Comparative Pharmacology
Head-to-head clinical analysis: ACYCLOVIR SODIUM versus ADEFOVIR DIPIVOXIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACYCLOVIR SODIUM versus ADEFOVIR DIPIVOXIL.
ACYCLOVIR SODIUM vs ADEFOVIR DIPIVOXIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Acyclovir is a synthetic nucleoside analogue with activity against herpes simplex virus (HSV) types 1 and 2, and varicella-zoster virus (VZV). It is converted to acyclovir monophosphate by viral thymidine kinase, then further phosphorylated to acyclovir triphosphate, which competitively inhibits viral DNA polymerase and incorporates into viral DNA, causing chain termination.
Adefovir dipivoxil is a prodrug of adefovir, an acyclic nucleotide analog of adenosine monophosphate. It is phosphorylated intracellularly to adefovir diphosphate, which inhibits hepatitis B virus (HBV) DNA polymerase by competing with the natural substrate deoxyadenosine triphosphate and causing DNA chain termination after incorporation into viral DNA.
Dosing is indication-specific. For herpes simplex encephalitis: 10 mg/kg IV every 8 hours for 10–14 days (adults and children ≥12 years) or 20 mg/kg IV every 8 hours (3 months–12 years). For severe genital herpes: 5 mg/kg IV every 8 hours for 5 days. For mucocutaneous HSV in immunocompromised: 5 mg/kg IV every 8 hours for 7–14 days. For varicella zoster in immunocompromised: 10 mg/kg IV every 8 hours for 7 days. For neonatal HSV: 20 mg/kg IV every 8 hours for 14–21 days (disseminated/CNS) or 14 days (skin/eyes/mouth).
10 mg orally once daily on an empty stomach.
Clinical Note
moderateAdefovir dipivoxil + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Adefovir dipivoxil."
Clinical Note
moderateAdefovir dipivoxil + Tenofovir disoproxil
"The therapeutic efficacy of Tenofovir disoproxil can be decreased when used in combination with Adefovir dipivoxil."
None Documented
None Documented
Terminal elimination half-life: 2.5-3.3 hours in adults with normal renal function; up to 20 hours in anuria/end-stage renal disease.
Terminal elimination half-life is 7.5 hours (range 5–10 h); clinically, supports once-daily dosing with dose adjustment for renal impairment.
Primarily renal excretion via glomerular filtration and tubular secretion: 62-91% of dose excreted unchanged in urine within 24 hours; minor biliary/fecal elimination (<2%).
Renal (90% as unchanged drug via active tubular secretion); biliary/fecal (<5%)
Category A/B
Category C
Antiviral
Antiviral