Zolaten Cold Sore Cream

Generic Name:
Product Name: Zolaten Cold Sore Cream

Indication

Ophthalmic ointment:

Used for the treatment of herpes simplex

keratitis Cream:

used for the treatment of herpes simplex infection of the lips.

Oral:

Used for the treatment of a first episode of genital herpes, and in some patients, the management of recurrent genital herpes episodes. Aciclovir does not prevent the establishment of latency in initial episodes.
Used in the management of patients with advanced and symptomatic HIV disease. -Aciclovir has no residual benefit effect, that is, there is no anti-viral effect outside of the period of intake, and it does not reduce the body viral pool.

Intravenous:

Used to hasten disease resolution of acute mucocutaneous herpes simplex virus infections in immunocompromised patients.
Used in the treatment of severe first episodes (primary or secondary) of genital herpes infections in immunocompetent individuals. -Used in the treatment of Herpes Zoster (shingles) infection in immunocompromised patients, or in a small number of immunocompetent patients with severe, acute infection. -Used in the treatment of Herpes Encephalitis.

Action

Aciclovir is a synthetic purine nucleoside analogue. It is an antiviral agent, active against the herpes simplex virus (HSV) types 1 & 2, and the varicella zoster virus (VSV). Development of resistance by HSV to aciclovir has been documented. Aciclovir is phosphorylated to the active antiviral compont aciclovir triphosphate in cells infected with HSV or VZV. Aciclovir triphosphate inhibits further DNA viral synthesis. Oral: Aciclovir is variably and only partially absorbed from the gut. Following oral administration, the mean half life ranges from 2.5-3.3 hours and is approximately 2.0 hours after intravenous administration. Half life is increased when aciclovir is co-administered with probenecid. Close to 60% of the drug is excreted unchanged by the kidney following glomerular filtration and tubular excretion. Accordingly, half-life is increased in elderly patients and patients with poor renal function (e.g. in patients with chronic renal failure, mean half life is 13.6-25.4 hours). Plasma aciclovir levels drop approximately 60% during dialysis.

Dose advice

Ophthalmic ointment:

Place a 1 cm ribbon of ointment inside the lower eyelid five times a day (e.g. every 4 hours while awake).
Treatment should be continued for 14 days, or at least 3 days after healing is complete.

Cream:

Apply 5-7 times daily to the affected site, rubbing in gently.
sufficient cream should be applied to ensure coverage of the entire lesion.
Usual dose: 1.25 cm ribbon of cream per 2.5 cm2 surface area

Oral:

Initial Genital Herpes: 5 x 200 mg tablets per day, (one tablet every 4 hours while awake), for 10 days. Total 50 tablets.
Chronic suppressive therapy for recurrent genital herpes: One 200 mg tablet three times per day, for up to 6 months.
Many patients may achieve adequate relief with one 200 mg tablet twice daily.
Intermittent therapy for recurrent genital herpes: 5 x 200 mg tablets per day (one tablet every four hours while awake), for 5 days. Total 25 tablets.

Herpes Zoster in adults:

5 x 800 mg tablets per day (one tablet every four hours while awake), for 7 days Advanced symptomatic HIV disease: 4 x 800 mg tablets per day (one tablet every 6 hours). Treatment is generally for 12 months.

Use in patients with renal impairment:

Genital Herpes:

For patients with creatinine clearance < 10 mL/min, a 200 mg dose twice daily is recommended.

Herpes Zoster and patients with advanced HIV disease: For patients with creatinine clearance 10-25 mL/min, a 800 mg dose three times daily is recommenced. For patients with a creatinine clearance < 10 mL/min, an 800 mg dose twice daily is recommended.

Intravenous:

Herpes Simplex infection (normal or immunocompromised): 5 mg/kg every 8 hours.
Very severe Herpes Zoster infection (normal immune status): 5 mg/kg every 8 hours.
Varicella zoster infection (immunocompromised): 10 mg/kg every 8 hours. Herpes
Zoster encephalitis (normal or immunocompromised): 10 mg/kg every 8 hours.

Impaired renal function:

Creatine clearance 25-50 ml/min: recommended dose (5-10 mg/kg) every 12 hours.
Creatine clearance 10-15 ml/min: recommended dose (5-10 mg/kg) every 24 hours.
Creatine clearance 0-10 ml/min: halve recommended dose (2.5-5 mg/kg) every 24 hours and after dialysis.

Dosage in children Dose should be calculated on the basis of body surface area:

Normal immune function: 250 mg/m2 (equal to 5 mg/kg in adults)
Immunocompromised: 500 mg/m2 (equal to 10 mg/kg in adults)

Dosage in elderly: It is recommended that the state of hydration and creatinine clearance be assessed before administration and the dosage reduced accordingly. Duration of treatment: For most indications, intravenous therapy should be continued for 5-10 days. In the treatment of herpes simplex encephalitis, treatment should be for at least 10 days.