Comparative Pharmacology
Head-to-head clinical analysis: ACYCLOVIR versus VITRASERT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACYCLOVIR versus VITRASERT.
ACYCLOVIR vs VITRASERT
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.
Vitrasert (ganciclovir implant) releases ganciclovir, a nucleoside analog that inhibits cytomegalovirus (CMV) replication by competitively inhibiting viral DNA polymerase (UL54) after intracellular phosphorylation to ganciclovir triphosphate. This results in chain termination and viral DNA synthesis inhibition.
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.
Intravitreal implant containing 0.59 mg fluocinolone acetonide; inserted into the vitreous cavity; releases drug over approximately 36 months; no systemic dosing.
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 half-life of 2.8 hours following intravitreal injection; sustained local levels for 2-3 weeks.
Renal excretion of unchanged drug via glomerular filtration and tubular secretion accounts for 62-90% of elimination. Fecal elimination is <2%.
Primarily biliary/fecal (approximately 90%) with minimal renal excretion (<10% unchanged in urine).
Category A/B
Category C
Antiviral
Antiviral