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For management of a suspected drug overdose, contact your regional Poison Control Centre.
Activated charcoal may be administered to aid in the removal of unabsorbed drug. General supportive measures are recommended.
Acyclovir is only partly absorbed in the gastrointestinal tract. Patients have ingested up to 20 g acyclovir on a single occasion, with no unexpected adverse effects. In clinical studies, the highest plasma concentration observed in a single patient at these doses was 10.0 μg/mL. Accidental, repeated overdoses of oral acyclovir over several days have been associated with gastrointestinal effects (such as nausea and vomiting) and neurological effects (headache and confusion).
Intravenous doses administered to humans have been as high as 1,200 mg/m² (28 mg/kg) 3 times daily for up to 2 weeks. Peak plasma concentrations have reached 80 μg/mL. Overdosage of intravenous acyclovir has resulted in elevations of serum creatinine, blood urea nitrogen and subsequent renal failure. Neurological effects including confusion, hallucinations, agitation, seizures and coma have been described in association with intravenous overdosage.
Patients should be observed closely for signs of toxicity. Hemodialysis significantly enhances the removal of acyclovir from the blood and may, therefore be considered a management option in the event of symptomatic overdose. Precipitation of acyclovir in renal tubules may occur if the solubility (2.5 mg/mL) in the intratubular fluid is exceeded. In the event of renal failure and anuria, the patient may benefit from hemodialysis until renal function is restored (see DOSAGE AND ADMINISTRATION).
ZOVIRAX® (acyclovir) is contraindicated for patients who develop hypersensitivity or who are hypersensitive to acyclovir, valacyclovir or any other components of the formulations of ZOVIRAX®. For a complete listing, see Dosage Forms, Composition and Packaging section of the product monograph.This monograph has been modified to include the generic and brand name in many instances.
Last reviewed on RxList: 1/7/2016
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