Vilerm Overdosage

Overdose and treatment: Tablet: There is no specific antidote for Acyclovir.
Acyclovir adult overdosage involving ingestion of up to 20 g of the drug have been reported. Inappropriately high doses and in patients with fluid and electrolyte imbalance result in elevations in BUN and serum creatinine concentration and subsequent renal failure. Acyclovir adult overdosage associated with the development of lethargy, agitation, seizures and coma. Patients generally do well with supportive care. Nausea and vomiting should be treated with antiemetics. Rashes should be treated with supportive care, discontinuation of the offending agent, and consideration of antihistamines and corticosteroids. With massive overdose, hydrate patients and monitor renal function. Supportive care remains the mainstay of care in severe toxicity. Seizures should be treated with benzodiazepines as first line therapy, followed by barbiturates or propofol, if seizures persist. Hydrate patients and monitor urine output and renal function. At renal concentrations exceeding 2.5 mg/mL, Acyclovir crystals may precipitate in the renal tubules, possibly causing renal dysfunction and eventual renal failure and anuria. If acute renal failure and anuria occur, use of hemodialysis should be considered until renal function is restored. Acyclovir has low protein binding and volumes of distribution, and can be removed by hemodialysis. Data are limited regarding peritoneal dialysis but this method does not appear to appreciably remove the drug.
Powder for infusion: Overdosage, when the drug was administered by rapid intravenous injection or inappropriately high dose, particularly in patients with water and electrolytes imbalance, may cause elevation of serum creatinine and blood urea nitrogen (BUN). At renal concentrations exceeding 2.5 mg/ml, Acyclovir crystal may precipitate in the renal tubules, possibly causing renal failure. Moreover, neurological effects including confusion, hallucinations, agitation, seizures and coma have been described in association with overdosage.
Acyclovir is removed by hemodialysis.