Zovirax: Effective Antiviral Treatment for Herpes Infections
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Synonyms | |||
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Zovirax (acyclovir) is a pioneering antiviral medication specifically formulated to manage infections caused by the herpes simplex virus (HSV) and varicella-zoster virus (VZV). As a nucleoside analogue DNA polymerase inhibitor, it targets viral replication with precision, offering both therapeutic and suppressive benefits. This prescription medication is available in multiple formulations, including oral tablets, topical cream, and intravenous injection, allowing for tailored treatment strategies based on infection type and severity. Trusted by healthcare professionals for decades, Zovirax remains a cornerstone in antiviral therapy, providing rapid symptom relief and reducing the risk of transmission.
Features
- Active ingredient: Acyclovir
- Available formulations: 200mg, 400mg, 800mg oral tablets; 5% topical cream; intravenous injection
- Mechanism: Selective inhibition of viral DNA polymerase
- Targets: Herpes simplex virus types 1 and 2 (HSV-1, HSV-2), varicella-zoster virus (VZV)
- Prescription-only medication
- Multiple packaging options for course-based treatment
Benefits
- Rapid reduction in viral shedding and lesion formation
- Shortens healing time for primary and recurrent herpes outbreaks
- Decreases the duration of pain and discomfort associated with lesions
- Effective in preventing recurrent episodes when used as suppressive therapy
- Reduces risk of transmission to sexual partners for genital herpes
- Helps prevent complications in immunocompromised patients
Common use
Zovirax is primarily indicated for the treatment of initial and recurrent episodes of genital herpes in immunocompetent patients. It is also approved for the management of herpes labialis (cold sores) through topical application. In hospital settings, intravenous Zovirax is used for severe herpes infections, including herpes encephalitis and disseminated herpes in immunocompromised individuals. Additionally, it is prescribed for the treatment of chickenpox (varicella) and shingles (herpes zoster), particularly in adults and immunocompromised patients where complications are more likely. Off-label uses include prophylaxis in transplant patients and management of herpes whitlow.
Dosage and direction
Oral Tablets:
- Genital herpes (initial): 200mg every 4 hours (5 times daily) for 10 days
- Genital herpes (recurrent): 200mg every 4 hours (5 times daily) for 5 days
- Chronic suppression: 400mg twice daily or 200mg three times daily
- Herpes zoster: 800mg every 4 hours (5 times daily) for 7-10 days
- Chickenpox: 20mg/kg (max 800mg) four times daily for 5 days
Topical Cream:
- Apply to affected area every 3 hours (6 times daily) for 7 days
- Begin treatment at earliest sign of recurrence
Intravenous:
- 5-10mg/kg every 8 hours for 7-10 days
- Dose adjustment required for renal impairment
Always complete the full course of treatment even if symptoms improve earlier. Take oral doses with plenty of water to ensure adequate hydration.
Precautions
Patients with renal impairment require dose adjustment and careful monitoring of renal function during treatment. Maintain adequate hydration, especially during high-dose oral or intravenous therapy, to prevent crystalline nephropathy. Use with caution in elderly patients due to age-related decreases in renal function. Neurological symptoms should be monitored closely, particularly in patients with pre-existing neurological conditions or those receiving intravenous therapy. Topical application should avoid contact with eyes, and application to mucous membranes should be done with medical guidance. Pregnancy category B - use only if clearly needed after risk-benefit assessment.
Contraindications
Hypersensitivity to acyclovir, valacyclovir, or any component of the formulation. Patients with history of severe neurological reactions to previous acyclovir treatment should not receive subsequent doses. The intravenous formulation is contraindicated in patients with pre-existing renal impairment unless the potential benefit justifies the risk and appropriate dose adjustments are implemented. Topical formulation should not be used on immunocompromised patients for prophylaxis without medical supervision.
Possible side effect
Common side effects include headache (approximately 10% of patients), nausea (5-8%), diarrhea (2-5%), and vomiting (3%). Topical application may cause mild pain, burning, or stinging at application site (approximately 30% of users). Less frequently, neurological symptoms such as dizziness, confusion, hallucinations, or tremors may occur, particularly with intravenous administration. Renal impairment manifested by elevated creatinine and BUN may develop, especially with dehydration or pre-existing renal disease. Hematological changes including thrombocytopenia and leukopenia have been reported in approximately 1% of patients. Severe allergic reactions including anaphylaxis are rare but possible.
Drug interaction
Probenecid significantly increases acyclovir plasma concentrations by reducing renal clearance, requiring dose adjustment. Concurrent use with other nephrotoxic drugs (aminoglycosides, cyclosporine, NSAIDs) may increase risk of renal toxicity. Zidovudine may potentiate fatigue and lethargy when co-administered with acyclovir. Medications that compete for tubular secretion may alter acyclovir concentrations. No significant interactions with oral contraceptives have been documented, but monitoring is advised during initial co-administration.
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed administration. For twice-daily dosing regimens, if remembered within 4 hours of the missed dose, take immediately then resume normal schedule. For more frequent dosing regimens, continue with the next scheduled dose without adjustment. Consistent dosing is important for maintaining effective antiviral concentrations, particularly during acute infection treatment.
Overdose
Symptoms of overdose may include agitation, coma, seizures, and renal impairment manifesting as elevated creatinine and decreased urine output. Management includes supportive care with maintenance of adequate hydration to promote renal excretion. Hemodialysis significantly enhances acyclovir removal (approximately 60% reduction in plasma concentrations during 4-hour dialysis session). In cases of recent ingestion, gastric lavage may be considered if presented within 1-2 hours. Monitor renal function and neurological status closely for at least 48 hours post-overdose.
Storage
Store at room temperature (15-30°C or 59-86°F) in original container. Protect from moisture and light. Keep oral tablets in tightly closed containers. Topical cream should not be exposed to extreme temperatures. Do not freeze any formulation. Keep all medications out of reach of children and pets. Discard any unused medication after completion of treatment course or after expiration date marked on packaging. Do not flush medications down toilet or drain unless instructed to do so.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Zovirax is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to treatment may vary based on medical history, renal function, and specific viral strain. Always follow your healthcare provider’s instructions regarding dosage, administration, and treatment duration. Report any adverse effects or concerns to your physician promptly. Not all uses described may be approved in your country - check local prescribing information.
Reviews
Clinical studies demonstrate Zovirax reduces healing time for primary genital herpes by 3-5 days compared to placebo. In recurrent herpes labialis, topical application initiated early reduces healing time by approximately 0.5-1 day. Suppressive therapy shows 70-80% reduction in recurrence frequency for genital herpes. Patient satisfaction surveys indicate high rates of symptom relief and quality of life improvement, particularly among immunocompromised patients receiving prophylaxis. Long-term safety data support continued use with appropriate monitoring, though viral resistance remains a consideration in immunocompromised populations after extended therapy.