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Aciclovir

Aciclovir
Aciclovir is an antiviral drug. Its action is aimed at suppressing infections caused by certain viruses in immunocompromised patients.

Brand: Aciclovir

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: December 2023
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Aciclovir 800 mg
270 pills - 800 mg
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$215.93 $0.80 $323.62 Add to cart
180 pills - 800 mg
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$157.93 $0.88 $201.77 Add to cart
120 pills - 800 mg
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$117.59 $0.98 $122.21 Add to cart
90 pills - 800 mg $99.99 $1.11 $79.86 Add to cart
60 pills - 800 mg $79.75 $1.33 $40.15 Add to cart
30 pills - 800 mg $59.95 $2.00 No Add to cart
Aciclovir 400 mg
270 pills - 400 mg
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$179.85 $0.67 $269.61 Add to cart
180 pills - 400 mg
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$133.95 $0.74 $165.69 Add to cart
120 pills - 400 mg $99.95 $0.83 $99.81 Add to cart
90 pills - 400 mg $83.95 $0.93 $65.87 Add to cart
60 pills - 400 mg $67.93 $1.13 $31.95 Add to cart
30 pills - 400 mg $49.94 $1.66 No Add to cart
Aciclovir 200 mg
270 pills - 200 mg
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$129.99 $0.48 $76.79 Add to cart
180 pills - 200 mg $94.95 $0.53 $42.90 Add to cart
120 pills - 200 mg $70.35 $0.59 $21.55 Add to cart
90 pills - 200 mg $58.95 $0.66 $9.98 Add to cart
60 pills - 200 mg $45.95 $0.77 No Add to cart

Product description

Composition active substance: aciclovir; 1 tablet contains 200 mg aciclovir; excipients: potato starch, sodium croscarmellose, calcium stearate. Dosage form Tablets. Basic physical and chemical properties: tablets of white or almost white color with beveled and scored. Pharmacological group Antiviral agents for systemic use. ATX code J05A B01. 

Antiviral agent Aciclovir

Pharmacological properties of the drug Aciclovir

Pharmacodynamics

Aciclovir is a synthetic analogue of a purine nucleoside with in vivo and in vitro inhibitory activity against human herpesvirus, including herpes simplex virus types I and II, chickenpox and herpes zoster virus, Epstein-Barr virus and cytomegalovirus. In cell culture, aciclovir is most active against herpes simplex virus type I and further, in decreasing activity, against herpes simplex virus type II, varicella-zoster virus and herpes zoster, Epstein-Barr virus and cytomegalovirus. 

The inhibitory activity of aciclovir against the aforementioned viruses is highly selective. The enzyme thymidine kinase in a normal uninfected cell does not use aciclovir as a substrate, therefore, the toxic effect on the cells of the host organism is minimal. However, thymidine kinase, encoded in herpes simplex viruses, varicella zoster virus and Epstein-Barr virus, converts aciclovir into aciclovir monophosphate, a nucleoside analogue, which is then converted sequentially to diphosphate and triphosphate using cell enzymes. Following the incorporation of aciclovir into the viral DNA, triphosphate interacts with the viral DNA polymerase, resulting in the termination of the viral DNA chain synthesis. 

 Virus zoster varicella

With prolonged or repeated courses of treatment of critically ill patients with reduced immunity, it is possible to reduce the sensitivity of certain strains of the virus, which do not always respond to treatment with Aciclovir. Most clinical cases of insensitivity are associated with a deficiency of viral thymidine kinase, however, there are reports of damage to viral thymidine kinase and DNA. In vitro interactions of certain herpes simplex viruses with Aciclovir can also lead to the formation of less sensitive strains. The relationship between the sensitivity of individual herpes simplex viruses in vitro and the clinical results of treatment with Aciclovir is not fully understood. 

Pharmacokinetics of the Aciclovir

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Aciclovir is only partially absorbed in the digestive tract (about 20% of the dose taken). Simultaneous food intake does not lead to a decrease in absorption. The maximum concentration is reached in 1.5-2 hours. 

The level of binding to blood plasma proteins is relatively low (from 9% to 33%) and does not change when interacting with other drugs. 

Aciclovir crosses the placental barrier, in cerebrospinal fluid (50% of the corresponding concentration in blood plasma), breast milk. 

Most of the drug (85-90%) is excreted unchanged by the kidneys, and only a small part (10-15%) is excreted as a metabolite (9-carboxymethoxymethylguanine). The renal clearance of aciclovir is significantly higher than the clearance of creatinine, which indicates that the excretion of the drug by the kidneys is carried out by not only glomerular filtration, but also by tubular secretion. 

The terminal half-life with intravenous administration of aciclovir is approximately 2.9 hours, in patients with chronic renal failure - 19.5 hours, during hemodialysis - 5.7 hours. Plasma aciclovir levels are reduced by about 60% during dialysis. 


 

Treatment of infections of the skin and mucous membranes caused by the Herpes simple virus, including primary and recurrent genital herpes. Prevention of recurrence of infections caused by the Herpes simple virus in patients with normal immunity. Prevention of infections caused by the Herpes simple virus in patients with immunodeficiency. Treatment of infections caused by the Varicella zoster virus (chickenpox, herpes zoster). 

Contraindications 

Hypersensitivity to aciclovir, valaciclovir or other components of the drug. 

Interaction with other drugs and other types of interactions 

Aciclovir is excreted mainly unchanged by the kidneys by tubular secretion, therefore, any drugs with a similar release mechanism can increase the concentration of aciclovir in blood plasma. 

With simultaneous use with other drugs, it is possible: 

  • with probenecid, cimetidine - lengthening the half-life of aciclovir and the area under the concentration / time curve; 
  • with immunosuppressants in patients after organ transplantation - an increase in the level of aciclovir and an inactive metabolite of the immunosuppressive drug in the blood plasma, given the wide therapeutic index of aciclovir, adjust the dose. 

No clinically important interactions of aciclovir with other drugs have been identified. 

Application features

When using high doses of the drug, an adequate level of body hydration should be maintained. 

The drug should be used with caution in patients with impaired renal function, since aciclovir is excreted from the body mainly by renal clearance. Dose adjustments should be made (see Section "Dosage and Administration"). 

The drug should be used with caution in elderly patients, since this group of patients is more likely to have renal dysfunction. If necessary, you should adjust the dose (see Section "Dosage and Administration"). 

Both of these groups (patients with impaired renal function and elderly patients) are at risk for neurological disorders, and therefore they should be closely monitored to detect these adverse reactions. According to the data obtained, such reactions are generally reversible in case of termination of treatment. 

Application during pregnancy and lactation 

In the post-registration register of monitoring pregnant women, the results of the use of various pharmaceutical forms of aciclovir by pregnant women are documented. There was no increase in the number of congenital malformations in children whose mothers used aciclovir during pregnancy compared to the general population. 

When taken orally, aciclovir at a dose of 200 mg 5 times a day, it penetrates into breast milk at concentrations of 0.6-4.1% of the corresponding level of aciclovir in blood plasma. Potentially, a child can assimilate aciclovir at a dose of up to 0.3 mg / kg of body weight per day. 

During pregnancy and lactation, the drug should be used when its potential benefit to the mother outweighs the possible risk to the fetus. 

Ability to influence the reaction rate when driving motor transport or operating other mechanisms

Clinical studies of the effect of aciclovir on the reaction rate when driving or operating other mechanisms have not been conducted. The pharmacology of aciclovir does not give reason to expect any negative effects. When deciding on the possibility of driving a car and other mechanisms, the clinical status of the patient and the profile of adverse reactions of the drug should be taken into account. 

Method of administration and dosage The

tablet should be taken whole with water. When using high doses of the drug, an adequate level of hydration of the body should be maintained. 

Adults

Treatment of infections caused by the Herpes simple virus. 

The drug should be used in a dose of 200 mg 5 times a day at approximately 4-hour intervals, with the exception of the night period. The duration of treatment is 5 days, but in the case of a severe primary infection, it can be continued.

If necessary, in patients with severe immunodeficiency or with reduced absorption in the intestine, a single dose can be doubled to 400 mg or an appropriate dose can be used for intravenous administration. 

Treatment should be started as early as possible after the onset of infection. In the case of recurrent herpes, it is better to start treatment in the prodromal period or after the first signs of skin lesions appear.

Prevention of recurrence of infections caused by the Herpes simple virus in patients with normal immunity.

The drug should be used at a dose of 200 mg 4 times a day with a 6-hour interval (or, for convenience, at a dose of 400 mg 2 times a day with a 12-hour interval). 

Treatment will be effective even after reducing the dose of the drug to 200 mg 3 times a day with an 8-hour interval, or even 2 times a day with a 12-hour interval. 

In some cases, a radical improvement is observed after taking a daily dose of 800 mg. 

To monitor possible changes in the natural course of the disease, drug therapy should be interrupted periodically at intervals of 6-12 months. 

Prevention of infections caused by the Herpes simple virus in patients with immunodeficiency. 

The drug should be used in a dose of 200 mg 4 times a day with a 6-hour interval. 

If necessary, in patients with severe immunodeficiency or with reduced absorption in the intestine, a single dose can be doubled to 400 mg or an appropriate dose can be used for intravenous administration. 

The duration of prophylaxis depends on the length of the risk period. 

Treatment of infections caused by the Varicella zoster virus. 

The drug should be used in a dose of 800 mg 5 times a day at approximately 4-hour intervals, with the exception of the night period. The duration of treatment is 7 days. 

Treatment should be started as early as possible after the onset of the disease, the result will be better if therapy is started immediately after the appearance of the rash. 

Patients with severe immunodeficiency or with reduced absorption in the intestine are better off using intravenous administration of the drug. 

Children from 2 years of age

Treatment and prevention of infections caused by the Herpes simple virus in children with immunodeficiency. 

The drug should be used in doses as for adults. 

Treatment for chickenpox. 

The drug should be used in a dose for children aged 2 to 6 years - 400 mg 4 times a day, children over 6 years old - 800 mg 4 times a day. 

More precisely, the dose of the drug can be calculated by the child's body weight - 20 mg / kg of body weight per day, divided into 4 doses. The maximum daily dose is 800 mg. The duration of treatment is 5 days. 

There are no specific data on the use of aciclovir  for the prevention of infections caused by the herpes simplex virus or for the treatment of infections caused by the herpes zoster virus in children with normal immunity. 

Patients with impaired renal function. 

Use the drug with caution. It is necessary to maintain an adequate level of hydration of the body. 

In the prevention and treatment of infections caused by the Herpes simple virus in patients with renal insufficiency, the recommended oral doses do not lead to an accumulation of aciclovir, the level of which would exceed the safe level established for intravenous administration. However, patients with severe renal failure (creatinine clearance less than 10 ml / min) are recommended to use the drug in a dose of 200 mg 2 times a day with approximately 12-hour intervals. 

In the treatment of infections caused by the Varicella zoster virus, patients with significantly reduced immunity are recommended to use the drug in a dose for severe renal failure (creatinine clearance less than 10 ml / min) - 800 mg 2 times a day with approximately 12-hour intervals, with moderate renal failure (creatinine clearance within 10-25 ml / min) - 800 mg 3 times a day with approximately 8-hour intervals.

Elderly patients

Use the drug with caution. It is necessary to maintain an adequate level of hydration of the body. It should be borne in mind the possibility of impaired renal function in elderly patients, and the dose of the drug for them should be changed accordingly. 

Children

Use the drug in children aged 2 years and older. 

Overdose

Symptoms. Aciclovir is only partially absorbed in the digestive tract. Cases of accidental ingestion by patients of up to 20 g of aciclovir without a toxic effect have been reported. 

In case of an accidental overdose of aciclovir for several days, the following symptoms occur: gastroenterological (nausea, vomiting) and neurological (headache, confusion). 

In case of an overdose of the administered aciclovir, the level of serum creatinine, urea nitrogen in the blood increases and, accordingly, renal failure appears. The neurological manifestations of an overdose can be confusion, hallucinations, agitation, convulsions, and coma. 

Treatment: should be examined to identify symptoms of intoxication, symptomatic therapy should be carried out, in severe cases - hemodialysis.


Storage conditions Store in original packaging at a temperature not exceeding 25 ° C. Keep out of reach of children.

From the cardiovascular system: palpitations, chest pain. 

On the part of the blood and lymphatic system: anemia, leukopenia, thrombocytopenia. 

From the nervous system and psyche: headache, dizziness, psychomotor agitation, confusion, tremor, ataxia, dysarthria, hallucinations, psychotic symptoms, convulsions, drowsiness, encephalopathy, coma. 

The above symptoms are reversible in most cases and are observed mainly in patients with renal insufficiency or other risk factors. 

From the respiratory system, chest and mediastinal organs: shortness of breath. From the digestive tract: nausea, vomiting, diarrhea, abdominal pain, loss of appetite, gastritis, dysphagia. 

From the digestive system: a transient increase in the activity of liver enzymes and the level of bilirubin, jaundice, hepatitis. 

From the urinary system: an increase in the concentration of urea and creatinine in the blood, acute renal failure, pain in the kidney area. 

Pain in the kidney area may be associated with renal failure and crystalluria. 

From the immune system, skin and subcutaneous tissue: hypersensitivity reactions, including rash, itching, hyperemia, urticaria, angioedema, anaphylactic reactions; photosensitivity, alopecia. 

Since hair loss can be associated with a large number of diseases and medications, no clear association has been found with aciclovir use. 


General disorders: fatigue, fever.