Acyclovir is an antiviral oral medication used to treat infections caused by the herpes virus, including shingles, chickenpox, and genital herpes. It comes as a tablet, capsule, and liquid suspension. Depending on your condition, you might need to take it by mouth 2 to 5 times a day. Acyclovir works best when you start it as soon as symptoms begin. Common side effects include nausea, vomiting, and diarrhea.
Genital herpes in adults
Shingles in adults
Chickenpox in people 2 years and older
Acyclovir is an antiviral medication, specifically a herpes virus nucleoside analogue. It works by blocking the herpes virus from making new DNA, which stops the virus from multiplying in your body.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Mild pain, burning, or stinging
Less common
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Available in tablet, capsule, and liquid forms
Safe for children 2 years and older
Can shorten how long outbreaks last
Not many interactions with other medications
Must be taken multiple times per day
Can cause unpleasant stomach side effects, like nausea and diarrhea
Not available over the counter
Doesn't cure herpes infection
Acyclovir works best when you start it as soon as you notice signs of an outbreak or infection. For shingles, take acyclovir within 72 hours of the rash appearing, and for chickenpox, within 24 hours of the rash appearing.
Acyclovir needs to be taken several times a day, which can be hard to keep up with. Using a phone alarm or a pill box can help you remember every dose.
Finish your full treatment course of acyclovir, even if you feel better. Don’t stop unless your prescriber tells you to.
If you're taking acyclovir liquid suspension, shake the bottle well before each dose and only use the measuring device provided by your pharmacist.
Drink plenty of water while taking acyclovir. Staying hydrated helps lower the risk of kidney damage.
Acyclovir won't cure genital herpes, but it helps shorten outbreaks and speeds healing. Avoid sexual contact during outbreaks and practice safe sex, such as using condoms.
Acyclovir can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Older adults | Low fluids in the body | Taking other medications that harm the kidneys
Acyclovir can sometimes cause serious kidney problems, especially in older adults. Your risk is higher if you get dehydrated or take other medications that can harm the kidneys, like ibuprofen or naproxen. Be sure to drink plenty of fluids while taking acyclovir, and talk to your prescriber before using any other medication, even over-the-counter pain or cold products. Your prescriber might also order lab tests to check your kidney health.
Risk factors: Medical conditions that weaken your immune system
It's rare, but some people have had serious blood clotting problems while taking acyclovir. This has mostly been seen in people with a weakened immune system. Your prescriber might order labs to check your blood work while you're taking this medication. Call your prescriber right away if you notice fever, unusual bleeding or bruising, confusion, extreme tiredness, or headaches.
Acyclovir is available as a capsule, tablet, and liquid suspension. Your dose will depend on the reason you're taking the medication. In general:
Shingles: The typical dose is 800 mg by mouth every 4 hours (5 times a day) for 7 to 10 days.
Genital herpes:
Treatment for initial infection: The typical dose is 200 mg by mouth every 4 hours (5 times a day) for 10 days.
Daily treatment to prevent infections: The typical dose is 400 mg by mouth twice a day for up to a year.
As-needed treatment: The typical dose is 200 mg by mouth every 4 hours (5 times a day) for 10 days.
Chickenpox:
Adults and children over 40 kg: The typical dose is 800 mg by mouth 4 times a day for 5 days.
Children (2 years and older under 40 kg): The typical dose is 20 mg/kg of body weight by mouth 4 times a day for 5 days.
Your dose might differ if you have kidney problems.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Allergy to acyclovir or valacyclovir
Genital herpes in adults
Shingles in adults
Chickenpox in people 2 years and older
Cold sores (herpes labialis)
Genital herpes
Shingles (herpes zoster)
Chickenpox (varicella) in children ages 2 to 17 years old
Cold sores in people age 12 years and older
Genital herpes in adults
Shingles (herpes zoster) in adults
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Advagen Pharma Limited. (2024). ACYCLOVIR suspension. DailyMed.
Carlsbad Technology, Inc. (2024). ACYCLOVIR capsule. DailyMed.
Carlsbad Technology, Inc. (2024). ACYCLOVIR tablet [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). How to Treat Chickenpox.
Emmert, D.H. (2000). Treatment of common cutaneous herpes simplex virus infections. American Family Physician.
Lorenzo, C. S., et al. (2016). Acyclovir crystalluria: A rare secondary effect of a common drug. Pediatrics & Therapeutics.
MotherToBaby. (2024). Acyclovir (Zovirax®) | Valacyclovir (Valtrex®).
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