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The drug known by its generic name, Acyclovir, belongs to the synthetic nucleoside analogues group of drugs used primarily to treat particular viral infections. Manufactured by GlaxoSmithKline and marketed as Zovirax, it comes in liquid, capsule and tablet forms. But acyclovir remains the oldest form of treatment for the herpes simplex 1 and simplex 2 viruses, or cold sores and genital herpes, which cause infections in those afflicted with HIV.
When a virus takes over a living cell and reproduces itself, at the host cell’s expense, acyclovir is converted into an activated form by the same virus, enabling it to use acyclovir’s active form instead of the nucleoside which it normally uses in the manufacture of DNA; DNA is a crucial element in the replication of a virus. Simply put, cells which have been virally infected tend to absorb more of the acyclovir than their normal counterparts; therefore there is more conversion of it into active forms, a condition which helps prolong the anti-viral activity. Acyclovir is not a curative treatment for viral infections but it can shorten the duration of the infections and lessen their possibility of developing into more serious medical conditions. In initial cases of genital herpes, acyclovir helps reduce lesions and decreases severity and frequency of infections which are recurrent. Depending on the severity of the genital herpes infection of an individual who has it for the first time, an oral dosage of acyclovir at 400mg thrice a day has been recommended by the CDCP or Center for Disease Control and Prevention; this dosage has to be ingested between seven and ten days.
The patient may then choose to have daily or episodic therapy; the former is also known as suppressive therapy. Patients who have existing conditions of HIV should take 400mg of oral acyclovir thrice a day between five and ten days. While there haven’t been sufficient clinical studies on the use of acyclovir by pregnant women and subsequent adverse effects, nursing women are cautioned against ingesting acyclovir since this can be transferred to an infant as an excretion in breast milk.
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Treatment for herpes simplex virus infections of the skin and mucous membranes including initial and recurrent genital herpes.
Treatment of primary herpes simplex infections, including genital herpes: 200 mg five times daily (usually every 4 hours while awake) for 5 to 10 days. Severely immunocompromised patients or those with impaired absorption: 400 mg five times daily for 5 days. Prophylaxis of herpes simplex in immunocompromised patients: 200 to 400 mg four times daily. Chronic suppressive treatment: is not suitable for mild or infrequent recurrences of herpes simplex. Administration in renal impairment: Doses of acyclovir should be reduced in renal impairment according to creatinine clearance (CC).


Acyclovir is contraindicated for patients who develop hypersensitivity to acyclovir or valacyclovir.
Occasional adverse effects after systemic administration include increased serum bilirubin and liver enzymes, haematological changes, skin rashes (including erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis), fever, headache, dizziness and gastrointestinal effects such as nausea, vomiting and diadiarrhoea.
The drug is also used for prophylaxis against herpes family viruses in immunocompromised patients (such as patients undergoing cancer chemotherapy).
Alghough Acyclovir is considered a narrow range antiviral agent and presents a relatively low cytotoxicity, it negatively and aggressively affects the state of biological equilibrium in a living organism. The drug’s toxicity should be considered in all patients where any organs have an impaired function, especially liver or kidneys.
When using the drug, it is advised to reduce dietary calcium as it alters calcium metabolism and drink plenty of water to reduce the strain on the kidneys.
Acyclovir should only be used as a last measure of the viral control if other methods are not effective. Information DisclaimerBy using this website the user assumes all responsibility and risk associated with using the information provided herein. In jurisdictions which do not allow some or all of the usage exception provided, liability shall be limited to the maximum extend allowed by an applicable law. Acyclovir is a prescriptive medication that prevents the division and multiplication of viruses responsible for said infections. When the active acyclovir is incorporated into a new virus in the DNA, production of DNA stops. Taking acyclovir for treatment of genital herpes can help reduce its severity or prevent it from further recurrences. The latter is experienced as a painful rash which could develop several years after having had chicken pox with the reactivation of the virus.
For shingles, acyclovir helps reduce pain, shorten the duration for healing, and halts the formation of more lesions and further spread of the virus.
Acyclovir may be used intravenously for patients who have severe cases of genital herpes as well as those whose immune systems are compromised.
Those who elected episodic therapy can choose to take acyclovir orally at 400mg thrice daily for a total of five days, 800mg thrice daily for a total of two days or 800mg twice a day for a total of five days.
For suppressive therapy, the CDCP recommends 400mg of oral acyclovir twice daily; those who are already infected with HIV should take it between 400mg and 800mg two or three times daily. There have  not been any reported cases where Acyclovir would cause the patient  to fail a drug test.


In such cases episodic treatment of recurrences may be more beneficial; a dose of 200 mg five times daily for 5 days has been recommended, preferably initiated during the prodromal period.
Acyclovir should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. However, in immune-compromised people, continuous use of the drug can lead to development of a viral resistance (viral mutation), significantly decreasing the effectiveness of the agent. Other methods of viral control are low carbohydrate diet, restoration of the digestive function, particularly protein absorption with protease enzymes, restoration of the intestinal flora particularly with acidophilus probiotics, reduction of stress, staying warm, dietary avoidance of coffee, beverages that contain citric acid, arginine rich foods, and raising body alkalinity with foods and especially with consumption of lemons. FDA (Food and Drug Administration) approved the drug for use against the virus known as varicella-zoster in the treatment of viral infections which caused shingles and chicken pox. A study published last year, however, revealed that herpes strains which are resistant to acyclovir could develop over a certain period of time.
Aside from acyclovir’s availability in 200 mg capsules, 400mg and 800mg tablets, and 200mg and 5ml liquid suspension, it is also available as a 50mg or 40ml injection, a 500mg and 1000mg powder and as 5% ointment. There have been reports of seizures, hepatitis, agitation, hypersensitivity reaction, muscle pain, and anemia, all of which must be reported to the patient’s doctor for advisement.
Once the drug resistance is developed, it would also reduce the effectiveness of other antiviral drugs such as valaciclovir and famciclovir. If any kidney discomfort continues with usage of the drug, it should be immediately discontinued. Supplementation of L-Lysine amino acid at 250-500mg daily in mornings for a couple of weeks can be helpful. Doctors have also prescribed acyclovir in the treatment of the Epstein-Barr virus which causes mononucleosis. Therefore, in order for the medication being effective, it has to be taken every few hours to sustain its concentration in the blood stream. If a long term acyclovir administration is warranted, the agent’s blood plasma concentrations should be measured regularly to avoid severe intoxication, especially in patients with renal dysfunctions.
Immunomodulatory herbs such as andrographis paniculata can be very helpful short term as well.



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