acyclovir ophthalmic (Rx)

Brand and Other Names:Avaclyr

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic ointment

  • 3% (3.5g tube)

Acute Herpetic Keratitis

Indicated for acute herpetic keratitis (dendritic ulcers) in patients with herpes simplex virus (HSV-1 and HSV-2)

Initial: Apply 1-cm ribbon to affected eye 5x/day (~q3hr while awake) until healed, followed by 7-day maintenance regimen

Maintenance: Apply 1-cm ribbon to affected eye 3x/day for 7 days

Dosage Forms & Strengths

ophthalmic ointment

  • 3% (3.5g tube)

Acute Herpetic Keratitis

<2 years: Safety and efficacy not established

≥2 years

  • Indicated for acute herpetic keratitis (dendritic ulcers) in patients with herpes simplex virus (HSV-1 and HSV-2)
  • Initial: Apply 1-cm ribbon to affected eye 5x/day (~q3hr while awake) until healed, followed by 7-day maintenance regimen
  • Maintenance: Apply 1-cm ribbon to affected eye 3x/day for 7 days
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Interactions

Interaction Checker

and acyclovir ophthalmic

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

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                    Adverse Effects

                    2-10%

                    Eye pain (stinging)

                    Punctuate keratitis

                    Follicular conjunctivitis

                    Frequency Not Defined

                    Blepharitis

                    Hypersensitivity reactions (eg, angioedema, urticaria)

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                    Warnings

                    Contraindications

                    Hypersensitivity to acyclovir or valacyclovir

                    Cautions

                    For ophthalmic use only

                    Patients should not wear contact lenses if they have signs or symptoms of herpetic keratitis or during the course of therapy

                    Product is sterile when packaged; patients should be advised to not allow the tip of the container to touch any surface; this may contaminate the ointment; if pain develops, or redness, itching, or inflammation becomes aggravated, patient should consult a physician

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                    Pregnancy & Lactation

                    Pregnancy

                    A prospective epidemiologic registry of acyclovir use from 1984-1999 reported birth defects in women exposed to systemic acyclovir during the first trimester of pregnancy

                    Likewise, oral and SC administration of acyclovir to pregnant mice, rats, and rabbits during organogenesis did not produce teratogenicity at clinically relevant doses

                    Lactation

                    Acyclovir concentrations reported in breast milk following oral administration of acyclovir

                    There is no information regarding presence of acyclovir in human milk following ocular administration, effects on the breastfed infant, or effects on milk production

                    Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition

                    Pregnancy Categories

                    A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                    B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                    C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                    D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                    X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                    NA: Information not available.

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                    Pharmacology

                    Mechanism of Action

                    Synthetic purine nucleoside analogue is converted by the viral encoded thymidine kinase into acyclovir monophosphate, a nucleotide analogue then further converted to acyclovir triphosphate by other cellular enzymes

                    Acyclovir triphosphate inhibits DNA synthesis and viral replication by competing with nucleotides for viral DNA polymerase and being incorporated into viral DNA

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                    Administration

                    Ophthalmic Administration

                    Advise patients to wash hands well and pull down lower lid of the affected eye to form a pocket

                    Apply 1-cm (1/2 inch) ribbon of ointment in the pocket formed by the lower lid (the lower cul-de-sac)

                    After application, advise patient to close their eye for 1-2 minutes Wipe any excess ointment away

                    Storage

                    Store at 20-25°C (68-77°F)

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                    Images

                    No images available for this drug.
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                    Patient Handout

                    A Patient Handout is not currently available for this monograph.
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                    Formulary

                    FormularyPatient Discounts

                    Adding plans allows you to compare formulary status to other drugs in the same class.

                    To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                    Adding plans allows you to:

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                    • Compare formulary status to other drugs in the same class.
                    • Access your plan list on any device – mobile or desktop.

                    The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                    Tier Description
                    1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                    2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                    3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                    4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                    5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                    6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                    NC NOT COVERED – Drugs that are not covered by the plan.
                    Code Definition
                    PA Prior Authorization
                    Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                    QL Quantity Limits
                    Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                    ST Step Therapy
                    Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                    OR Other Restrictions
                    Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                    Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.