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At a glance

Acyclovir is an antiviral medication used to treat herpes simplex virus infections, chickenpox, shingles and genital herpes. It prevents viral multiplication and helps clear the infection.

Indications

Herpes simplex virus infections (genital herpes, herpes labialis), chickenpox (varicella), shingles (herpes zoster).

Pharmacology

Acyclovir is activated by viral thymidine kinase to form acyclovir triphosphate. This triphosphate competitively inhibits viral DNA polymerase and incorporates into growing DNA chains causing chain termination, thereby stopping viral DNA replication.

Dosage

Herpes Simplex (Oral):

  • Adults: 200-400 mg 3-5 times daily for 5-10 days.
  • Children: 900 mg/m2/day every 8 hours (max 4 g/day).

Genital Herpes (Initial):

  • Adults: 200 mg 5 times daily for 10 days OR 400 mg 3 times daily for 7-10 days.

Genital Herpes (Recurrent):

  • Adults: 200 mg 5 times daily for 5 days OR 400 mg 3 times daily for 5 days OR 800 mg twice daily for 5 days.

Genital Herpes Suppression (Maintenance):

  • Adults: 400 mg twice daily.

Herpes Labialis (Cold Sores):

  • Adults: 400 mg 3 times daily for 5 days OR 200 mg 5 times daily for 5 days.

Shingles (Herpes Zoster):

  • Adults: 800 mg 5 times daily (every 4 hours) for 7-10 days.

Chickenpox (Children):

  • >2 years: 60-80 mg/kg/day (max 4 g/day) every 6-8 hours for 5 days.

Renal Adjustment: Adjust dose based on creatinine clearance.

Side effects

Common side effects: Headache, dizziness, nausea, vomiting, fatigue, fever, abdominal pain, diarrhea, skin rash, photophobia.

Serious (rare): Kidney damage (especially in dehydrated or renal impaired patients), neurological effects (confusion, hallucinations, seizures), elevated liver enzymes.

Use in pregnancy

Generally considered safe during pregnancy (Pregnancy Category: B). Animal studies have shown low or no adverse effects on the fetus; human studies are limited.

Pregnancy Category: B — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • Maintain adequate hydration (prevents kidney damage)
  • Consult your doctor during pregnancy and lactation
  • Use condoms and avoid sexual contact while genital herpes lesions are present
  • Dose adjustment needed in renal impairment
  • Does not usually affect driving ability
Overdose effects

Overdose symptoms: nausea, vomiting, diarrhea, confusion, renal impairment. Treatment: symptomatic and supportive measures; hemodialysis is effective.

Storage conditions

Store in a cool and dry place, protected from light. Keep out of reach of children.

Acyclovir — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.