Acyclovir renal dosing
Common Questions and Answers about Acyclovir renal dosing
zovirax
Please note Tenofovir is principally cleared through the kidney and dosing adjustments due to renal impairment have not been clinically tested.
The followings are extracts from the label information for Tenofovir:
2.3 Dose Adjustment for Renal Impairment in Adults
Significantly increased drug exposures occurred when VIREAD was administered to subjects with moderate to severe renal impairment [See Clinical Pharmacology (12.3)].
I have been on acyclovir (400mg) twice daily for the past 6 months. Prior to that I was taking Valtrex (500 mg) once daily for 18 months. For the past few months I have noticed that my blood pressure is elevated (140s-160s sys over 80s-90s dia). Could the use of acyclovir be causing this?
Any insight is appreciated.
I am not aware that impaired renal function precludes treatment for HCV. I have read that kidney disease is a negative predictor of SVR but, so too are a lot of conditions yet people have overcome them. I have seen articles which discuss the plasma levels of ribavirin with renal impaired patients. The suggestion is that rather than weight base dose these patients the dose should be arrived at by considering GFR (glomerular filtration rate).
This is from Clinical Care Options @ http://tiny.
I am overseas and have access to acyclovir. Does that seem to work the same as the other two?
By "AGE" I'm assuming you mean a persons age in years. I don't believe age has anything to do with Janumet's "effectiveness" but age has a larger role with renal function. To make it clear for other readers, Janumet is combination of two drugs; Sitagiptin and Metformin.
This a brief from the Merck web site - makers of Janumet - Section 8.5 - Geriatric Use JANUMET.
I also have kidney damage from a bout of high blood pressure 4 years ago, and I am a frequent kidney stone former, so I am being watched carefully by a nephrologist too. I have renal panels frequently too. I was wondering if any of this could increase my stone risk. I was reading about the cytomel and stones. The nephrologist wants me to remain on the synthroid and cytomel.
Acyclovir is always 2x/day for suppressive therapy. You can not take acyclovir just 800mg 1x/day. It's not effective that way. Call your provider up and question that dose. If they say that that dose works too -ask them to please cite the research that backs that. I guarantee you they can't provide any that shows that 800mg once a day is effective for acyclovir!!
do you have hsv1 or hsv2 genitally? How about orally - which one?
I think it depends on some individual factors, particularly renal clearance of the drug. I found this information in the drug reference:
According to the manufacturer's tests, the drug reaches maximum serum levels between 15 and 44 hours after subcutaneous injection of a single dose. The mean elimination half-life is 22 to 60 hours (mean = 40 hours). So, I would expect that after 7 days (4.2 half-lifes) that the concentration would be about 5.5% (0.5^4.2) of the maximum levels.
My initial outbreak was just one painful blister that quickly disappeared with a course of Acyclovir for 5 days. Since then I had some more outbreaks near the top of my penis, which to be honest weren't really that bad and I managed to get rid of them quite fast with Acyclovir. Since I had outbreaks quite often, I was prescribed suppressive treatment of two 200mg Acyclovir tablets per day.
Most articles online state that outbreaks typically get less significant and frequent over time.
The NEW Doctor tells me that the only difference between taking Valtrex (what I have been taking) to Acyclovir (What they now want to prescribe) is the number of times a day you take it. I looked online...they say that Valtrex does a better job of helping you not to transmit the virus (most of this information provided by GlaxoSmithKline of course). The supression study has them identical. I am in a relationship where I really enjoy our "personal time".
Glomerular filtration rate or its approximation of the creatinine clearance are measured whenever renal disease is suspected or careful dosing of nephrotoxic drugs is required. The normal ranges of GFR, adjusted for body surface area for males is 70 ± 14 mL/min/m2 (56-84) . Risk factors for kidney disease include diabetes, high blood pressure, family history and older age.
Take care and keep us posted.
What levels of Acyclovir do you generally reccommend daily for effective suppressive therapy? Is once or twice a day more or less effective, morning or night dosing or both. Are there long term health problems related to suppressive therapy? I have read extensive information on Immunovex and Acambis working on Vaccines of a preventative and therapeutic modality. They are utilizing different and emerging technologies than past attempts.
I don't think we have info on famvir dosing during pregnancy. We recommend the higher immunosuppression doses of valtrex and acyclovir during the last month of pregnancy. Your body is naturally immunosuppressed during pregnancy so it takes the higher doses to better control the virus.
since you were infected with hsv2 prior to pregnancy, the odds of transmission to your baby during birth are less than 1% as long as you don't have any obvious symptoms during delivery.
One doctor thought my skin looked odd and had me tested for all stds. I decided to try some acyclovir to see if it would help but its awful stuff. I am just trying it cause I have used a ton of anti-fungals and anti-infectives before that didn't help. The doc said 400mg 4 times daily for ten days. But I am seriously dehydrated. What is shorted possible course? Can I use 400mg 3 times daily for 5 days? As a trial to see if it helps.
I have never had any sysmptoms to indicate this. They prescribe me acyclovir now I am experiencing a bloody discharge? Can this be a sign of active HSV? Or should I go get a second opinion?
herpes doesn't "never go away" . even though you have hsv2, that doesn't mean that everything going on genitally is due to herpes. following up with the dermatologist if your gyn is stumped is a good idea. Many skin sensitivities that can occur and having the 2 of them work together, is often very helpful. Have you ever googled vulvodynia?
how were you diagnosed as having hsv2? did you have a lesion culture done?
There are preferred opiates drugs that are use in patients with liver disease that have shorter half-lives and have less harmful side effects on the renal system. Your liver doctor should be aware of these drugs and be able to determine if you may be able to use them.
With regards to OTC medications, normal recommended doses of acetaminophen can be safely given to patients who suffer from cirrhosis in the short term.
ll have an answer but anything would help. First off, I was originally prescribed acyclovir 200 mg, 2 pills 3 times a day. I have a couple refills on it but the thought of always having to go to the doctor really depresses me and I'm scared to death of someone seeing me especially at the pharmacy. When my refills are out, I have been planning on ordering Zovirax online in the dosage prescribd by my doctor. I know this is probably advised against, but are there any risks in doing this?
I got informed about it since a year ago, and I started taking Acyclovir 400 mg twice a day as suppressive therapy in order to make sure that my partner will be safe. I am not in a relationship since two months ago, and I stopped taking the medicine also since two months ago. I wonder if this is a right practice? Before taking the medicine, I was having 5-6 outbreaks per year, and during the suppressive therapy I only had one very mild one.
But regarding this Vit D , should i need to take along with calcium supllements Or no need? I have renal stones of 0.5mm. Does this have any effect on this?
If you are stage 3 you can take any analgesic within dosing limits. Your liver function has not been altered by your liver disease yet. If you become stage 4 (cirrhosis) then you will have to modify what drugs you can take because the liver is no longer able to process drugs in a normal manner.
Tramadol is an synthetic opiate and should not be taken for "mild" pain.
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