When is Zovirax ointment prescribed?

Composition and release form

5 pcs in blister; There are 5 blisters in a box.

in bottles; There are 5 bottles in a box.

in tubes of 4.5 g; 1 tube in a cardboard box.

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).

Description of the dosage form

Tablets: blue, flat, shield-shaped (irregular polygonal) tablets; On one side there is the inscription “ZOVIRAX” and on the other there is a triangle. Minor inclusions may be visible on the surface of the tablet.

Powder for the preparation of solution for injection: sintered mass (porous cake) or lyophilized powder of white or almost white color. The drug is hygroscopic.

Eye ointment: soft, homogeneous, white or almost white, translucent oily mass with a weak characteristic odor, free of grains, lumps and foreign particles.

pharmachologic effect

Pharmacological action - antiviral.

After entering virus-infected cells, acyclovir is converted by viral thymidine kinase to acyclovir monophosphate, which is then sequentially phosphorylated to diphosphate and triphosphate by the action of cellular enzymes. Acyclovir triphosphate acts as a nonspecific inhibitor and substrate for viral DNA polymerase, is included in the viral DNA chain, causes chain termination and blocks further replication of viral DNA without damaging host cells.

Pharmacokinetics

After oral administration, acyclovir is only partially absorbed from the intestine. When taking 200 mg of acyclovir every 4 hours, the mean maximum steady-state plasma concentration (Cssmax) was 3.1 µmol (0.7 µg/ml), and the mean steady-state minimum plasma concentration (Cssmin) was 1.8 µmol (0.4 µg/ml). When taking 400 and 800 mg of acyclovir every 4 hours, Cssmax was 5.3 µmol (1.2 µg/ml) and 8 µmol (1.8 µg/ml), respectively, and Cssmin was 2.7 µmol (0.6 µg/ml ) and 4 µmol (0.9 µg/ml), respectively.

After intravenous administration of acyclovir to adults, the mean Cmax values ​​1 hour after infusion at doses of 2.5 mg/kg, 5 mg/kg, 10 mg/kg and 15 mg/kg were 22.7 µmol (5.1 µg/ml ); 43.6 µmol (9.8 µg/ml); 92 µmol (20.7 µg/ml) and 105 µmol (23.6 µg/ml), respectively. Cmin 7 hours after infusion was respectively equal to 2.2 µmol (0.5 µg/ml); 3.1 µmol (0.7 µg/ml); 10.2 µmol (2.3 µg/ml) and 8.8 µmol (2.0 µg/ml). In children over 1 year of age, similar Cmax and Cmin were observed when administered at a dose of 250 mg/m2 instead of 5 mg/kg (adult dose) and at a dose of 500 mg/m2 instead of 10 mg/kg (adult dose). In neonates (0 to 3 months) who received acyclovir as an infusion over 1 hour every 8 hours, Cmax was 61.2 µmol (13.8 µg/ml) and Cmin was 10.1 µmol (2.3 µg/ml). Their T1/2 was 3.8 hours.

T1/2 in adults is 2.5–3.3 hours. Most of the drug is excreted unchanged by the kidneys. The renal clearance of acyclovir significantly exceeds the clearance of creatinine, which indicates that acyclovir is eliminated through not only glomerular filtration, but also tubular secretion. The main metabolite of acyclovir is 9-carboxymethoxy-methylguanine, which accounts for about 10–15% of the administered dose in the urine. When acyclovir was administered 1 hour after taking 1 g of probenecid, the T1/2 of acyclovir and the area under the plasma concentration-time curve increased by 18 and 40%, respectively.

In elderly people, the clearance of acyclovir decreases with age in parallel with a decrease in creatinine clearance, but the T1/2 of acyclovir changes slightly.

In patients with chronic renal failure, T1/2 of acyclovir averaged 19.5 hours, and during hemodialysis, the average T1/2 of acyclovir was 5.7 hours, and the concentration of acyclovir in plasma decreased by approximately 60%.

The concentration of acyclovir in the cerebrospinal fluid is approximately 50% of its plasma concentration. Acyclovir binds to plasma proteins to a small extent (9–33%), so drug interactions due to displacement from protein binding sites are unlikely.

When acyclovir and zidovudine were administered simultaneously to HIV-infected patients, the pharmacokinetic characteristics of both drugs remained virtually unchanged.

After applying ophthalmic ointment, acyclovir is quickly absorbed by the corneal epithelium and periocular tissues, resulting in the concentration of the drug necessary to suppress the virus in the intraocular fluid. After using Zovirax ophthalmic ointment, acyclovir is detected only in the urine, and in small quantities.

Clinical pharmacology

In patients with severe immunodeficiency, long-term or repeated courses of acyclovir therapy may lead to the emergence of resistant strains, and therefore further treatment with acyclovir may be ineffective. The majority of isolated strains with reduced sensitivity to acyclovir had a relatively low content of viral thymidine kinase and a disorder in the structure of viral thymidine kinase or DNA polymerase. The effect of acyclovir on HSV strains in vitro can also lead to the formation of strains that are less sensitive to it. A correlation has not been established between the sensitivity of HSV strains to acyclovir in vitro and the clinical effectiveness of the drug.

It has been shown that intravenous administration of Zovirax in high doses reduces the incidence and delays the development of CMV infection. If, after infusion therapy with Zovirax in a high dose, treatment with Zovirax for oral administration in a high dose is carried out for 6 months, then mortality and the incidence of viremia are reduced.

Indications for Zovirax®

Powder for solution for injection:

treatment of infections caused by the herpes simplex virus;

prevention of infections caused by the herpes simplex virus in patients with immunodeficiency;

treatment of infections caused by the varicella zoster virus and herpes zoster;

treatment of infections caused by the herpes simplex virus in newborns;

prevention of CMV infections in bone marrow transplant recipients.

Pills:

treatment of skin and mucous membrane infections caused by the herpes simplex virus, including primary and recurrent genital herpes;

prevention of relapses of infections caused by the herpes simplex virus in patients with normal immune status;

prevention of infections caused by the herpes simplex virus in patients with immunodeficiency;

treatment of chickenpox and herpes zoster;

treatment of patients with severe immunodeficiency, mainly with HIV infection (CD4+ cell count < 200/mm3, early clinical manifestations of HIV infection and stage of AIDS) and who have undergone bone marrow transplantation.

Eye ointment: treatment of keratitis caused by the herpes simplex virus.

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.

Use during pregnancy and breastfeeding

An analysis of acyclovir treatment of women during pregnancy did not reveal an increase in the number of birth defects in their children compared to the general population. However, caution should be exercised when prescribing Zovirax to women during pregnancy and assess the expected benefit to the mother and the possible risk to the fetus.

After taking Zovirax orally at a dose of 200 mg 5 times a day, acyclovir was detected in breast milk in concentrations ranging from 0.6 to 4.1 of plasma concentrations. At such concentrations in breast milk, breastfed children can receive acyclovir at a dose of up to 0.3 mg/kg/day. Given this fact, caution should be exercised when prescribing Zovirax to nursing women.

Side effects

Powder for solution for injection, tablets

Gastrointestinal tract: nausea, vomiting; when taken orally - diarrhea, abdominal pain.

Blood system: anemia, leukopenia and thrombocytopenia.

Hypersensitivity reactions and skin: rash, photosensitivity, urticaria, itching, fever; rarely - shortness of breath, angioedema, anaphylaxis; with intravenous administration - severe local inflammatory reactions leading to necrosis of the skin when Zovirax solution gets under the skin.

Kidneys: rarely - increased levels of urea and creatinine in the blood. This complication is believed to be related to plasma Cmax and the patient's hydration status. To avoid such phenomena, instead of an IV bolus injection, a slow infusion over 1 hour should be prescribed. Patients should be maintained in fluid balance. Renal failure that develops during treatment with Zovirax for intravenous infusion usually resolves quickly when patients are rehydrated and/or the dose of the drug is reduced or discontinued. Progression to acute renal failure occurs in exceptional cases.

Liver: reversible increase in bilirubin levels and liver enzyme activity; with intravenous administration - hepatitis and jaundice (very rare).

CNS: when administered intravenously, reversible neurological deficits such as confusion, hallucinations, agitation, tremor, somnolence, psychosis, seizures and coma have commonly been observed in patients with predisposing conditions; when taken orally - headache; rarely - reversible neurological disorders.

Others: fatigue; rarely - rapid diffuse hair loss (no connection with taking acyclovir has been established).

In patients receiving antiretroviral drugs (mainly Retrovir orally), additional use of Zovirax did not cause a significant increase in toxic effects.

Eye ointment

From the immune system: very rarely (<1/10000) - immediate hypersensitivity reaction, including angioedema.

On the part of the organ of vision: very often (>1/10) - punctate superficial keratopathy (does not require cessation of treatment and disappears without consequences); often (from >1/100 to <1/10) - mild burning sensation that goes away with time, conjunctivitis; rarely (>1/10000 to <1/1000) - blepharitis.

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 clinically significant interactions were observed with Zovirax.

Acyclovir is excreted unchanged into the urine by active tubular secretion. All drugs with a similar route of elimination may increase plasma concentrations of acyclovir. CCBs and cimetidine increase the AUC of acyclovir and reduce its renal clearance (no dose adjustment is required due to the wide range of therapeutic doses of acyclovir).

In patients receiving IV Zovirax, caution is required when coadministering drugs that compete for elimination due to the potential for increased plasma levels of one, both drugs, or their metabolites. The combined use of acyclovir and mycophenolate mofetil leads to an increase in the AUC for acyclovir and the inactive metabolite mycophenolate mofetil.

Caution should be used when combining intravenous administration of Zovirax (monitoring of renal function is necessary) with drugs that impair renal function (for example, cyclosporine, tacrolimus).

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.

Directions for use and doses

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 (with the exception of herpetic encephalitis) and FOG - intravenous infusion at a dose of 5 mg/kg every 8 hours.

Treatment of infections caused by FOG and herpetic encephalitis in patients with immunodeficiency - intravenous 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. The duration of treatment is 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 - intravenous infusion at a dose of 250 mg/m2 every 8 hours.

Treatment of herpetic encephalitis and infections caused by FOG in children with immunodeficiency - intravenous 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, 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.

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 243 order
• Zovirax Zovirax for colds on the lips, cream 5%, 5gGlaxo Welcome Operations

  RUB 193 order

• Zovirax Zovirax DUO-ACTIVE for colds on the lips, cream 5%, 2gGlaxo Welcome Operations/Contract Pharmaceuticals Limited

  RUR 387 order

• Zovirax Lyof. for prig solution for inf. 250 mg 5 pcs GlaxoSmithKline SpA

  RUB 1,325 order

Pharmacy Dialogue

• Zovirax (lyof. d/p. solution d/inf. 250 mg No. 5)GlaxoSmithKline

  RUB 1,203 order

• Zovirax (200 mg tablet No. 25) Glaxo Wellcome S.A.

  RUB 246 order

• Zovirax for cold lips, cream 5% 5gGlaxo-Wellcome

  177 RUR order

• Zovirax DUO-ACTIVE for colds on the lips, cream 5% 2gGlaxo-Wellcome

  RUB 401 order

• Zovirax tablets 200 mg No. 25GlaxoSmithKline Pharmaceuticals CA

  RUB 228 order

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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

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Precautionary measures

In case of renal failure, Zovirax doses should be adjusted according to its degree to prevent the accumulation of acyclovir in the body.

In patients receiving IV Zovirax in high doses for herpetic encephalitis, it is necessary to monitor renal function, especially if it is initially impaired or there is dehydration.

Patients taking high doses of Zovirax by mouth should receive sufficient fluids.

The prepared Zovirax solution has a pH of 11.0 and cannot be used orally.

Patients should be informed of the possibility of a transient mild burning sensation after application of Zovirax ophthalmic ointment. During treatment with the drug, patients should not wear contact lenses.

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 .