Acyclovir Stella Dosage/Direction for Use

Dosage: Dosage in adults: Treatment of herpes simplex infections: 200 mg aciclovir should be taken five times daily at approximately four-hourly intervals omitting the night time dose. Treatment should continue for five days, but in severe initial infections this may have to be extended.
In severely immunocompromised patients (e.g. after marrow transplant) or in patients with impaired absorption from the gut the dose can be doubled to 400 mg aciclovir or alternatively intravenous dosing could be considered.
Dosing should begin as early as possible after the start of an infection; for recurrent episodes this should preferably be during the prodromal period or when lesions first appear.
Suppression of herpes simplex infections in immunocompetent patients: 200 mg aciclovir should be taken four times daily at approximately six-hourly intervals.
Many patients may be conveniently managed on a regime of 400 mg aciclovir twice daily at approximately twelve-hourly intervals.
Dosage titration down to 200 mg aciclovir taken three times daily at approximately eight-hourly intervals or even twice daily at approximately twelve-hourly intervals, may prove effective.
Some patients may experience break-through infections on total daily doses of 800 mg aciclovir.
Therapy should be interrupted periodically at intervals of six to twelve months, in order to observe possible changes in the natural history of the disease.
Prophylaxis of herpes simplex infections in immunocompromised patients: 200 mg aciclovir should be taken four times daily at approximately six-hourly intervals.
In severely immunocompromised patients (e.g. after marrow transplant) or in patients with impaired absorption from the gut, the dose can be doubled to 400 mg aciclovir or, alternatively, intravenous dosing could be considered.
The duration of prophylactic administration is determined by the duration of the period at risk.
Treatment of varicella and herpes zoster infections: 800 mg aciclovir should be taken five times daily at approximately four-hourly intervals, omitting the night time dose. Treatment should continue for seven days.
In severely immunocompromised patients (e.g. after marrow transplant) or in patients with impaired absorption from the gut, consideration should be given to intravenous dosing.
Dosing should begin as early as possible after the start of an infection: Treatment of herpes zoster yields better results if initiated as soon as possible after the onset of the rash.
Treatment of chickenpox in immunocompetent patients should begin within 24 hours after onset of the rash.
Dosage in the paediatric population: Treatment of herpes simplex infections, and prophylaxis of herpes simplex infections in the immunocompromised: Children aged two years and over should be given the adult doses and children below the age of two years should be given half the adult dose.
For treatment on neonatal herpes virus infections, intravenous aciclovir is recommended.
Treatment of varicella infection: Children under 2 years should be given 200 mg four times daily.
Children aged 2-5 years should be given 400 mg four times daily.
Children aged 6 years and over should be given 800 mg four times daily.
Treatment should continue for 5 days.
Dosing may be more accurately calculated as 20 mg/kg bodyweight (not to exceed 800 mg four times daily).
A liquid formulation might be more suitable for small children.
No specific data are available on the suppression of herpes simplex infections or the treatment of herpes zoster infections in immunocompetent children.
Dosage in the elderly: The possibility of renal impairment in the elderly must be considered and the dosage should be adjusted accordingly (see Dosage in renal impairment as follows).
Adequate hydration of elderly patients taking high oral doses of aciclovir should be maintained.
Dosage in renal impairment: Caution is advised when administering aciclovir to patients with impaired renal function. Adequate hydration should be maintained.
In the management of herpes simplex infections in patients with impaired renal function, the recommended oral doses will not lead to accumulation of aciclovir above levels that have been established by intravenous infusion. However, for patients with severe renal impairment (creatinine clearance less than 10 ml/minute) an adjustment of dosage to 200 mg aciclovir twice daily at approximately twelve-hourly intervals is recommended.
In the treatment of herpes zoster infections it is recommended to adjust the dosage to 800 mg aciclovir twice daily at approximately twelve-hourly intervals for patients with severe renal impairment (creatinine clearance less than 10 ml/minute), and to 800 mg aciclovir three times daily at intervals of approximately eight hours for patients with moderate renal impairment (creatinine clearance in the range 10 - 25 ml/minute).
Administration: Acyclovir STELLA is orally taken.