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Antiviral Pregnancy: Caution — use if benefit outweighs risk (herpes encephalitis in pregnancy is life-threatening)

Aciclovir

Brand names: Zovirax

Adult dose

Dose: Herpes simplex: 200–400 mg 5 times daily; Herpes zoster: 800 mg 5 times daily; IV herpes encephalitis: 10 mg/kg every 8 hours
Route: Oral / IV
Frequency: 5 times daily (oral); every 8 hours (IV)
Max: 4 g/day oral; 15 mg/kg/day IV (in severe immunosuppression)
Herpes simplex (oral): 5 days. Herpes zoster: 7 days (start within 72 hours of rash). IV: for encephalitis, neonatal HSV, immunocompromised. IV must be given over 1 hour — precipitation if too rapid.

Paediatric dose

Dose: 10–20 mg/kg
Route: IV
Frequency: Every 8 hours
Max: Based on ideal body weight
Neonatal HSV: 20 mg/kg IV every 8 hours for 14–21 days. Herpes zoster in immunocompromised child: 10 mg/kg IV every 8 hours. Oral doses depend on indication and age — BNFc guidance.

Dose adjustments

Renal

Dose reduction required: if eGFR 10–25: reduce to every 12 hours (IV); eGFR <10: every 24 hours. Ensure adequate hydration to prevent crystalline nephropathy.

Hepatic

No dose adjustment required.

Paediatric weight-based calculator

Neonatal HSV: 20 mg/kg IV every 8 hours for 14–21 days. Herpes zoster in immunocompromised child: 10 mg/kg IV every 8 hours. Oral doses depend on indication and age — BNFc guidance.

Clinical pearls

  • IV aciclovir must be given with 1L of fluid per dose (IV bag) or good oral hydration — to prevent crystalline deposits in renal tubules
  • Valaciclovir (prodrug) is better absorbed orally and preferred for outpatient treatment of herpes zoster
  • Start within 72 hours of zoster rash — no benefit if started later unless new lesions still appearing
  • Herpes encephalitis: start IV aciclovir empirically while awaiting PCR results — do not wait for confirmation

Contraindications

  • Hypersensitivity to aciclovir or valaciclovir

Side effects

  • Nausea
  • Headache
  • Rash
  • Renal crystalline nephropathy (IV — if poorly hydrated)
  • Neurological effects (tremor, encephalopathy — IV at high doses)
  • Phlebitis at IV site

Interactions

  • Probenecid (reduces renal excretion — increases aciclovir levels)
  • Mycophenolate (both renally excreted — increased toxicity risk)
  • Zidovudine (risk of neurotoxicity)

Monitoring

  • Renal function (especially IV use)
  • Urine output and hydration status
  • Neurological status (high-dose IV)

Reference: BNFc; BNF 90; NICE CKS (Herpes simplex); BNFc; TOXBASE. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.