ADR: Bullous on Acyclovir Infusion

Availability in Hospital Keningau:

• IV Acyclovir 250mg

Indication:

• Treatment and prophylaxis of herpes simplex in immunocompromised, severe initial genital herpes and Varicella -Zoster.

 Skin Reactions

• According to previous report, adverse cutaneous reactions have been reported with all routes of administration
• Local inflammation or phlebitis at the injection site are well-known dermatologic reactions of intravenous acyclovir therapy.
• Common dermatological reactions include alopecia, erythema multiforme, photosensitive rash, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, and urticaria
•  Severe local inflammatory reactions, including tissue necrosis, have occurred following infusion of acyclovir into extravascular tissues
• There are rarely reported on acyclovir infusion induced the bullous.
• But recently, Yorulmaz et al., 2015, present a case of localized bullous eruption and phlebitis associated with intravenous acyclovir treatment in a patient with metastatic breast cancer
• Others case reported of acyclovir infusion induced bullous which mostly appeared after 10-15 days of infusion.

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271519/
2. https://www.ncbi.nlm.nih.gov/pubmed/26911608
3. https://aidsinfo.nih.gov/drugs/8/acyclovir/39/professional
4. http://www.jacionline.org/article/S0091-6749(16)31818-8/fulltext
5. Formulary Ubat KKM August, 2017