A guanine nucleoside analog antiviral. Acyclovir inhibits viral DNA synthesis by selective phosphorylation via viral thymidine kinase, followed by incorporation into viral DNA and chain termination. It is active primarily against herpes simplex virus (HSV-1, HSV-2) and varicella-zoster virus (VZV). Acyclovir is administered orally, intravenously, or topically, eliminated primarily by the kidneys, and requires dose adjustment in renal impairment. Key adverse effects include nephrotoxicity (IV, crystal nephropathy) and neurotoxicity at high doses or with renal dysfunction.
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