China
Africa
Explore chapters and articles related to this topic
Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Valacyclovir is an active metabolite of acyclovir use to treat herpes infections. It is an FDA category B drug. Among 229 infants born to women who used valacyclovir during pregnancy the frequency of birth defects was not increased (Pasternak and Hviid, 2010). In the Swedish Registry, the frequency of birth defects was not increased among 645 infants whose mothers took valacyclovir during the first trimester (Kallen, 2019).
Antiviral therapeutics for viral infections of the central nervous system
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Few adverse reactions to oral or intravenous formulations have been reported. Transient increases in blood urea nitrogen and creatinine occur in 10% of patients given bolus injections. These renal changes can be largely avoided by reducing the rate of infusion, providing adequate hydration and adjusting dosage in renal failure. Nausea, vomiting, diarrhea and abdominal pain occasionally occur, particularly in association with an elevated creatinine concentration. Acute reversible renal failure has been reported. Reconstituted acyclovir has a pH of about 11; severe inflammation and ulceration have been reported after extravasation at the infusion site. Encephalopathy, tremors, confusion, hallucinations, convulsions, psychiatric disorders, bone-marrow depression, and abnormal liver function have occasionally arisen, particularly if the dosage is increased above standard recommendations. Skin rashes have been reported in a few patients but resolved on discontinuation of the drug. Headache and nausea have been reported as side effects of valacyclovir, but occurred with similar frequency in subjects receiving placebo.
Genital herpes
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
The following regimens can be used but the duration of antiviral therapy may need to be extended until the lesions have recovered: aciclovir 200–400 mg five times per day for 5 to 10 days.aciclovir 400–800 mg three times per day for 5 to 10 days.famciclovir 250–500 mg three times per day for 5 to 10 days.valaciclovir 500–1000 mg two times per day for 5 to 10 days.
Herpes zoster (shingles) complicating the course of COVID19 infection
Published in Journal of Dermatological Treatment, 2022
Mohamed L. Elsaie, Hesham A. Nada
A lady presented to our attention photographs of her 44 years old male husband complaining of a skin rash on his left upper chest and back. She described the onset to be 24 h earlier with a mild itchy rash (which she kept photographs of) and thought to be an insect bite of no much significance to seek consultation for and for which she applied him an antihistaminic gel (dimethindene maleate) twice daily. She described his pain as stabbing and very painful however not much itchy. Upon his wife’s report, she uncovered that he was diagnosed one week earlier with COVID 19 infection after a chest CT and a confirmatory nasopharyngeal swab. As the patient general condition was good and his oxygen saturation was 96%, he was followed out patiently by his COVID 19 treating consultants and was prescribed (Oseltamivir PO every 12 h, Azithromycin 500 mg PO every day, paracetamol and Vitamin C). Based on self-photographs sent, multiple vesicles and papules spread over an erythematous base were seen, affecting the upper chest and back in a dermatomal pattern. The diagnosis of Hz was made based on the sent photographs and the relevant history and symptoms reported. He was advised to start on valaciclovir 1 g every 8 h and for 7 days along with continuing his other COVID prescribed protocol (Figures 1 and 2).
Should atopic dermatitis patients starting JAK inhibitors take prophylactic acyclovir?
Published in Journal of Dermatological Treatment, 2021
Milaan A. Shah, Katherine G. Beuerlein, Joseph L. Jorizzo, Steven R. Feldman
In addition to being effective treatment, valacyclovir and acyclovir are safe and well-tolerated drug with no associated toxicities and minimal adverse effects aside from crystalluria and increased creatinine levels (37,39,40). The risk of these side effects can be mitigated with fluid administration prior to taking acyclovir and adjustment in acyclovir dosage according to renal function (41). An ability to prevent reactivation of herpes simplex virus and herpes zoster coupled with this tolerability make valacyclovir and acyclovir options for prophylaxis in patients needing long-term suppression due to severe or recurrent outbreaks or extreme immunosuppression (39,40,42,43). The use of valacyclovir or acyclovir for prophylaxis in patients at risk of eczema herpeticum specifically has not yet been studied. Valacyclovir and acyclovir are equally efficacious in the treatment and prophylaxis of herpes simplex virus, but valacyclovir requires less frequent dosing due to the increased bioavailability (44–46). Twice daily dosing of 500 mg of valacyclovir effectively prevents herpes simplex virus reactivation (47,48). A 15-day supply of this dosage could be obtained for $11 (49). Prophylaxis to prevent eczema herpeticum in patients with atopic dermatitis being treated with a JAK inhibitor may only be needed until clinical improvement occurs (reducing the risk of eczema herpteticum), which may occur in as little as four weeks depending on the agent used and the patient’s response (50).
Twenty years since the Herpetic Eye Disease Study: Lessons, developments and applications to clinical practice
Published in Clinical and Experimental Optometry, 2021
Sana Arshad, Constantinos Petsoglou, Taehwan Lee, Abdullah Al-Tamimi, Nicole A. Carnt
For stromal HK, Cabrera-Aguas et al.75 suggest in Australia and New Zealand, to use the topical corticosteroid Prednefrin Forte 1% (prednisolone acetate 1% and phenylephrine 0.12%, Allergan, Irvine, CA), starting at four to six times/day, tapered for at least 10 weeks along with the oral antiviral valaciclovir 500 mg, once daily for cases without an epithelial defect. With an epithelial defect, topical Prednefrin Forte 1% is prescribed BD and Valaciclovir 1 g is prescribed three times per day for seven to 10 days. Valaciclovir is reduced to the prophylactic dose after seven to 10 days and maintained for as long as frequent topical steroids are in use. Oral antivirals have the potential to cause nephrotoxicity in older patients, marked by increased serine creatine or blood urea nitrogen concentrations,86 and so caution with patients 65 years and over is recommended.