Acyclovir (Aciclovir)

Acyclovir (Aciclovir) is a antiviral (nucleoside analogue) medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

Acyclovir (Aciclovir) is prescribed for infections caused by herpes-group viruses, including:

• Herpes simplex: first episodes and recurrences of genital herpes, cold sores around the lips, and herpes infections of the skin and mouth
• Suppressive therapy to reduce frequent recurrences of genital herpes
• Chickenpox (varicella), especially in adults and teenagers, who get more severe disease
• Shingles (herpes zoster), to speed healing and reduce nerve pain
• Herpes infections in people with weakened immunity, under specialist care

It reduces the severity and duration of attacks but does not remove the virus from the body, so recurrences can still happen later.

Most people tolerate Acyclovir (Aciclovir) well. Possible side effects include:

• Nausea, vomiting, diarrhoea or abdominal pain
• Headache, dizziness or tiredness
• Mild skin rash or itching; increased sensitivity to sunlight in some people

Rare but important: kidney problems caused by drug crystals — much likelier if you are dehydrated or take high doses, which is why plenty of fluids matter; and neurological effects such as confusion, tremor, hallucinations or unusual drowsiness, mainly in elderly people or those with kidney impairment. Seek medical help for reduced urine output, severe rash, easy bruising, yellowing of the eyes, or any confusion or behaviour change during treatment.

The golden rules with Acyclovir (Aciclovir): start early and complete the full course. The virus multiplies fastest in the first days — treatment begun after 72 hours helps much less. Stopping midway can let blisters rebound; take every scheduled dose until the course ends, even if the rash crusts over sooner.

• Drink plenty of fluids throughout treatment to protect your kidneys
• Tell your doctor about kidney disease or if you are elderly — doses usually need reduction
• Herpes can still spread to others during an outbreak despite treatment: avoid intimate contact until sores heal, and avoid touching the lesions
• If outbreaks return frequently (six or more per year), ask your doctor about daily suppressive therapy instead of repeated short courses

Acyclovir (Aciclovir) has fewer drug interactions than most medicines, but a few combinations need care. Tell your doctor about everything you take, especially:

• Probenecid and cimetidine: slow the kidney's removal of aciclovir and raise its blood level
• Kidney-stressing drugs — aminoglycoside antibiotics, NSAID painkillers used heavily, tenofovir, ciclosporin or tacrolimus: combined use increases the risk of kidney injury, particularly if you are dehydrated
• Theophylline (for asthma/COPD): levels may rise, so monitoring may be needed
• Mycophenolate (transplant medicine): both drugs' levels can increase when taken together

Drinking adequate water and avoiding unnecessary painkillers during the course reduces most of these risks.

Do not take Acyclovir (Aciclovir) if you are allergic to aciclovir or to valaciclovir (a prodrug that converts into aciclovir in the body). True allergy is uncommon but shows as rash, hives, swelling of the face or breathing difficulty after a dose — stop the medicine and seek care if this happens.

Use Acyclovir (Aciclovir) only with medical supervision and dose adjustment if you have:

• Significant kidney impairment or are on dialysis
• Advanced age with reduced kidney function
• Severe dehydration that cannot be corrected quickly
• A weakened immune system — herpes infections in such patients need specialist-guided, sometimes intravenous, therapy

Always give your doctor a full medicine and illness history before starting.

Pregnancy: Decades of use and large pregnancy registries have shown no increase in birth defects with Acyclovir (Aciclovir), so doctors prescribe it in pregnancy when treatment is genuinely needed — for example, chickenpox in pregnancy, which can be serious and needs urgent medical advice. Never self-medicate while pregnant; the decision belongs with your doctor.

Breastfeeding: Acyclovir (Aciclovir) passes into breast milk in small amounts that are far below treatment doses for infants, and breastfeeding is usually considered compatible with treatment. Mention that you are nursing, watch the baby for unusual sleepiness or feeding changes, and avoid feeding from a breast that has active herpes sores on it until healed.

Store Acyclovir (Aciclovir) below 30°C in a dry place away from direct sunlight and moisture. In Bangladesh's humid climate, a cool, dry cupboard is better than a bathroom cabinet or kitchen shelf. Keep tablets in their original blister until the moment of use, and keep all medicines out of the reach and sight of children.

• Shake Acyclovir (Aciclovir) suspension well before each dose and follow the label's instructions on how long an opened bottle may be used
• Do not use Acyclovir (Aciclovir) after the expiry date printed on the pack
• Dispose of leftover medicine through a pharmacy rather than household waste or drains