Vilerm Dosage/Direction for Use

Tablet: Acyclovir should be given as soon as possible after symptoms appear. Therapy should be initiated at the earliest sign or symptom (prodrome) of recurrence.
Food does not appear to affect oral absorption of Acyclovir, and the drug may be administered without regard to meals.
The dose and duration of administration depend on severity of the infection and the patient's condition.
Acyclovir should be taken continuously for the specified period or Acyclovir should be used as prescribed by the physician.
Adults: Herpes simplex infections: 200 mg orally 5 times daily (usually every 4 hours while awake) for 5-10 days.
In severe infections, the physician may consider increasing the dose and duration.
400 mg orally 5 times daily (usually every 4 hours while awake) for 7-14 days or as prescribed by the physician.
Chronic suppressive and maintenance prophylaxis of herpes simplex: 200 mg 4 times daily or 400 mg orally twice daily or as prescribed by the physician.
In severe HIV-infected patients, 400 mg orally 3 times daily for 7-14 days or may switch to intravenous therapy.
Genital herpes simplex infections initial episodes: 200 mg orally 5 times daily (usually every 4 hours while awake) for 10 days or as prescribed by the physician.
Episodic treatment of recurrent genital herpes simplex. Acyclovir should be initiated at the earliest prodromal sign or symptom of recurrence: 200 mg orally 5 times daily (usually every 4 hours while awake) for 5 days or as prescribed by the physician.
Chronic suppressive therapy of recurrent episodes: 400 mg orally 2 times daily for up to 12 months or as prescribed by the physician. Therapy should be interrupted every 6 to 12 months for reassessment of the condition. Dosage reduction to 400 to 600 mg orally daily can be tried.
Varicella (chickenpox): 800 mg orally 4 times daily for 5 days.
Herpes Zoster (Shingles): 800 mg orally 5 times daily (usually every 4 hours while awake) for 7-10 days.
Severely immunocompromised patients: Herpes simplex infections: 400 mg orally 5 times daily (usually every 4 hours while awake) for 7-14 days.
Episodic treatment of recurrent genital Herpes simplex. Acyclovir should be initiated at the earliest prodromal sign or symptom of recurrence: 400 mg orally 3 times daily for 5-14 days.
Chronic suppressive therapy of recurrent episodes: 400 mg orally 2 times daily; continue indefinitely regardless of CD₄ count in patients with severe recurrences of genital herpes or in patients who want to minimize frequency of recurrences or 400-800 mg 2-3 times daily.
Varicella (chickenpox): 800 mg orally 5 times daily for 5-7 days.
Herpes zoster (Shingles): 800 mg orally 5 times daily for 7-10 days.
Prophylaxis of CMV infection in bone marrow transplant recipients: In the management of bone marrow recipients this would normally be preceded by up to one month's therapy with intravenous Acyclovir [500 mg/m² of body surface area (3 times daily) every 8 hours (5 days before up to 30 days after transplant)]. The patients received intravenous Acyclovir followed by oral Acyclovir. The duration of oral Acyclovir treatment in bone marrow recipients was 6 months (from 1 to 7 months post-transplant) [800 mg orally 4 times daily].
Children: Treatment and suppressive therapy in immunocompromised patients: Treatment: 20 mg/kg/dose orally 3 times daily for 7-14 days. Maximum dose 400 mg/dose.
Suppressive therapy: 20 mg/kg/dose orally 2 times daily. Maximum dose 800 mg/dose. Reassess after 12 months.
Varicella (chickenpox): 2 years and older: 20 mg/kg/dose orally 4 times daily (80 mg/kg per day) for 5 days, or as prescribed by the physician.
2 years and older, more than 40 kg: usual adult dose (800 mg orally 4 times daily for 5 days).
Prophylaxis of CMV infection in bone marrow transplant recipients: Prophylaxis of CMV infection in children, over 2 years of age, who have undergone bone marrow transplantation, the adult dose may be given.
Administration in hepatic impairment: Acyclovir should be used with caution in hepatic impairment.
Administration in renal impairment: Doses of Acyclovir should be reduced in renal impairment according to creatinine clearance. (See Table 1.)

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Because Acyclovir is removed by hemodialysis. The patients undergoing hemodialysis receive a supplemental oral dose of the drug immediately after each dialysis period. The supplemental doses of oral Acyclovir do not appear to be necessary following peritoneal dialysis.
For immunocompromised patients with impaired renal function: A usual dosage regimen is 200-800 mg every 4-6 hours. Adjusted dosage regimen based on the patient's creatinine. (See Table 2.)

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Patients undergoing hemodialysis receive a supplemental oral dose of the drug immediately after each dialysis period.
Elderly: Acyclovir is excreted by the kidney. The possibility of renal impairment in the elderly must be considered and the dosage should be adjusted. Adequate hydration of elderly patients taking high oral doses of Acyclovir should be maintained.
Pediatric: Safety and efficacy of oral Acyclovir in children younger than 2 years of age have not been established.
Powder for infusion: The dose and duration of administration depend on the type of virus, severity of the infection and the patient's condition or VILERM IV INFUSION is used as directed by the physician.
A course of treatment with Acyclovir for infusion usually lasts 5 days, but this may be adjusted according to the patient's condition and response to therapy. Treatment for herpes encephalitis and neonatal herpes simplex infections usually lasts 10 days.
Acyclovir should be administered by IV infusion.
IV infusion: Reconstitution and IV preparation for IV administration: VILERM IV INFUSION (250 mg vial) should be reconstituted using 10 ml of either sterile water for injection or 0.9% sodium chloride injection to provide a solution containing 25 mg Acyclovir per ml.
VILERM IV INFUSION (500 mg vial) should be reconstituted using 20 ml of either sterile water for injection or 0.9% sodium chloride injection to provide a solution containing 25 mg Acyclovir per ml.
VILERM IV INFUSION (500 mg vial) should be reconstituted using 10 ml of either sterile water for injection or 0.9% sodium chloride injection to provide a solution containing 50 mg Acyclovir per ml.
Do not use bacteriostatic water for injection containing benzyl alcohol or parabens for reconstitution.
After that, the reconstituted solutions could be diluted to 50-100 ml of compatible infusion solution such as 0.9% sodium chloride injection, 0.45% sodium chloride injection, 4% dextrose injection and 0.18% sodium chloride injection, 2.5% dextrose injection and 0.45% sodium chloride injection, compound sodium lactate solution (Hartmann's solution) (Infusion concentrations of 7 mg/ml or lower are recommended).
Add the required volume of reconstituted solution to the chosen infusion solution, as recommended, and shake well to ensure adequate mixing occurs.
Acyclovir solution for infusion should be administered by slow intravenous infusion at a constant rate over 60 minutes and may be administered by a controlled-rate infusion pump.
The risk of contamination should be taken into account for IV preparations. Reconstitution and dilution of the Acyclovir solution should be carried out immediately before use and should be under full aseptic conditions. Any unused solution should be discarded.
Reconstituted or diluted solutions should not be refrigerated. Refrigeration of the reconstituted solution may result in formation of a precipitate which will redissolve at room temperature; potency of the drug does not appear to be affected by precipitation and subsequent redissolution.
If Acyclovir sodium is diluted in solutions, the color of solution may be pale yellow. A yellow discoloration may appear and the color of solution depends on the concentration of the solvent. In case the healthcare professional is following the recommendation, this discoloration of the solution does not affect the drug's potency.
Stability after reconstitution: Stability after reconstitution of VILERM IV INFUSION.
VILERM IV INFUSION 250 MG: See Table 3.

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VILERM IV INFUSION 500 MG: See Table 4.

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The Acyclovir solution should be administered by slow intravenous infusion at a constant rate over at least 60 minutes.
Administration in patients with normal renal function: Obese patients should be dosed at the recommended adult dose using ideal body weight, rather than actual body weight. (See Table 5.)

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Administration in acute and chronic renal impairment: Caution is advised when administering Acyclovir intravenous for infusion to patients with impaired renal function. Adequate hydration should be maintained.
The dose and frequency of administration of Acyclovir should be adjusted in patients with impaired renal function, according to the degree of impairment. (See Table 6.)

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Administration in elderly: Elderly patients are likely to have reduced renal function. Therefore, should use with caution in the elderly.