Aciclovir
Active form: Acyclovir Triphosphate.
JFDA label: Virustat-200 mg tablet
Mechanism of Action
Inhibitor of DNA polymerase catalytic subunit — Human herpesvirus 1 DNA polymerase inhibitor
| Target | Action | Gene / class |
|---|---|---|
| DNA polymerase catalytic subunit efficacy | INHIBITOR |
Indications
Approved
- Chickenpox — chickenpox
- Eye Infections — eye infection
- Herpes Genitalis — genital herpes
- Herpes Labialis — Herpes Labialis
- Herpes Simplex — Herpes simplex infection
- Herpes Zoster — Herpes Zoster
- Virus Diseases — viral disease
Off-label
- Cytomegalovirus Infections
- HIV Infections
Antimicrobial Spectrum
Expected / intrinsic spectrum (EUCAST breakpoints & labels) — not local resistance. Source: openfda-label.
Viruses
| Organism | Activity | MIC |
|---|---|---|
| Herpes Simplex | Active | — |
Adverse Reactions
Vascular disorders (1)
Common Phlebitis (IV)
Nervous system disorders (2)
Common Headache
Uncommon CNS effects (IV — confusion, hallucinations, seizures)
Renal and urinary disorders (1)
Uncommon Nephrotoxicity (IV, dehydrated patients)
Gastrointestinal disorders (1)
Common Nausea
Pregnancy & Lactation
Pregnancy
Safe
Recommended for primary genital herpes in pregnancy (oral). IV for disseminated VZV infection or neonatal herpes prevention. Suppressive therapy from 36 weeks for recurrent genital herpes
Lactation
Even with the highest maternal dosages, the dosage of acyclovir in milk is only about 1% of a typical infant dosage and would not be expected to cause any adverse
Chemistry & Properties
| Formula | C8H11N5O3 |
|---|---|
| Molecular weight | 225.21 g/mol |
| IUPAC name | 2-amino-9-(2-hydroxyethoxymethyl)-1H-purin-6-one |
| CAS | 59277-89-3 |
| PubChem CID | 135398513 |
| InChIKey | MKUXAQIIEYXACX-UHFFFAOYSA-N |
| logP | -1.33 (XLogP -1.9) |
| Polar surface area | 119.05 Ų |
| H-bond acceptors / donors | 7 / 3 |
| Drug-likeness (QED) | 0.55 |
| Lipinski violations | 0 |
SMILES
Nc1nc2c(ncn2COCCO)c(=O)[nH]1Biology & Pharmacokinetics
Pharmacokinetics
| BBB penetrant | Yes (logBB -0.8) |
|---|
Transporters
BCRP (Inhibitor)BCRP (Inhibitor)BSEP (Inhibitor)BSEP (Inhibitor)CNT2 (Inhibitor)CNT3 (Inhibitor)MDR1 (Inhibitor)MRP1 (Inhibitor)MRP2 (Inhibitor)MRP3 (Inhibitor)MRP4 (Inhibitor)OAT1 (Inhibitor)OAT2 (Inhibitor)OAT3 (Inhibitor)OAT4 (Inhibitor)OATP1B1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)OATP1B3 (Inhibitor)OATP2B1 (Inhibitor)OCT1 (Inhibitor)OCT2 (Inhibitor)OCTN2 (Inhibitor)P-gp (Inhibitor)PEPT1 (Inhibitor)PEPT2 (Inhibitor)ASBT (Substrate)MATE1 (Substrate)MATE2 (Substrate)MDR1 (Substrate)OAT (Substrate)OAT1 (Substrate)OAT2 (Substrate)OAT3 (Substrate)OCT1 (Substrate)OCT2 (Substrate)P-gp (Substrate)PEPT1 (Substrate)Transporter(unspecified) (Substrate)
Drug–drug interactions (48, DDInter)
| Interacting drug | Severity | Management |
|---|---|---|
| Cidofovir | major | |
| Diatrizoate | major | |
| Everolimus | major | |
| Inotersen | major | |
| Iodipamide | major | |
| Iodixanol | major | |
| Iohexol | major | |
| Iopamidol | major | |
| Iopromide | major | |
| Iothalamic acid | major | |
| Ioversol | major | |
| Ioxilan | major | |
| Sirolimus | major | |
| Tacrolimus | major | |
| Temsirolimus | major | |
| Tizanidine | major | |
| Varicella Zoster Vaccine (Recombinant) | major | |
| Balsalazide | moderate | |
| Ceftazidime | moderate | |
| Cladribine | moderate | |
| Clofarabine | moderate | |
| Cyclosporine | moderate | |
| Entecavir | moderate | |
| Ethotoin | moderate | |
| Fosphenytoin | moderate | |
| Givosiran | moderate | |
| Ifosfamide | moderate | |
| Lithium carbonate | moderate | |
| Meperidine | moderate | |
| Mephenytoin | moderate | |
| Mesalazine | moderate | |
| Olsalazine | moderate | |
| Pemetrexed | moderate | |
| Phenytoin | moderate | |
| Plazomicin | moderate | |
| Ramelteon | moderate | |
| Remdesivir | moderate | |
| Sulfasalazine | moderate | |
| Talimogene laherparepvec | moderate | |
| Trospium | moderate |
Showing 40 of 48.
Registered Products (28)
| Brand | Form / strength | Pack | Agent | Citizen (JOD) |
|---|---|---|---|---|
| CYCLOHERP CREAM | Cream 50 mg | 2 g tube pack varies | Dar Al Dawa Development and Investment Co Ltd/Jordan | 2.220 |
| herpavir cream | Cream 5 % | 2 g tube pack varies | MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN | 2.220 |
| Imavir skin cream | Cream 5 % | 5 g tube pack varies | Amman Pharmaceutical Indusries | 2.560 |
| herpavir cream | Cream 5 % | 5 g tube pack varies | MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN | 2.560 |
| Zovirax Cream | Cream 5 % | 2 g tube pack varies | Suleiman Tannous & Sons Co. Ltd | 3.260 |
| Zovirax 200mg/5 ml Oral Suspension | Suspension 200 mg\5 ml | 125 ml | Suleiman Tannous & Sons Co. Ltd | 3.770 |
| CYCLOHERP CREAM | Cream 50 mg | 10 g tube pack varies | Dar Al Dawa Development and Investment Co Ltd/Jordan | 4.870 |
| Civar Cream | Cream 5 % | 10 g tube | Pharma International Company/ Jordan | 4.870 |
| Herpoles Cream | Cream 5 % w/w | 10 g tube | PHILADELPHIA PHAEMACEUTICALS.COMP/JORDAN | 4.870 |
| herpavir cream | Cream 5 % | 10 g tube pack varies | MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN | 4.870 |
| Zovirax Cream | Cream 5 % | 10 g tube pack varies | Suleiman Tannous & Sons Co. Ltd | 5.410 |
| Supraviran | Tablet 200 mg | 25 tab | Nabulsi Drug Store | 6.160 |
| Zovirax Tablets | Tablet 200 mg | 25 tab | Suleiman Tannous & Sons Co. Ltd | 6.580 |
| Imavir skin cream | Cream 5 % | 15 g tube pack varies | Amman Pharmaceutical Indusries | 7.300 |
| Zovirax Opth. Ointment | Ointment 3 % | 4.5 g tube | Suleiman Tannous & Sons Co. Ltd | 7.640 |
| Virustat-200 mg tablet | Tablet 200 mg | 25 tab pack varies | AL-RAM PHARMA.INDUS.CO.LTD/JORDAN | 7.780 |
| herpavir capsule | Capsule 200 mg | 30 cap | MIDDLE EAST PHARMA&CHEMICAL IND/JORDAN | 7.940 |
| Virustat-200 mg tablet | Tablet 200 mg | 30 tab pack varies | AL-RAM PHARMA.INDUS.CO.LTD/JORDAN | 9.340 |
| Virustat-400mg tablets | Tablet 400 mg | 20 tab pack varies | AL-RAM PHARMA.INDUS.CO.LTD/JORDAN | 16.170 |
| Virpes tablet | Tablet 400 mg | 30 tab | The Arab Pharmaceutical Manufacturing PSC/Salt | 19.500 |
| Virpes tablet | Tablet 800 mg | 30 tab | The Arab Pharmaceutical Manufactruing Co. | 24.840 |
| Zovirax Tablets | Tablet 800 mg | 35 tab | Suleiman Tannous & Sons Co. Ltd | 28.980 |
| Virustat-400mg tablets | Tablet 400 mg | 40 tab pack varies | AL-RAM PHARMA.INDUS.CO.LTD/JORDAN | 30.720 |
| Virustat-200 mg tablet | Tablet 200 mg | 500 tab pack varies | AL-RAM PHARMA.INDUS.CO.LTD/JORDAN | 132.260 |
| Virustat-200 mg tablet | Tablet 200 mg | 1000 tab pack varies | AL-RAM PHARMA.INDUS.CO.LTD/JORDAN | 264.520 |
| Aciclovir Azevedos | Vial 250 mg | 1 vial | Alshefra Dru Store company | — |
| Salaclovir 250mg powder for solution for injection. | Powder for Injection 250 mg | 5 vial | Reda Jardaneh Drug Store | — |
| Zovirax 250mg/5ml IV Vials Powder for IV Infusion | Infusion 250 mg | 5 | Suleiman Tannous & Sons Co. Ltd | — |