Xovir 250 mg/vial

Xovir intravenous infusion is indicated for the treatment of-

• Acute clinical manifestations of Herpes simplex virus in immunocompromised patients
• Severe primary or non-primary genital herpes in immune competent patients
• Varicella zoster virus infection in immunocompromised patients
• Herpes zoster (shingles) in immune competent patients who show very severe acute local or systemic manifestations of the disease
• Herpes simplex encephalitis

• Pharmacology

  Acyclovir exerts its antiviral e­ects on Herpes simplex virus and Varicella zoster virus by interfering with DNA synthesis and inhibiting viral replication. In cells infected with Herpes virus, the antiviral activity of Acyclovir appears to depend principally on the intracellular conversion of the drug to Acyclovir Triphosphate. Acyclovir is converted to Acyclovir Monophosphate principally via virus coded thymidine kinase, the monophosphate is phosphorylated to diphosphate via cellular guanylate kinase and then via other cellular enzymes to the Triphosphate, which is the pharmacologically active form of the drug.

  Dosage

  • Herpes simplex infection: For normal or immunocompromised immune status: 5 mg/kg every 8 hours
  • Very severe Herpes zoster infection (shingles): For normal immune status: 5 mg/kg every 8 hours
  • Varicella zoster infection: For immunocompromised immune status: 10 mg/kg every 8 hours
  • Herpes simplex encephalitis: For normal or immunocompromised immune status: 10 mg/kg every 8 hours

  Each dose should be administered by slow intravenous infusion over a one-hour period.

  Administration

  It is recommended that Acyclovir IV Injection for Intravenous Infusion should be administered for five to seven days in the treatment of most infections and for at least ten days in the treatment of Herpes simplex encephalitis.

  Acyclovir IV Injection after reconstitution may be injected directly into a vein over one hour by a controlled-rate infusion pump or be further diluted for administration by infusion. For intravenous infusion each vial of Acyclovir IV Injection should be reconstituted and then, wholly or in part according to the dosage required, added to and mixed with at least 50 mL-100 ml infusion solution. A maximum of 250 mg & 500 mg of Acyclovir may be added to 50 ml & 100 ml infusion solution respectively. After addition of Acyclovir IV Injection to an infusion solution the mixture should be shaken to ensure thorough mixing. Acyclovir IV Injection when diluted in accordance with the above schedule will give an Acyclovir concentration not greater than 0.5% w/v.

  Acyclovir IV Injection is known to be compatible with the following infusion fluids and stable for up to 12 hours at room temperature (below 25°C) when diluted to a concentration not greater than 0.5% w/v Acyclovir.

  • Sodium Chloride Intravenous Infusion BP (0.45% and 0.9% w/v)
  • Sodium Chloride (0.18% w/v) and Glucose (4% w/v) Intravenous Infusion
  • Sodium Chloride (0.45% w/v) and Glucose (2.5% w/v) Intravenous Infusion
  • Compound Sodium Lactate Intravenous Infusion BP (Hartmann’s Solution)

  Acyclovir IV Injection for Intravenous Infusion contains no preservative. Reconstitution and dilution should therefore be carried out immediately before use and any unused solution should be discarded. The solution should not be refrigerated.

  Interaction

  Co-administration of probenecid with Xovir has been shown to increase the mean Xovir half-life and the area under the concentration time curve. Urinary excretion and renal clearance correspondingly reduced. In patients over 60 years of age concurrent use of diuretics increases plasma levels of Xovir very significantly.

  Contraindications

  Acyclovir IV Injection is contraindicated in patients known to be hypersensitive to Acyclovir or Valacyclovir.