Renal function after acyclovir intravenous injection

Acute kidney injury due to acyclovir

“…Typically, crystalluria develops within 24-48 h of the initiation of acyclovir therapy. Severe intraparenchymal precipitation of crystals can cause interstitial congestion and hemorrhage, leading to a decrease of renal blood flow [7,[10][11][12]. The serum creatinine levels of our patient also began to rise within 48 h of acyclovir treatment.…”

“…Acyclovir dose should be reduced in patients with underlying renal insufficiency. Furthermore, slow drug infusion, over 1-2 h, adequate fluid replacement, and induction of high urinary flow rates (100-150 ml/h) should be encouraged in order to prevent crystal precipitation and subsequent tubular obstruction [7,[9][10][11]16]. Despite vomiting 4-5 times a day as a predisposing factor for prerenal failure in our patient, she was adequately hydrated and no clinical evidence of hypovolemia was observed.…”

“…Acyclovir is rapidly excreted in the urine via glomerular filtration and tubular secretion, and reaches high concentrations in the tubular lumen. Renal excretion of unchanged drug reaches approximately 60-90 % [7,9,10]. Acyclovir is relatively insoluble in the urine, particularly in the distal tubular lumen [7,[9][10][11][12].…”

“…Renal excretion of unchanged drug reaches approximately 60-90 % [7,9,10]. Acyclovir is relatively insoluble in the urine, particularly in the distal tubular lumen [7,[9][10][11][12]. Rapid intravenous administration of high-dose acyclovir is associated with high luminal concentrations of this drug and the intratubular precipitation of crystals can cause renal injury [7,9,10].…”

Efficacy of 2'-nor-2'-deoxyguanosine treatment for orofacial herpes simplex virus type 1 skin infections in mice

“…By contrast, oral administration of ACV more effectively reduces genital lesions (9), and more recent studies in which ACV was administered orally to prevent herpetic lesion recurrence indicate that this prophylactic treatment approach may be highly effective (3). The limited solubility of ACV has resulted in reversible renal disturbances after bolus injection (2) and may, in part, be responsible for the poor absorption after oral administration (6). In addition, the limited solubility of ACV in vehicles such as polyethylene glycol, used for topical administration, may result in poor drug availability to the HSV-infected cells (7).…”