Acyclovir ointment

Intravenous acyclovir is used in the treatment of herpes simplex encephalitis, neonatal HSV infection, and mucocutaneous HSV infection in immunocompromised individuals. Acyclovir ointment is used in the treatment of initial genital herpes but is not effective for recurrent disease. Ophthalmic acyclovir formulations, although not available in the United States, are effective in the treatment of herpes keratoconjunctivitis. 

A small, multicenter, double-blind, randomized trial comparing the efficacy of 0.5% idoxuridine ointment and 3% acyclovir ointment showed no significant difference in overall healing patterns, duration of symptoms, or frequency of development of deeper involvement (McCulley et al.). 

A small, randomly assigned, double-blind, placebo-controUed study of patients with dendritic HSV keratitis treated with oral acyclovir or topical acyclovir ointment showed no significant difference between treatment groups in the number of patients healed or the median healing time (CoUum et al.). 

A small, multicenter, open-label, randomized study showed that patients with early HZO who received topical acyclovir ointment had a higher rate of significant ocular complications after one month than patients receiving oral acyclovir (Neoh et al.). 

A small randomized clinical trial demonstrated significantiy faster healing of HSV keratitis with oral valacyclovir than topical acyclovir ointment (Sozen,Avunduk,Akyol). 

Chetoni, P. Rossi, S. BurgalassL S. Monti, D. Mariotti, S. Saettone, M.F. Comparison of liposome-encapsulated acyclovir with acyclovir ointment Ocular pharmacokinetics in rabbits. J. Ocul. Pharmacol. Then 2004, 20 (2), 169-177. 

Initiate therapy as early as possible following onset of signs and symptoms. Ointment Apply sufficient quantity to adequately cover all lesions every 3 hours 6 times daily for 7 days. Use approximately a one-half inch ribbon of ointment per 4 square inches of surface area. Use a finger cot or rubber glove when applying acyclovir to prevent autoinoculation of other body sites and transmission of infection to other people. 

Ointment- Systemic absorption of acyclovir after topical application is minimal. 

Topical acyclovir (Zovirax) is available as a 5% ointment topical penciclovir (Denavir), as a 1% cream for the treatment of recurrent orolabial herpes simplex virus infection in immunocompetent adults. Adverse local reactions to acyclovir and penciclovir may include pruritus and mild pain with transient stinging or burning. 

Topical acyclovir (Zovirax) is available as a 5% ointment for application to primary cutaneous herpes simplex infections and to limited mucocutaneous herpes simplex virus infections in immunocompromised patients. In primary infections, the use of topical acyclovir shortens the duration of viral shedding and may decrease healing time. In localized, limited mucocutaneous infections in immunocompromised patients, its use may be associated with a decrease in the duration of viral shedding. 

Topical for HSV. Acyclovir is arailable in Europe and Canada as a 3% ophthalmic ointment but is not commercially manufectured as a topical formulation in the United States. The most common side effects of acyclovir 3% ointment are punctate superficial keratitis, occurring in about 10% of patients, and burning or stinging on application (4%) (Table 11-11 see also Table 11-10). 

Grant DM. Acyclovir (Zovirax) ophthalmic ointment a review of clinical tolerance. Curr Eye Res 1987 6(l) 231-235. 

Hovding G.A comparison between acyclovir and trifluorothymi-dine ophthalmic ointment in the treatment of epithelial dendritic keratitis. Acta Ophthalmol 1989 67(l) 51-54. 

Within 2 weeks of using 1% trifluridine solution, 97% of cases resolve. Although drug-resistant HSV is rare, it is possible and should be considered if there is no improvement within the first few days. If there is no improvement or an adverse reaction occurs, use of a different antiviral is indicated. Acyclovir 3% ointment, although not commercially available for ophthalmic use in the United States, has been shown to be effective and well tolerated... 

Some fatty acids, especially unsaturated fatty acids, are well-known skin penetration enhancers. It is also known that many fatty acids possess antimicrobial activity. The topical activity of the anti-viral drug acyclovir is hampered by its inadequate permeability through the skin barrier. Some reports have shown that fatty acid extract of cod liver oil as well as the extract in the form of an ointment show effective antiviral properties against herpes simplex virus (HSV-1) (37). 

Antiviral activity has been demonstrated mainly for A. membranaceus, that represents the most studied species, expecially against Coxsackie viruses [234] but also against different kinds of viral infections. "Astragali radix" extracts show protective effects against Japanese Encephalitis Vitus (JEV) infection in mice both by oral and infraperitoneal injection this effect is based on a non-specific mechanism during the early stage of injection, before it shifts to antibody production. A. membranaceus (AM) shows curative effects on the mice infected with Herpes Simplex Virus type-1 (HSV-1) when somministated with acyclovir (ACV) [329]. The anti-HSV activity of suppository and ointment forms of AM combined... 

Adverse reactions arc few. Some patients experience w-ca.sional gastrointestinal up.set. di/z.ines.s. headache, lethargy. and joint pain. An ointment composed of S% acyclovir in a polyethylene glycol base is available for the treatment of initial, mild episodes of herpes genitalis. The ointment is not an effective preventer of recurrent episodes. 

Antiviral Acyclovir Antiviral Control of viral infections Eye ointment... 

Acyclovir is available for topical application (Zovirax ointment 5% 50 mg/kg in a polyethylene glycol base), which may cause mucosal irritation and transient burning when applied to genital lesions. 

Herpes zoster ophthalmicus is a latent reactivation of a varicella zoster infection in the first division of the trigeminal cranial nerve. Systemic acyclovir, valacyclovir, and famciclovir te. effective in reducing the severity and complications of herpes zoster ophthalmicus. Currently, there are no ophthalmic preparations of acyclovir approved by the FDA, although an ophthalmic ointment is available for investigational use. 

In a further study, citric acid has been found to form an amorphous mixture with the antiviral drug acyclovir upon co-precipitation from N, N-dimethylformamide (Masuda et al. 2012). The molar ratio of acyclovir and citric acid was determined to be 1 2 in the co-precipitates. The miscibility of the components in the amorphous mixture was indicated by a single Tg value (68 °C) and the presence of hydrogen bonding interactions between acyclovir and citric acid. The formation of the amorphous mixture offered a significant improvement of skin permeation flux of the amorphous form from a polyethylene glycol (PEG) ointment in vitro compared to crystalline acyclovir. 

Acyclovir,2-amino-l,9-dihydro-9-[(2-hydroxyethoxy)methyl]-6H-purm-6-one, is also known as acycloguanosine and by its tradename Zovirax. It is sold by Glaxo Welcome as a powder, pill, and ointment. 

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