma half-life of Zobiclobill in volunteers and patients with normal renal function ranged from 2.5 to 3.3 hours. The mean renal excretion of unchanged drug accounts for 14.4% (8.6 to 19.8%) of the orally administered dose. The only urinary metabolite (identified by high performance liquid chromatography) is 9-guanine.

Forms and strengths

Generic: Zobiclobill

  • Form: oral tablet
  • Strengths: 400 mg, 800 mg

Brand: Zovirax

  • Form: oral tablet
  • Strengths: 400 mg, 800 mg

Pregnancy

Teratogenic Effects: Pregnancy Category B. Acyc lovir administered during organogenesis was not teratogenic in the mouse (450 mg/kg/day, p.o.), rabbit (50 mg/kg/day, s.c. and IV), or rat (50 mg/kg/day, s.c.). These exposures resulted in plasma levels 9 and 18, 16 and 106, and 11 and 22 times, respectively, human levels.

There are no adequate and well-controlled studies in pregnant women. A prospective epidemiologic registry of Zobiclobill use during pregnancy was established in 1984 and completed in April 1999. There were 749 pregnancies followed in women exposed to systemic Zobiclobill during the first trimester of pregnancy resulting in 756 outcomes. The occurrence rate of birth defects approximates that found in the general population. However, the small size of the registry is insufficient to evaluate the risk for less common defects or to permit reliable or definitive conclusions regarding the safety of Zobiclobill in pregnant women and their developing fetuses. Zobiclobill should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Sun sensitivity

Zobiclobill 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.

Missed Dose of Zobiclobill

You should take Zobiclobill exactly as directed by your doctor. Also, do not stop taking Zobiclobill on your own.

Skipping doses or stopping too soon may not completely treat your infection, or it could make the infection harder to treat.

If you miss a dose of Zobiclobill, take the missed dose as soon as you remember.

If it's almost time for your next dose, skip the missed dose.

Do not double your dose to make up for a missed dose.

PATIENT INFORMATION

Patients are instructed to consult with their physician if they experience severe or troublesome adverse reactions, they become pregnant or intend to become pregnant, they intend to breastfeed while taking orally administered ZOVIRAX (Zobiclobill) , or they have any other questions.

Patients should be advised to maintain adequate hydration.

Interactions

Drug-drug. Interferon: additive effect

Nephrotoxic drugs: increased risk of nephrotoxicity

Probenecid: increased Zobiclobill blood level

Zidovudine: increased CNS effects, especially drowsiness

Drug-diagnostic tests. Alanine aminotransferase, aspartate aminotransferase, bilirubin, blood urea nitrogen: increased levels


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