Comparative Pharmacology
Head-to-head clinical analysis: ACYCLOVIR versus REBETOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACYCLOVIR versus REBETOL.
ACYCLOVIR vs REBETOL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Acyclovir is a synthetic nucleoside analog that inhibits viral DNA replication. It is phosphorylated to acyclovir monophosphate by viral thymidine kinase, then converted to acyclovir triphosphate by cellular kinases. Acyclovir triphosphate competes with deoxyguanosine triphosphate for viral DNA polymerase, incorporating into viral DNA and causing chain termination.
Ribavirin, a guanosine analog, inhibits viral RNA-dependent RNA polymerase and inosine monophosphate dehydrogenase, leading to a decrease in intracellular guanosine triphosphate pools and impairment of viral RNA synthesis.
400 mg orally twice daily for herpes zoster; 200 mg orally 5 times daily for genital herpes; 5-10 mg/kg intravenously every 8 hours for severe infections.
Oral: 400-600 mg twice daily (800-1200 mg/day) based on body weight (≤75 kg: 400 mg twice daily; >75 kg: 600 mg twice daily) in combination with interferon alfa or peginterferon alfa.
None Documented
None Documented
Clinical Note
moderateAcyclovir + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Acyclovir."
Clinical Note
moderateTizanidine + Acyclovir
"The serum concentration of Acyclovir can be increased when it is combined with Tizanidine."
Terminal elimination half-life is 2.5–3.3 hours in adults with normal renal function; increases to 19.5 hours in anuria.
Terminal elimination half-life: 120-200 hours (multiple doses, due to extensive accumulation in erythrocytes). Single dose: 24-36 hours. Clinically, steady state is reached in approximately 4 weeks.
Renal excretion of unchanged drug via glomerular filtration and tubular secretion accounts for 62-90% of elimination. Fecal elimination is <2%.
Renal: 10-15% unchanged; biliary/fecal: 60-70% as metabolites; pulmonary excretion of CO2 contributes to elimination of ribavirin's triazole moiety. Approximately 10-20% excreted in feces as unchanged drug and metabolites.
Category A/B
Category C
Antiviral
Antiviral