Zovirax - Instructions For Use, Indications, Doses, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Zovirax

Instructions for use:

1. 1. Release form and composition
2. 2. Indications for use
3. 3. Contraindications
4. 4. Method of application and dosage
5. 5. Side effects
6. 6. Special instructions
7. 7. Drug interactions
8. 8. Analogs
9. 9. Terms and conditions of storage
10. 10. Terms of dispensing from pharmacies

Prices in online pharmacies:

from 153 rub.

Buy

Zovirax is an antiviral drug.

Release form and composition

Zovirax is available in the following dosage forms:

• Cream for external use 5%: homogeneous, almost white or white (2 g each in plastic bottles with a dosing device, 2, 5 or 10 g in aluminum tubes, 1 bottle or tube in a cardboard box);
• Eye ointment 3%: translucent, almost white or white, oily, soft, homogeneous without lumps, grains and foreign particles, with a characteristic weak odor (4.5 g each in tubes with a polyethylene nozzle, 1 tube each in a cardboard box);
• Lyophilisate for preparation of solution for infusion: sintered mass (porous cake) or hygroscopic powder of almost white or white color (250 mg in glass vials, 5 vials in plastic trays, 1 tray in a cardboard box);
• Tablets: biconvex, round, white, with the inscription "GXCL3" on one side (5 pcs. In blisters, 5 packs in a cardboard box).

The composition of 1000 mg cream for external use includes:

• Active ingredient: acyclovir - 50 mg;
• Auxiliary components: liquid paraffin, propylene glycol, soft white paraffin, cetostearyl alcohol, sodium lauryl sulfate, poloxamer 407, dimethicone, glycerol monostearate, macrogol stearate, purified water.

The composition of 1000 mg ophthalmic ointment includes:

• Active ingredient: acyclovir - 30 mg;
• Auxiliary component: white petroleum jelly.

The composition of 1 bottle with a lyophilisate for preparing a solution for infusion includes:

• Active ingredient: acyclovir - 250 mg;
• Auxiliary component: sodium hydroxide.

The composition of 1 tablet includes:

• Active ingredient: acyclovir - 200 mg;
• Auxiliary components: lactose monohydrate, sodium starch glycolate, povidone K30, magnesium stearate, microcrystalline cellulose.

Indications for use

Zovirax in the form of a cream for external use is prescribed for the treatment of infections of the skin and mucous membranes caused by the herpes simplex virus (Herpes simplex) types 1 and 2, including herpes of the lips.

Eye ointment is used for keratitis caused by herpes simplex virus types 1 and 2.

Zovirax inside and in the form of a solution for infusion is used if the following indications are present:

• Treatment of infections caused by the Varicella zoster virus (herpes zoster and chickenpox);
• Prevention of infections caused by herpes simplex virus types 1 and 2 in patients with immunodeficiency.

The solution for infusion is also used in the treatment of infections caused by herpes simplex virus types 1 and 2 (including newborns), and for the prevention of cytomegalovirus infection in bone marrow transplant recipients.

Additional indications for taking Zovirax in tablet form are:

• Treatment of infections of the mucous membranes and skin caused by herpes simplex virus types 1 and 2, including genital herpes (primary and recurrent);
• Treatment of patients with severe immunodeficiency (mainly with a detailed clinical picture of AIDS, with HIV infection (with a CD4 + cell count <200 / μl), with early clinical manifestations of HIV infection) who underwent bone marrow transplantation;
• Prevention of recurrence of infections caused by herpes simplex virus types 1 and 2 in patients with normal immune status.

Contraindications

The use of Zovirax in all dosage forms is contraindicated in the presence of hypersensitivity to the components of the drug, as well as to valacyclovir.

For lactating and pregnant women, the drug can be used only in cases where the benefits to the mother's health are higher than the possible risk to the child or fetus.

When administered intravenously and taking Zovirax inside, caution should be exercised in patients with renal insufficiency, in patients with signs of dehydration. In addition, the solution for infusion should be administered with caution during the development of reactions to cytotoxic drugs during their intravenous administration (and if there are indications of such reactions in history), as well as in the presence of neurological disorders.

Method of administration and dosage

It is recommended to apply a cream for external use with a thin layer on the affected and surrounding areas of the mucous membranes and skin 5 times a day (4 hours apart). To avoid additional infection of the affected areas, Zovirax should be applied with clean hands or with a cotton swab.

The duration of therapy is at least 4 days. If there is no effect, the duration of the course can be increased to 10 days. If the symptoms of the disease persist for more than 10 days, you should consult your doctor.

An eye ointment strip 1 cm long is placed in the lower conjunctival sac. The drug is used 5 times a day (with intervals of 4 hours between applications). After healing, treatment should be continued for another 3 days.

Zovirax solution is intended for intravenous infusion.

For adults, in the treatment of infections caused by the Varicella zoster and Herpes simplex viruses (except for herpes encephalitis), Zovirax is prescribed every 8 hours at 5 mg / kg of body weight.

For infections caused by the Varicella zoster virus and herpetic encephalitis in immunocompromised patients with normal renal function, intravenous infusions are performed every 8 hours at a dose of 10 mg / kg of body weight.

In bone marrow transplantation for the prevention of cytomegalovirus infection, Zovirax is used 3 times a day (with a break of 8 hours) at a dose of 500 mg / m² of body surface. The duration of therapy is from 5 days before transplantation and up to 30 days after it.

Obese patients are advised to use the same doses as for patients with normal body weight.

For patients with renal insufficiency, the dosage regimen should be adjusted in accordance with the creatinine clearance parameters:

• 25-50 ml per minute: every 12 hours at 5-10 mg / kg or 500 mg / m²;
• 10-25 ml per minute: every 24 hours at 5-10 mg / kg or 500 mg / m²;
• Less than 10 ml per minute (including anuria): every 24 hours at 2.5-5 mg / kg or 250 mg / m² (with continuous ambulatory peritoneal dialysis).

In hemodialysis, the drug is administered every 24 hours and after dialysis at 2.5-5 mg / kg or 250 mg / m².

Doses of Zovirax for intravenous infusion for children from 3 months to 12 years old are set individually, depending on the body surface area.

The dosage regimen in newborns is set depending on body weight. The recommended dose for the treatment of Herpes simplex type 1 and 2 infections is 10 mg / kg every 8 hours. The duration of therapy for herpes encephalitis and infections caused by the Herpes simplex virus is usually 10 days. For infections caused by the viruses Varicella zoster and Herpes simplex (except for herpes encephalitis), Zovirax is administered every 8 hours at 250 mg / m².

In children with immunodeficiency (with normal renal function), in the treatment of herpes encephalitis and infections caused by the Varicella zoster virus, the drug is administered every 8 hours at 500 mg / m².

For children aged 2 years and older who have undergone bone marrow transplantation, Zovirax can be administered in adult doses to prevent cytomegalovirus infection.

In children with reduced renal function, the dose should be adjusted according to the degree of renal impairment.

Elderly patients with reduced creatinine clearance may require dose reduction.

As a rule, the course of treatment with Zovirax in the form of intravenous infusion is 5 days, however, depending on the patient's condition and the response to the therapy, it may change. The duration of prophylactic use of Zovirax is determined by the duration of the period of existence of the risk of infection.

The recommended dose of Zovirax should be administered over 1 hour as a slow intravenous infusion.

To prepare the solution, use water for injection or 0.9% sodium chloride solution for injection at the rate of every 25 mg of the drug per 1 ml of dilution solution (add to the ampoule with the powder and shake gently until the powder contained in the ampoule completely dissolves).

The resulting Zovirax solution is injected using a special infusion pump that regulates the rate of its administration. Another method of administration is possible, in which the prepared solution is diluted to obtain an acyclovir concentration not higher than 5 mg / ml (0.5%).

Zovirax in tablet form is taken orally with water (200-250 ml). The drug can be taken with meals (food intake does not significantly affect its absorption).

The recommended adult single dose of Zovirax in tablet form for the treatment of infections caused by the Herpes simplex virus types 1 and 2 is 200 mg. The drug is taken 5 times a day, observing breaks of 4 hours (except for the period of night sleep). As a rule, the duration of the therapeutic course is 5 days; in case of severe primary infections, it can be extended.

In case of impaired absorption from the intestine or in the presence of severe immunodeficiency (for example, after bone marrow transplantation), a single dose of Zovirax can be increased to 2 tablets (400 mg). After the onset of infection, therapy should be started as early as possible. With the development of relapses, it is recommended to start taking the drug when the first elements of the rash appear or in the prodromal period.

In patients with normal immune status, to prevent recurrence of infections caused by the Herpes simplex virus types 1 and 2, Zovirax is taken every 6 hours (4 times a day), 1 tablet. It is also possible to use the drug 2 times a day (after 12 hours), 2 tablets (400 mg). Sometimes lower doses of Zovirax are effective: 3 times a day (with a break of 8 hours) 1 tablet or 2 times a day (with a break of 12 hours). Periodically, therapy should be interrupted for 6-12 months in order to identify possible changes in the course of the disease.

For patients with immunodeficiency, to prevent the occurrence of infections caused by the Herpes simplex virus types 1 and 2, Zovirax is recommended to be taken 4 times a day (every 6 hours), 1 tablet. In case of impaired absorption from the intestine or in patients with severe immunodeficiency (for example, after bone marrow transplantation), a single dose may be doubled (400 mg) and the frequency of administration of the drug up to 5 times a day. The duration of the preventive course of treatment is determined by the duration of the period of existence of the risk of infection.

In the treatment of herpes zoster and chickenpox, Zovirax is prescribed 5 times a day (every 4 hours, except for the period of night sleep), 4 tablets. The duration of the therapeutic course is 7 days.

After the onset of infection, Zovirax should be prescribed as early as possible, since in this case, therapy is more effective.

The recommended single dose for severe immunodeficiency is 4 tablets, the frequency of administration is 4 times a day (every 6 hours).

After bone marrow transplantation, before taking Zovirax internally, it is usually recommended to undergo a course of intravenous therapy with acyclovir for 1 month. Clinical studies have established that the maximum duration of the course of therapy for bone marrow transplant recipients was 6 months. In patients with an advanced clinical picture of HIV infection, the duration of the course of treatment was 12 months, however, longer courses of therapy may be effective.

For immunocompromised children aged 2 years and older, for the treatment and prevention of infections caused by Herpes simplex viruses, Zovirax is prescribed in adult doses, for younger children, the dose should be reduced by 2 times.

A single dose for children from 6 years old for the treatment of chickenpox is 4 tablets; from 2 to 6 years old - 2 tablets; under 2 years old - 1 tablet. The frequency of taking the drug is 4 times a day. More precisely, a single dose is determined at the rate of 20 mg / kg of body weight (but not more than 4 tablets). The course of therapy is 5 days.

There are no data on the effectiveness of the use of Zovirax in the treatment of herpes zoster and for the prevention of recurrence of infections caused by Herpes simplex viruses in children with normal immunity indicators.

According to the very limited information available, when treating children from 2 years of age with severe immunodeficiency, the same doses of Zovirax can be prescribed as for adults.

When prescribing the drug to elderly patients, it is necessary to take into account the possibility of reducing the clearance of acyclovir simultaneously with a decrease in the clearance of creatinine. If there are signs of renal failure, consider lowering the dose of Zovirax. When taking high doses of the drug inside, elderly patients need to drink a sufficient amount of liquid.

In patients with renal insufficiency, taking the drug orally in recommended doses for infections caused by Herpes simplex viruses (for treatment and prevention) does not lead to the accumulation of the active substance to concentrations exceeding the established safe levels. However, when creatinine clearance is less than 10 ml per minute, the dose of Zovirax must be reduced to 1 tablet 2 times a day (12 hours apart). In the treatment of herpes zoster, chickenpox, as well as for the treatment of patients with severe immunodeficiency with creatinine clearance less than 10 ml per minute, the recommended doses of Zovirax are 4 tablets 2 times a day (12 hours apart); with a creatinine clearance of 10-25 ml per minute - 4 tablets 3 times a day (8 hours apart).

Side effects

When using Zovirax in the form of an external cream, the following side effects may develop:

• Allergic reactions: rarely - allergic dermatitis (in most cases, such violations are associated with a reaction to excipients); in some cases - Quincke's edema;
• Local reactions: sometimes - short-term itching, redness, peeling, tingling or burning in the areas of application of the cream.

When using an eye ointment, disorders such as:

• Organ of vision: often - light burning sensation that transient over time; sometimes - conjunctivitis, punctate superficial keratopathy (disappears without consequences, discontinuation of treatment is not required); rarely - blepharitis;
• Allergic reactions: very rarely - immediate-type hypersensitivity reactions (including angioedema).

With intravenous administration and taking Zovirax inside, side effects may develop from some body systems:

• Central nervous system: reversible neurological disorders, including hallucinations, confusion, tremors, agitation, psychosis, drowsiness, coma and seizures (usually, these disorders occur in patients with renal failure, taking the drug in excess of the recommended doses);
• Digestive system: vomiting, nausea, reversible increase in liver enzyme activity and bilirubin levels; very rarely - jaundice, hepatitis;
• Urinary system: rarely - an increase in the level of creatinine and urea in the blood (to avoid this, the solution should be administered as a slow infusion over 1 hour and maintain the water balance of patients); very rarely - acute renal failure;
• Hematopoietic system: anemia, thrombocytopenia and leukopenia;
• Allergic reactions: photosensitivity, rash, urticaria, fever, pruritus; rarely - angioedema, shortness of breath, anaphylaxis.

When Zovirax solution gets under the skin, severe inflammatory reactions can occur, causing necrosis.

When taking the drug in the form of tablets, the development of rapid fatigue is also possible, in rare cases, rapid diffuse hair loss may occur (the connection with the intake of Zovirax has not been established).

In patients receiving antiretroviral drugs, additional intake of Zovirax does not cause a significant increase in toxic effects.

special instructions

With pronounced manifestations of herpes of the lips, it is recommended to consult a doctor.

To achieve the maximum effect, Zovirax should be applied externally when the first signs of the disease appear (itching, tingling, burning, redness and a feeling of tension). Do not apply the drug to the mucous membranes of the eyes and mouth, as this can lead to the development of local inflammation.

With genital herpes, you should avoid sexual intercourse or use condoms, since the use of the drug does not prevent sexual transmission of the virus.

Patients with immunodeficiency in the treatment of any infectious disease should adhere to the doctor's recommendations.

After applying Zovirax in the form of an ophthalmic ointment, a slight burning sensation may appear, which goes away on its own. Contact lenses should not be worn during therapy.

Patients with herpes encephalitis receiving high doses of Zovirax in the form of infusions should monitor renal function (especially in case of initial impairment of the functional state of the kidneys or dehydration).

Zovirax should be used with caution, monitoring the functional state of the kidneys, along with drugs that impair renal function (for example, tacrolimus, cyclosporine).

The prepared solution of Zovirax has pH = 11, so it cannot be taken orally.

Patients using high doses of the drug in the form of tablets should drink a sufficient amount of liquid.

Drug interactions

When Zovirax was used in all dosage forms with other drugs, no clinically significant interactions were noted.

An increase in the concentration of active substances or their metabolites in plasma is possible with the simultaneous administration of Zovirax with drugs excreted by active tubular secretion (caution must be exercised when using such combinations).

Analogs

Zovirax's analogs are: Acyclovir, Acyclovir Sandoz, Acyclovir Forte, Acyclovir-Akrikhin, Acyclovir-Ferein, Acyclovir-Teva, Acyclovir Belupo, Acyclovir-Acri, Herperax, Viroleks, Acigerpin, Acyclostad, Vivoraxovir Duo.

Terms and conditions of storage

Store in a dry place out of reach of children.

Shelf life:

• Topical cream - 3 years at temperatures up to 25 ° C (do not freeze);
• Eye ointment and tablets - 5 years at temperatures up to 25 ° C;
• Lyophilisate for preparation of solution for infusion - 5 years at temperatures up to 30 ° C.

Eye ointment after opening the package must be used within 1 month.

Terms of dispensing from pharmacies

The cream is dispensed without a prescription, other forms of the drug are available with a prescription.

Zovirax: prices in online pharmacies

Drug name Price Pharmacy

Zovirax Zovirax for colds on the lips, cream 5%, 5g 153 r Buy

Zovirax 5% cream for external use 5 g 1 pc. 153 r Buy

Zovirax Duo-Active 5% + 1% cream for external use 2 g 1 pc. 285 r Buy

Reviews Zovirax Duo-Active 285 r Buy

Zovirax 200 mg tablets 25 pcs. 428 r Buy

Zovirax tablets 200mg 25 pcs. 575 RUB Buy

Zovirax 250 mg lyophilisate for preparation of solution for infusion 5 pcs. 1456 RUB Buy

Zovirax lyof. for prig solution for inf. 250mg 5 pcs. 1555 RUB Buy

See all offers from pharmacies

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!