Use of Acyclovir ointment for chickenpox in children and adults

Use of Acyclovir in infants

Acyclovir in tablet form is contraindicated for children under one year of age, since there are currently no studies showing its safety in this age group. The recommended age for using this drug in tablet form is from 3 years.

However, the use of ointments and creams with Acyclovir is also permitted in infants, since in this dosage form the drug does not penetrate the skin and does not have a systemic effect on the baby’s body. At the same time, the effectiveness of the drug does not decrease, since the therapeutic effect on the focus of the herpetic infection continues to be provided.

What is chickenpox

To understand whether it is possible to smear chickenpox rashes in children with Acyclovir, you need to understand what the disease is. Chickenpox is an easily transmitted infection. The causative agent is the herpes virus Varicella Zoster. Once in the blood, it multiplies, causing fever and headache. The virus also penetrates the skin, where papules and blisters with liquid form.

In a person who has had chickenpox, the virus remains in the nerve ganglia. There he remains in an inactive state. When immunity decreases, the pathogen wakes up, migrates from the blood under the skin, manifesting itself in the form of herpes zoster . This form of infection is characterized by a rash along the intercostal spaces. Papules are very painful and contain the same virus. Therefore, a person, as an adult, is just as contagious as he was in childhood, when he had chickenpox. The patient poses a danger to other family members, and most of all to pregnant women. If infected in the first and second trimester, a woman may give birth to a child with congenital chickenpox and pathology of the nervous system. The Varicella Zoster virus has another feature: it spreads faster in the body of an adult. The rash lasts longer, the blisters are more difficult to heal, and the temperature rises to 38-39 degrees. Therefore, in adults, antiviral drugs in tablets are used in the treatment of chickenpox and herpes zoster. In children, the infection in most cases is mild and without complications. Medicines with antiviral effects are rarely prescribed to children.

How to use in the treatment of diseases

For infectious diseases caused by the herpes virus, adults are prescribed acyclovir. The product effectively fights the disease. Can acyclovir be given to children under two years of age? In some cases, treatment with the drug is possible when prescribed by a pediatrician and under his supervision.

The method of administration and dosage of Acyclovir depend on the nature of the disease, age and body weight of the patient. The use of the drug for ARVI is considered unacceptable.

The instructions for use of the ointment say that Acyclovir is prescribed for the treatment of children in a strict dosage. It is calculated taking into account the child’s weight: per 25 cm2 of skin there should be no more than 0.25 grams (1.25 cm in a thin layer) of the product. Let's consider how to use the drug in the treatment of various viral diseases in children.

In rare cases, acyclovir tablets are prescribed to children under one year of age, reducing the dosage depending on the child’s weight. For herpes sore throat, your baby can be given a quarter of a tablet containing 200 mg of acyclovir, 3 times daily, for 5 days. For type 1 virus infection in a newborn, the doctor may prescribe a 10-day course of acyclovir, taken three times daily, at a dose of 10 mg per 1 kg of baby’s weight. The tablets need to be dissolved in boiled water, because the baby does not yet know how to swallow them.

Acyclovir ointment, instructions for use in children under one year of age:

• Dosage – no more than 80 mg per kg of baby’s weight per day (normal for children under 12 years of age);
• Apply up to 5 times daily directly to rashes or sores;
• The ointment should not be applied to healthy skin - the consistency is thick and limits the access of oxygen. In the last stages it is more convenient to apply the cream - it is quickly absorbed. It is better to use the ointment at the beginning of the disease, because it lasts better;
• For the drug to be effective, do not bathe the child after application;
• The course is 5 days, if the rash does not go away, continue use for another 5 days.

Indications for use of Acyclovir

The drug treats infections caused by the herpes virus:

1. Chickenpox. Acyclovir is prescribed to a child for severe cases and severely weakened immunity. In most cases, treatment is carried out without antiviral therapy.
2. Constantly renewed course of herpetic infection on the surface of the mucous membranes and skin. Local remedies (cream, ointment) are used, and in case of prolonged treatment, tablets and lyophilisate for infusion. Indications: herpetic sore throat, conjunctivitis, keratitis, stomatitis, vaginal herpes.
3. Shingles.
4. Cytamegalovirus.

Acyclovir is also used prophylactically to prevent herpetic infections in weakened children.

Important: Acyclovir is used to prevent infection with herpes, not influenza or acute colds.

The drug is used as prescribed by a doctor. Acyclovir for children under one year of age is used in the form of external agents and intravenous infusions in a short course with condition monitoring and dosage calculation based on body weight.

How to use acyclovir ointment for children?

Despite the fact that Acyclovir is a universal remedy for the treatment of diseases caused by herpesvirus, the drug has contraindications:

• hypersensitivity to the main or excipients;
• renal failure.

Should Acyclovir be given for chickenpox or a cold? If chickenpox is mild, it is better to avoid taking the medicine. For colds, the drug does not bring the desired effect.

If the drug does not have the desired effect or causes side effects that do not go away after a few days, your doctor may prescribe a different drug. Children's analogues of Acyclovir: Zovirax, Gerpevir, Virolex, Lovir, Herpesin. The most effective for children is Zovirax, which is also available in the form of tablets, ointments, creams and powders.

Acyclovir can be used to relieve herpetic lesions in a child’s body, or for other forms of viral infection that are sensitive to the components of the drug.

The drug is indicated for children to take orally with the following disorders:

• herpes sore throat;
• chicken pox;
• as a prevention of herpes;
• weakened immune system;
• cytomegalovirus infection;
• Epstein-Barr virus;
• for the prevention of complications due to acute respiratory diseases, influenza, enterovirus infections.

Possible side effects:

• lightheadedness
• vomit,
• loose stools,
• headache,
• impaired coordination of movements,
• weakness,
• skin rashes,
• intestinal pain,
• itching of the skin, peeling,
• mood swings (drowsiness, hyperactivity),
• convulsions,
• pathological changes in blood composition,
• the occurrence of hallucinogenic visions.

After taking Acyclovir, children may experience malaise, swelling of the skin, and impaired respiratory function.

IMPORTANT! If any side effects occur, you should immediately consult a doctor! Otherwise, you can cause irreparable harm to the health of the little patient!

Acyclovir in the form of an ointment can be used for infants. Since chickenpox, or in other words, as written in the instructions, the Varicella zoster virus, is a type of herpetic infection, treatment is quick. It should be used as prescribed by a doctor. You can smear painful areas twice a day, morning and evening, if the baby is very small. If children are over one year old, then the use of the ointment can be increased up to 3 times a day.

Contraindications and side effects

All forms of Acyclovir are contraindicated in case of pathological sensitivity to the active substance. Intravenous infusions are not given to women who are breastfeeding. If therapy is necessary, feeding is canceled so that the baby does not receive acyclovir in milk.

The drug is prescribed to children strictly according to indications, with great caution in case of hepatic and renal dysfunction. External agents are not used to lubricate mucous membranes.

Children may experience the following negative reactions from medications containing acyclovir:

• when using external agents and eye ointment - allergic reactions on the skin and mucous membranes (itching, burning, redness);
• when taken orally – dyspeptic disorders, headache, changes in blood composition, sleep disturbances, loss of orientation;
• with infusions - renal dysfunction, at the injection site - phlebitis, allergic reactions.

Acyclovir should be used for children according to the specified regimen, without exceeding the dose and duration of use.

How to use acyclovir ointment for children?

A child is not a testing ground, especially when it comes to medications, so it is important to consult with your pediatrician before starting any medications.

If Acyclovir ointment is prescribed for children, then the instructions for use must be read.

The annotation for the medication indicates important aspects and nuances of taking liniment, which is important for parents who did not have time to clarify their questions with the doctor.

Acyclovir ointment is a popular topical antiviral drug widely used in pediatrics. The drug is useful for the most common childhood diseases: chickenpox, stomatitis, herpes (colds). In the article we will look at the features of Acyclovir in the form of an ointment, find out how to use it, its properties, and whether there are any contraindications.

April 17, 2018

Acyclovir is an antiherpes drug that is widely used to treat viral infections in patients of different age groups. The instructions for using Acyclovir ointment for children are similar to those for adults, since this drug is available in the same dosage for everyone.

Despite the fact that the instructions for use do not recommend applying the ointment to children under 2 years of age, practicing pediatricians assure that it can be used almost from birth, if there are medical indications confirmed by a doctor or laboratory tests. In order not to harm the baby, you should take into account all the nuances of treatment.

Reviews

Daria, 42 years old

We used various creams for colds to get rid of conjunctivitis in my nephew. The child recently turned 4 years old, so together with his sister we took a responsible approach to the selection of the drug and consulted a pediatrician (we went ourselves, we did not take Kiryusha for an examination). As a result, they decided that Acyclovir ointment was best suited. They put it in 1 cm every 5 hours. On the 4th day everything returned to normal, there was no trace of the disease left.

Christina, 21 years old

After a cold, my daughter Milashulka developed 4 small pimples on her lips. I thought that they would go away, but on the 2nd day, to be on the safe side, I applied Acyclovir ointment. I didn’t go to the doctor, I just read the instructions carefully. I had to treat the sponges for 3 days, although the baby constantly wanted to lick off the medicine. After the conversation and the story about how it would burn in her mouth, she listened and stopped being mischievous. I don’t know, maybe it wasn’t herpes, but the pimples went away quickly.

Vyacheslav, 37 years old

To be honest, I don’t understand how a child under the age of 2 can put ointment on something without him wiping it off in the next 10 minutes. No matter how much I tried, nothing worked. I had to go to our pediatrician (with chicken pox). They prescribed this ointment and applied it to the tomboy while he was sleeping. Since the disease was at an early stage, we got rid of it on the 5th day. The child itched a lot and complained that the pimples hurt. It’s unpleasant to remember, but my wife and I managed.

Mechanism of action of Acyclovir

The effectiveness of the drug on the spread of the virus is due to the selective mechanism of action specifically on the affected cells. The pharmacological effect is explained by the absence of viral thymidine kinase (an enzyme involved in DNA formation) in uninfected cells. Once in the body, the active drug is phosphorylated under the influence of pathogenic enzymes and converted into acycloguanosine triphosphate, i.e. a compound that inhibits viral DNA. The concentration of the substance reaches its maximum after 1.5-2 hours.

Acyclovir is an antiviral drug active against herpes viruses. As soon as the main active substance enters the baby’s body, it penetrates the affected cells and takes the form of a false nucleotide. When it interacts with the virus, the latter dies. The components of the drug act only on affected cells and do not affect healthy ones.

Acyclovir comes in 4 forms: tablets, ointment, cream and powder for solution. The suspension is not produced in Russia. The main active ingredient is acyclovir. The powder, which is used for intravenous administration of the drug, does not contain other components.

Acyclovir tablets are available in different dosages of the main component - 200 and 400 mg. Excipients: starch, stabilizer, magnesium stearate, etc. The tablets are packaged in blister packs. They are prescribed to children from 2 years of age.

Acyclovir ointment for external use contains 5% of the main active ingredient. It additionally contains emulsifiers, propylene glycol and pure water. The ointment has a viscous consistency and a yellow tint, is available in tubes and glass jars of 2, 3, 5, 10 g. The ointment is used to lubricate bubbles.

Pharmacies also sell Acyclovir eye ointment. The concentration of the active ingredient is 3%. Doctors prescribe Acyclovir for herpetic conjunctivitis. Self-medication using 5% ointment can damage the mucous membrane of the eyes.

Acyclovir cream for external use has a more delicate consistency. It contains 5% active substance. The white drug is available in aluminum tubes of 2 and 10 g and jars of 25 and 50 g. The cream is convenient to use for treating blisters on the child’s body. A significant advantage is the absence of stains on clothes after use.

General information about the drug Acyclovir

Acyclovir is an antiviral drug that blocks the assembly and reproduction of the herpes virus inside the body's cells. Available in various dosage forms:

• tablets of 200 and 400 mg for different age groups;
• 3% eye ointment;
• injection solutions;
• ointment and cream for external use.

Acyclovir is active against many herpetic viruses, including cytomegalovirus, Epstein-Barr virus and herpes zoster virus, which is the causative agent of chickenpox in children and adults. Acyclovir is indicated for use in the following diseases:

• Herpetic rashes in the oral cavity similar to stomatitis;
• Herpes zoster, characterized by profuse herpetic rashes on the skin;
• Herpetic lesion of the conjunctiva of the eye with the development of an inflammatory reaction;
• Common herpes on the lips;
• Chicken pox, characterized by skin rashes and general intoxication phenomena (fever, weakness, etc.).

Acyclovir should always be prescribed by a pediatrician after examining the child and prescribing additional examination methods.

It is important to note that the use of these drugs by the mother during pregnancy or breastfeeding is also undesirable due to the possibility of indirect penetration of the drug through the placenta or milk.

Features of use in children's practice

The use of Acyclovir eye ointment in children is permitted.
The usual daily dosage of Acyclovir in the form of an eye ointment for local use in children and adults does not differ and is about half a gram of eye ointment. A strip of ointment 1 cm long is used 5 times a day until healing and another 3 days after. Reapplication can be done after 4 hours.

The step-by-step application technique is as follows:

1. Hand washing, eye rinsing if necessary, preparing gauze pads.
2. Older children are seated, small children are laid down and calmed down.
3. Open the tube.
4. Take the tube between the index and thumb in your working hand, and a napkin in the other hand.
5. Place the napkin on the bottom one and pull it down, looking up.
6. Squeezing out the ointment into a 1 cm strip, place it behind the lower eyelid in the direction from the outer edge inwards.
7. The eyelid is released, the eye is closed, and the tube is screwed on.
8. Then you need to make circular movements with your eyes with your eyelids closed to distribute the ointment evenly, and wipe off the excess with a napkin.

If other medications are prescribed locally in the form of drops, then the ointment is applied half an hour to an hour after applying liquid forms or rinsing.

Useful video about Acyclovir

List of sources:

• Herpesvirus infection / A. K. Polukchi, ed. V. P. Maly. – M.: Eksmo, 2009. – 304.
• Guide to Infectious Diseases. / ed. acad. RAMS, prof. Yu. V. Lobzina, prof. K. V. Zhdanova. – 4th ed. – St. Petersburg: Foliant Publishing House LLC, 2011. – 744 p.
• Cytomegalovirus infection in young children (clinical presentation, diagnosis, modern treatment options): a guide for doctors. – 2nd ed. / N. A. Korovina. – M.: Medpraktika, 2001. – 64.
• https://medi.ru/instrukciya/atsiklovir-akrikhin-tabletki_4380
• https://medi.ru/instrukciya/atsiklovir_3761/

Author
Oksana Belokur

Pediatrician

In 2012 she graduated from the Medical Institute of Sumy State University. She received a higher education in the specialty “Pediatrics” and qualified as a doctor. In 2012-2013, there were treatment and preventive activities at the Sumy Regional Children's Hospital. In 2013-2015 worked as a local pediatrician at Children's Clinic No. 2. I am currently on maternity leave. In my free time I do embroidery and knitting, and study English. All articles by the author

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Analogue drugs

Experts recommend giving preference to well-known manufacturers. Based on this, the table below presents drugs with a similar composition.

Prevention of the disease in children

The first thing to do to prevent herpes in children is to prevent infection. Since most adults are infected, this issue should be taken seriously. To prevent infection, it is enough to follow basic hygiene rules, monitor the quality of food, and limit the child’s contact with people who have active herpes. If one of the parents has a cold on the lips, they should wear a medical bandage when interacting with the baby. It is important that a sick person uses a separate set of dishes.

If infection cannot be avoided, it is important to prevent the recurrence of herpes. To do this, it is important to monitor the state of the immune system. Avoid hypothermia and overheating. Do not neglect the prevention of ARVI, etc.

As for the use of immunomodulators to prevent the appearance of herpes, their effectiveness has not yet been proven. As well as the advisability of their use during an epidemic of influenza or ARVI. Here, each parent must decide for himself whether such drugs should be given to the child.

Remember that the health of a child up to a certain age is completely in the hands of the parents. And any manifestation of herpes is a signal that the baby’s immune defense has weakened and immediate action must be taken. Be healthy and take care of your loved ones!

Composition, release form

The main active component of the drug, due to which the drug exerts its effect, is the substance acyclovir.

In addition to the main component, the composition includes auxiliary ingredients:

• Vaseline oil;
• propylene glycol;
• emulsifiers;
• purified water;
• nipazole, other medicinal compounds.

The safe composition does not lead to allergies, rashes, or unwanted reactions of the body. Use is permitted in pediatrics from a very early age.

The composition has a characteristic viscous consistency , the color is white or slightly yellowish. The concentration of the active substance is 5%. The medicine is packaged either in aluminum tubes or glass jars: the first type of packaging is most often sold in pharmacies. The volume of one package is from 2 to 30 grams.

Use in pediatrics

Many parents ask: can Acyclovir ointment be used for children, and at what age will treatment with the drug be safe?

This external application is approved for the treatment of children, starting from birth. The composition of the drug is safe , so it will not cause harm even to a newborn baby if used wisely.

The ointment can be used at any other age of the child - both one and three years old: there are no contraindications or restrictions based on age.