Excreted Unchanged %
40-70
Half-Life (Normalesrd) Hours
2.1-3.8/20
Plasma Protein Binding %
15-30
Volume Of Distribution L/Kg
0.7
Dose For Normal Renal Function
5-10 mg/kg q8h
Adjustment For Renal Failure Method
D,I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% q8h [D]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% q12-24h [D]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50% q24h [D]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: 5-10 mg/kg q24h, [A]
References
Bleyzac N, Barou P, Massenavette B, Contamin B, Maire P, Berthier JC, et al. Assess-ment of acyclovir intraindividual pharmacokinetic variability during continuoushemofiltration, continuous hemodiafiltration, and continuous hemodialysis. Ther Drug Monit. 1999; 21: 520-5. [PMID: 10519448] / Boulieu R, Bastien O, Gaillard S, Flamens C. Pharmacokinetics of acyclovir in patients undergoing continuous venovenous hemodialysis. Ther Drug Monit. 1997; 19: 701-4. [PMID: 9421114] / Khajehdehi P, Jamal JA, Bastani B. Removal of acyclovir during continuous veno-venous hemodialysis and hemodiafiltration with high-efficiency membranes. Clin Nephrol. 2000; 54: 351-5. [PMID: 11076113] / Krasny HC, Liao SH, de Miranda P, Laskin OL, Whelton A, Lietman PS. Influence of hemodialysis on acyclovir pharmacokinetics in patients with chronic renal failure. Am J Med. 1982; 73: 202-4. [PMID: 7102703] / Laskin OL. Clinical pharmacokinetics of acyclovir. Clin Pharmacokinet. 1983; 8: 187-201. [PMID: 6342900]
Toxicity Notes
Neurotoxicity in ESRD. IV preparation can cause renal failure if injected rapidly.