Indications

Acyvir cream is indicated for the treatment of initial and recurrent labial and genital Herpes simplex infections. Treatment should begin as early as possible.

Pharmacology

Aciclovir is a synthetic purine derivative. It exerts its antiviral effect on Herpes simplex virus (HSV) and Varicella zoster virus by interfering with DNA synthesis and inhibiting viral replication. In cells infected with herpes virus, the antiviral activity of Aciclovir
appears to depend principally on the intracellular conversion of the drug to Aciclovir Triphosphate. Aciclovir is converted to Aciclovir Monophosphate principally via virus coded thymidine kinase; the monophosphate is phosphorylated to the diphosphate via cellular guanylate kinase and then via other cellular enzyme to the triphosphate, which is the pharmacologically active form of the drug. Percutaneous absorption of Aciclovir appears to be minimal following topical application of the drug to intact skin.

Dosage & Administration

Acyclovir cream should be applied to lesions 5 times daily for 5-10 days. The affected area should be kept clean and dry; patients should be instructed to wear loose-fitting clothing to avoid irritation to the lesion.

Safety and effectiveness in pediatric patients less than 12 years of age have not been established.

Interaction

Clinical experience has identified no interactions resulting from topical or systemic administration of other drugs concomitantly with Acyvir cream. Due to minimal systemic absorption of Acyvir cream, systemic drug interactions are unlikely.

Contraindications

Acyclovir cream is contraindicated in patients with known hypersensitivity to acyclovir, valacyclovir, or any component of the formulation.

Side Effects

The most common adverse reactions at the site of topical application were dry lips, desquamation, dryness of skin, cracked lips, burning skin, pruritus, flakiness of skin, and stinging on skin; each adverse reaction occurred in less than 1% of patients receiving Acyvir cream and placebo. Three patients on Acyvir cream and one patient on placebo discontinued treatment due to an adverse event.

Pregnancy & Lactation

Pregnancy category B. Aciclovir should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. Caution should be exercised when it is administered to a nursing mother.

Precautions & Warnings

Acyvir cream should only be applied on the affected external aspects of the lips and face in patients with herpes labialis. Because no data are available, application to human mucous membranes is not recommended. Acyvir cream is intended for cutaneous use only and should not be used in the eye or inside the mouth or nose. Cream has a potential for irritation and contact. The effect of Acyvir cream has not been established in immunocompromised patients.

Use in Special Populations

Pediatric Use: An open-label, uncontrolled trial with Acyvir cream 5% was conducted in 113 patients aged 12 to 17 years with recurrent herpes labialis. In this trial, therapy was applied using the same dosing regimen as in adults and subjects were followed for adverse events. The safety profile was similar to that observed in adults. Safety and effectiveness in pediatric patients less than 12 years of age have not been established.

Geriatric Use: Clinical studies of Acyvir cream did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Systemic absorption of Acyvir after topical administration is minimal.

Therapeutic Class

Topical Antiviral preparations

Storage Conditions

Store Acyvir cream at room temperature between 20°C to 25°C
Pack Image of Acyvir 5% w/w Cream Pack Image: Acyvir 5% w/w Cream
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