Comparative Pharmacology
Head-to-head clinical analysis: ACYCLOVIR SODIUM versus ZOVIRAX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACYCLOVIR SODIUM versus ZOVIRAX.
ACYCLOVIR SODIUM vs ZOVIRAX
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.
After intracellular phosphorylation to acyclovir triphosphate, selectively inhibits viral DNA polymerase and incorporates into viral DNA, causing chain termination.
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).
Herpes simplex: 200 mg orally 5 times daily for 10 days; or 400 mg orally 3 times daily for 5-10 days. Herpes zoster: 800 mg orally 5 times daily for 7-10 days. IV: 5-10 mg/kg every 8 hours for immunocompromised patients with HSV/VZV.
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 2.5-3.3 hours in adults with normal renal function; prolonged to 19.5 hours in anuria (creatinine clearance <10 mL/min).
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 excretion of unchanged drug via glomerular filtration and tubular secretion accounts for 76-82% of elimination; fecal excretion is less than 2%.
Category A/B
Category C
Antiviral
Antiviral