Acivir Cream (Acyclovir 5%)

About brand name of the drug

Acivir cream 5gm is an allopathic formulation available in the form of cream. It is manufactured by the Pharmaceutical Company Cipla Ltd, India. Acivir cream 5gm contains an antiviral agent which is used in the treatment of infections caused by herpes virus. Each gram of Acivir cream, 0.05% contains 5gm of acyclovir in quantity sufficient inactive ingredients. Acivir cream 5gm is a generic version of USA brand Zovirax and available at much lower rates than the branded version.

About the drug 

Acivir 0.05% cream contains an active ingredient Acyclovir which is effective in the treatment of infections caused by herpes virus. The medicine belongs to the class of antiviral and works by stopping the growth of virus. This medicine can be applied 5 times in a day for four days or should be used as instructed by doctor or Pharmacist. The medicine should be applied quickly as the symptoms appear. The drug belongs to schedule H category. Schedule H stands for all those drugs which are to be sold on prescription of a registered medical practitioner only.

About salt of the drug

Acyclovir is an active drug present in Acivir cream 5gm which is responsible for therapeutic actions. This cream is applied topically on the affected area. Acyclovir belongs to the class of antiviral and it is primarily used in the treatment of herpes simplex virus (A virus which causes contagious sores around the mouth or on the Genitals), Chicken pox (viral infection which causes an itchy, blister –like rash on the skin) and Shingles (it is reactivation of the chickenpox virus in the body). This medicine can be formulated in the form of tablet, cream and injection.

Medical Uses of the drug

This medicine works by stopping the developing of virus and hence it is prescribed for the following indications:

• Herpes Zoster infections
• Genital Herpes
• Chickenpox
• Cold sores (herpes simplex labialis)
• Shingles
• Herpes simplex encephalitis
• Neonatal herpes simplex
• Herpes of eye

This medicine is used for the prevention of herpes virus infections in immunocompromised patients (patients who are undergoing cancer chemotherapy)

Working of a drug 

• Acyclovir has an inhibitory activity against herpes simplex virus type 1 and type 2 and varicella zoster virus(VZV)
• Acyclovir has inhibitory activity due to its affinity for the enzyme Thymidine kinase which is encoded by HSV(herpes simplex virus) and VZV(varicella zoster virus)
• Through number of steps acyclovir gets converted into acyclovir triphosphate inside the virus. Acyclovir triphosphate stops the replication of herpes viral DNAs
• Inhibitory activity is accomplished by the following ways:
• Inhibits viral DNA Polymerase(enzyme which helps in DNA replication)
• Terminates the growth of viral DNA chain by getting incorporated inside the DNA

In this way, Acyclovir show antiviral activity

Side effects 

Acivir cream 5gm is commonly associated with the following common side effect:

• Dryness of the skin
• Flaking skin
• Burning sensation
• Erythema
• Itching 
• Angio-oedema
• Anaphylaxis
• Application site reactions showing signs and symptoms of inflammation
• Contact dermatitis

Ophthalmic Acivir cream may cause superficial punctate keratitis or some allergic reactions

How to use 

•  Patient should read patient information Leaflet provided inside the kit 
• This medication should be used as soon as the first sign of infection appears (such as redness, tingling, burning)
• Patient should wash their hands with soap before and after applying the medicine
• Before applying the medication, one should first clean and dry the affected area
• Apply the cream gently on the affected areas, generally 5 times a day in every 3-4 hours
• If it irritates your skin then one should wash the area by flushing with plenty of water
• Dosage of the medicine depends on the type of infection and response to the treatment
• One should use the medicine regularly with constant time intervals in order to get most benefit from it

Drugs that are known to interact with this medicine

When a person is using multiple drugs, all drugs may interact with each other depending from person to person. Hence, one should check all possible interactions of drug with doctor before starting any new therapy. Following drugs are known to interact with Acivir cream 5gm:

• Ketoconazole
• Phenytoin 
• Sulphasalazine
• Probenecid
• tacrolimus

When to avoid taking the drug

• Patient should avoid taking drug if any kind of hypersensitivity reactions appear to drugs like acyclovir, valacyclovir or any other ingredient of the formulation
• If persistent itching occurs then avoid applying the cream and inform to doctors immediately
• Patient should avoid using the medicine inside the eyes, nose or vagina as it may cause irritation

Things to avoid when using the drug

• Nursing women should avoid nursing if active herpetic lesion have occurred on or near to breast 
• One should avoid taking bathe immediately after applying medicine as the drug would get washed away
• Do not apply other skin or cosmetic products (sunscreen, lotion, lip balm)unless you are instructed by doctor
• One should not cover the area with waterproof bandages or plastic unless you are instructed by doctor
• Avoid close contact with the other person until you get completely healed

General Information and Precautions

• This medicine should be used as prescribed by the doctor 
• It should be applied on the affected areas as instructed by doctors or by Pharmacist
• One should apply cream to the whole affected area(tingling/red/burning areas)
• The patient should inform doctor about his undergoing treatment or any herbal medicines which he may be taking
• The doctor should be informed if patient has any kind of allergies against the drugs in antiviral class
• While using medicine, if a person experiences any unusual side effects then he must inform doctor immediately

Precautions

• Alcohol: The interaction with alcohol is unknown , hence patient should consult doctor before consumption
• Pregnancy: This medicine is safe in pregnant women. Still the cream should be applied only if benefits overweigh risk. 
• Driving: The drug has no effect on driving, hence it is considered to be safe
• Breastfeeding: It is not clearly known that whether the drug gets excreted in the breast milk when it is topically applied. Hence systemic exposure following the drug is minimal and it is considered safe to be used by lactating mothers. 
• Nursing mothers who have herpes lesion on or around breast should avoid nursing

Storage

• The Acivir cream 5gm should be stored in cool and dry place
• This drug should be stored away from heat, moisture and light
• Any unused medicine should be discarded after its expiration date.
• The drug should be kept out of reach of children 
• If the cream tube is already pierced then you should not use that medicine

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