IV to Oral Conversion : Acyclovir

Availability:

• IV Acyclovir 250mg
• Tab Acyclovir 200mg

General

• Work as DNA polymerase inhibitors, thereby reducing DNA synthesis and viral replication

Indications

• Management of recurrent episodes of genital herpes
• Treatment of initial episodes of genital herpes
• Treatment of chickenpox (varicella)
• Treatment of herpes zoster (shingles)
• Herpes Simplex Encephalitis (IV only)
• Neonatal HSV infection (IV only)
• Recurrent cold sores (topical only)

Oral Acyclovir

• Low bioavailability, 10-20%
• Poorly absorbed from the GI tract
• Has a half life of 3 hours

Conversion

• Based on specific indications [refer to dosing guide in www.lexicomp.com]
• clinical efficacy of oral acyclovir in high-risk immunocompromised patients is limited by its low bioavailability
• some guidelines recommends IV to Oral conversion not applicable in Meningitis and endocarditis
• no oral conversion for encephalitis and meningitis

 References:

1. http://www.emedexpert.com/compare-meds/valacyclovir.shtml
2. www.lexicomp.com