Герпевир

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Aciclovir

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Method of action: Antibiotics And Chemotherapeutics For Dermatological Use, Antiherpetic, Antivirals For Systemic Use

Treatment option: Chickenpox, Genital Herpes, Cold Sore, Infection, Shingles

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

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Overview of Герпевир

Property	Description
Active ingredient	Aciclovir (Acyclovir)
Forms	Tablet, Suspension, Cream, Injection, Ointment
Pharmacological class	Antiviral Agent
General purpose	To control and limit viral replication
Origin	Synthetic purine nucleoside analogue

Герпевир is a medicinal preparation whose therapeutic action is derived entirely from the active substance Aciclovir (Acyclovir). Its fundamental identity is that of a synthetic purine nucleoside analogue developed to target and control specific viral infections. This agent is globally recognized as an antiviral agent, positioned as a core substance for managing specific herpes-type pathogens, and is included on the World Health Organization’s List of Essential Medicines (WHO). The medicine is clinically recognized for its essential role in addressing viral activity in both immunocompetent and immunocompromised patient groups.

Classification and Composition of Герпевир

Герпевир is classified within the antiviral group of anti-infective agents, distinguished by its highly targeted action. The core component, Aciclovir, is a synthetic compound, chemically identified as a guanosine analogue. This specific composition places the medicine in the mechanism group of Herpesvirus Nucleoside Analog DNA Polymerase Inhibitors. As a widely utilized formulation, Герпевир is often positioned as an accessible, multi-form product containing this established International Nonproprietary Name (INN).

Physical Forms and Delivery Type

The medicinal entity is manufactured in multiple pharmaceutical preparations to enable diverse administration strategies. These forms include common oral forms, such as tablets and suspensions, designed for systemic absorption via the oral route. Additionally, it is available in topical forms, like creams and ointments, intended for localized application to the skin or mucosa. The efficacy profile of Aciclovir is consistent across various formulations. This confirms that the medicine maintains its function whether applied directly to the skin or taken internally. Specialized injectable forms are also available for intravenous administration, allowing for flexibility in drug delivery based on the viral presence.

General Purpose and Function

The general purpose of Герпевир is to control and limit the reproduction of targeted viruses within the body. By leveraging its ability to selectively inhibit key processes necessary for viral replication, the medicine effectively prevents the infectious agent from spreading rapidly. This action is central to its therapeutic role as it aids the body's natural defenses in managing the viral load, thereby reducing the intensity and duration of the viral activity in the patient. For instance, the medicine is typically used during periods of active viral outbreak to minimize the severity of symptoms associated with herpes-type infections.

Regulatory References

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What side effects are possible with Герпевир?

Possible side effects and safety information

The safety profile of Герпевир, whose active ingredient is Aciclovir, is systematically defined by regulatory authorities based on the frequency and system-organ class affected. This classification establishes the officially documented risk profile of the medicine.

Frequency-Classified Adverse Reactions

The frequency of observed adverse reactions is categorized in official documents:

Common (1/100 to < 1/10): Effects such as headache, dizziness, fatigue, and gastrointestinal symptoms including nausea, vomiting, diarrhoea, and abdominal pain.
Uncommon (1/1,000 to < 1/100): Skin and subcutaneous tissue disorders, including rashes, pruritus (itching), urticaria, and photosensitivity reactions.

Serious Adverse Reactions and Safety Considerations

Specific serious adverse reactions are documented, although they are officially classified as Rare or Very Rare events. These include immune system disorders like Anaphylaxis and Angioedema, as well as severe renal and nervous system effects. The most significant very rare reactions are Acute Renal Failure and severe neurological events such as encephalopathy and convulsions (seizures), which are generally reported as reversible.

Safety notes in the regulatory labels highlight considerations for specific groups. Older adults and patients with impaired renal function are noted to have a higher potential for developing neurological side effects, due to how the drug is cleared from the body. Additionally, regulatory documents state that maintaining adequate hydration is required, particularly during high systemic exposure, to help prevent the risk of drug crystal formation in the kidneys (crystalluria).

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Overdose and Emergency Response

Overdose and when to seek help

The following information details the officially documented signs of overdosage and the mandatory actions required as described in government regulatory documents for Aciclovir (the active substance in Герпевир).

Property	Documented Regulatory Statement
Documented Manifestations	Gastrointestinal effects (nausea, vomiting, diarrhea, abdominal pain), and neurological symptoms, including confusion, agitation, hallucinations, lethargy, and headache [EMA/FDA].
Severe Outcomes	Acute renal failure (due to crystal precipitation in renal tubules, especially after IV overdose) and severe CNS effects like seizures and coma are documented risks.
Risk Factors	Elderly patients and those with pre-existing renal impairment are at increased risk of developing severe neurological and renal toxicity.
Specific Antidote	Regulatory information states that no specific antidote is known for Aciclovir overdose.
Supportive Treatment	Management is described as symptomatic and supportive. Haemodialysis is documented as a procedure that significantly enhances the removal of the substance from the blood.

When Immediate Medical Help Is Required

Seek immediate medical attention for any suspected overdosage. Contacting emergency services (e.g., 911) is required if the person has collapsed, has had a seizure, has trouble breathing, or cannot be awakened, as stated in authoritative government instructions. Hospital observation and close monitoring of renal function, including serum creatinine and BUN levels, may be required following significant overexposure.

The overall regulatory profile emphasizes the potential for toxicity affecting the kidneys and the central nervous system, mandating urgent professional intervention when severe symptoms occur.

Therapeutic Uses of Герпевир

Герпевир (Aciclovir) is an antiviral medicine that is commonly used in managing infections caused by the Herpes Simplex Virus (HSV) and the Varicella-Zoster Virus (VZV). It is relevant across therapeutic domains where additional symptomatic support is needed against these specific viral pathogens.

Therapeutic Scope and Patient Comfort

Герпевир is generally used across conditions characterized by periods of heightened symptoms, specifically including genital herpes, cold sores (herpes labialis), shingles (Herpes Zoster), and chickenpox (Varicella). The medication helps address symptom clusters that may appear suddenly, like the eruption of blisters, sores, and ulcers on the skin, and the localized pain, burning, and intense itching that accompany an active outbreak.

This supportive relief helps patients cope more steadily with difficult episodes, assisting with maintaining functional stability. For individuals experiencing recurrent or episodic manifestations, the medicine is used for managing the frequency of future recurrences, contributing to long-term comfort and well-being.

“The core benefit is providing support that helps ease the overall symptom burden and may help support the healing of active lesions.”

Quick Fact: Relief for Localized Discomfort The medication is relevant for easing acute pain, burning, and itching associated with active viral lesions, supporting improved comfort during symptomatic periods.

Regulatory References

NIH MedlinePlus guidance

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Eligibility and Restrictions for Use

Eligibility and Contraindications for Герпевир

The official regulatory profile for Герпевир (Aciclovir) defines eligibility based on hypersensitivity, organ function, age, and reproductive status. This information strictly outlines who is permitted to use the medicine and under what conditional terms.

Absolute Contraindications

Use of Герпевир is contraindicated in patients with known hypersensitivity to the active substance, aciclovir, or to its prodrug, valaciclovir, as well as to any excipients in the specific formulation. Individuals with this condition must not use the medicine.

Conditional Use and Restrictions

Renal Function: Patients with impaired renal function require close monitoring and a dosage adjustment due to the drug's primary dependence on the kidneys for clearance. Similarly, geriatric patients must be monitored closely for potential neurotoxicity, given their increased risk of reduced kidney function.

Age Groups: Most adults and children are eligible. However, specific forms, like topical creams for cold sores, may be restricted to immunocompetent patients 12 years and older.

Reproductive Status: Use during pregnancy or lactation is permitted only when the potential clinical benefits are judged to outweigh the possible risks to the fetus or infant, as the drug is excreted into breast milk.

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What should I know about interactions with other medicines?

Interactions with other medicines and products

The official regulatory interaction profile for Герпевир (Aciclovir) primarily concerns substances that influence its clearance through the kidneys or those that share a common potential for renal effects. This profile is structured around label-based pharmacokinetic and pharmacodynamic interactions.

Interacting Substance/Category	Official Interaction Outcome
Probenecid and Cimetidine	Reduces the renal clearance of aciclovir, resulting in increased systemic exposure (higher AUC) due to competition for active tubular secretion.
Nephrotoxic medicinal products	Increases the risk of additive nephrotoxicity and potential renal impairment when co-administered with agents such as Ciclosporin or Tacrolimus.
Mycophenolate Mofetil (MPA metabolite)	Co-administration leads to documented increased plasma concentrations of both aciclovir and the inactive MMF metabolite, due to competition for excretion pathways.

Interaction Restrictions and Conditions

Timing Rules: Official labeling does not specify any mandatory separation rules (e.g., "must be separated by X hours") for the administration of oral Aciclovir with other medicinal products.
Food Interaction: The absorption of the oral formulation is formally documented as not significantly affected by food intake according to regulatory data.
Population-Specific Note: The potential for interaction may be elevated in elderly patients due to the higher incidence of reduced renal function in this population, which intensifies the drug's reliance on the renal elimination pathway.

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Mechanism of Action

The action of Герпевир (Aciclovir) is strictly reliant on a two-step biochemical strategy to interfere exclusively with the viral replication cycle. The drug requires Viral Thymidine Kinase (vTK), an enzyme produced only by the target herpesviruses, to perform the initial and most critical step of activation, known as phosphorylation. This enzyme-dependent conversion ensures that the drug preferentially becomes concentrated and active inside the virus-infected cell.

The fully activated drug, Aciclovir Triphosphate, functions as a competitive inhibitor of Viral DNA Polymerase. Once incorporated into the growing viral DNA chain, the drug structurally prevents the addition of the next building block, causing an irreversible chain termination. This blockade physically prevents the virus from completing its genetic blueprint, thereby arresting the formation of new, infectious viral particles.

The mechanism is functionally contingent upon the expression of vTK by the actively replicating virus. Consequently, the mechanism is ineffective against the latent viral reservoir residing silently in nerve ganglia, as the necessary viral enzyme is not produced during this phase. The physiological effect is strictly limited to interfering with viral nucleic acid synthesis during the active replicative phase, and does not alter the non-replicative, latent viral reservoir.

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Dosage and Administration Information

How to Use Герпевир (Acyclovir) — Official Administration Guidelines

Official instructions for using Acyclovir (marketed as Герпевир in some regions) define precise administration requirements across its various dosage forms. All therapy initiation is advised to begin as early as possible following the onset of signs or symptoms of infection.

Administration Scope

Feature	Official Instruction Summary
Route of Administration	Oral (tablets, suspension), Intravenous (IV) infusion, Topical (cream, ointment).
Standard Dosing Schedule	Acute Oral: Typically 200 mg or 800 mg, taken five times daily, often requiring omission of a night-time dose. Chronic Suppression: Often 400 mg taken twice daily.
Timing in Relation to Meals	Oral tablets and capsules may be taken with or without food.
Preparation Requirements	The intravenous powder formulation must be reconstituted and further diluted to a concentration not exceeding 7 mg/mL for infusion.
Age-Group Administration	Dosing for pediatric patients is frequently determined based on body weight (mg/kg). Older adults may require a dose adjustment due to likely age-related changes in renal function.
Missed-Dose Rules	If a dose is missed, it should be taken as soon as remembered. Patients should be advised to avoid taking a double dose to compensate for the missed one.
Special Procedural Conditions	Patients receiving systemic Acyclovir (oral or IV) must maintain adequate hydration. IV infusions must be administered slowly over at least one hour and must not be given by rapid injection, intramuscular (IM), or subcutaneous (SC) routes.

Resulting Procedural Structure

Official guidelines establish a clear sequence for the drug's use:

Initiation: Begin dosing promptly at the earliest sign of infection.
Dosing: Follow the prescribed dose and frequency precisely, adhering to the standard schedules (e.g., five times daily for acute treatment).
Conditions: For systemic use, ensure adequate fluid intake and adhere to the time-bound duration of therapy (e.g., 5 to 10 days for acute episodes).
Adjustment: If renal function is impaired, the dose and/or dosing interval must be modified according to technical tables for creatinine clearance.

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Recent Clinical Evidence

Evidence for Use in Treating Herpes Simplex (HSV) Infections

The use of this medicine for conditions presenting with cycles of stability and flare-ups, such as cold sores or initial and recurrent genital herpes, research examined its use through numerous short-term Randomized Controlled Trials (RCTs). These studies were applied in trials assessing short-term or episodic symptom patterns in otherwise healthy adult populations. The research primarily monitored outcomes related to patient-reported outcomes describing perceived discomfort (like pain or itching) and objective outcomes, such as the time elapsed until lesion healing. Findings describe patterns observed in the studies when comparing groups receiving the medicine to control groups.

Evidence for Use in Treating Herpes Zoster (Shingles) and Chickenpox

The use of this medicine for conditions involving periods of heightened symptoms such as shingles (Herpes Zoster) was studied for. Large-scale Randomized Controlled Trials (RCTs) and meta-analyses studies explored its use in adult populations. These studies monitored outcomes related to outcomes describing episodic or acute changes, specifically the time it took for the rash to resolve and the duration and intensity of acute pain. Research also explored outcomes related to Postherpetic Neuralgia (PHN), which is a complication of long-term nerve pain. Findings were mixed across various studies regarding PHN, with some evidence was associated with differences in the duration of pain measured during the study period, while other trials reported no distinct pattern.

Evidence for Prevention and Suppressive Use

The use of this medicine for long-term control of conditions characterized by fluctuating or episodic manifestations was evaluated in trials focused on monitoring recurrence frequency. The research monitored the number of symptomatic recurrences and outcomes related to daily functioning or activity level over periods typically lasting six months to several years. Findings describe patterns observed in the studies where continuous administration was studied for outcomes describing episodic or acute changes. There is limited information for long-term outcomes that would fully characterize the sustained effects after the medication is discontinued.

What is Still Uncertain About Герпевир’s Research

The comparative evidence is lacking in large-scale trials directly comparing this medicine against all newer antiviral options for all indications. For specific high-risk populations, like pregnant individuals, data for certain groups remain insufficient, with reliance often placed on large registry data rather than dedicated clinical trials. Furthermore, the results apply only to the populations studied, meaning the patterns observed in a trial of young, otherwise healthy adults may not translate directly to an older patient with multiple chronic health issues. This is why evidence quality varies across studies, and future research is needed to refine our understanding of its use in every context.

Key Studies & References

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Frequently Asked Questions (FAQ)

Common questions about Герпевир (FAQ)

Q: How quickly can I expect to see an effect after starting Герпевир?

Clinical trials for acute outbreaks examined outcomes such as the reduction in the duration of pain and the time required for lesions to heal. Studies describe that starting the medicine is associated with shortening these time periods when compared to results from a control group.

Q: Is it possible for Герпевир to stop an outbreak from developing if I use it early?

Official administration instructions for intermittent therapy advise that treatment should be initiated at the earliest sign or symptom, known as the prodrome, of a recurrence. This timing reflects the intended goal of intervention according to official documents.

Q: Is it true that the effectiveness of Герпевир is greater if taken within 48 hours of symptoms starting?

For the treatment of Herpes Zoster, also known as shingles, clinical studies indicate that the medicine showed the greatest reported benefit when treatment was started within the first 48 hours after the rash began. This specific timing guidance is noted in the official regulatory product information for certain indications.

Q: Does research show that Герпевир reduces the risk of complications from the infection?

Research examining Herpes Zoster infections has reported themes related to complication risk. Specifically, studies indicated a reduced prevalence of localized neurological symptoms, such as long-term nerve pain, in participants who received the medicine.

Q: What is the main goal of treatment with Герпевир?

The medicine is officially indicated for the treatment of specific viral infections. The primary therapeutic goals documented in clinical research include reducing the overall duration of acute symptoms and shortening the time required for any lesions to heal.

Q: Is Герпевир used for shingles (herpes zoster)?

Yes, official indications for this medicine include the treatment of infections caused by Herpes Zoster (shingles) and Varicella (chickenpox) viruses. It is used to manage acute viral activity related to these pathogens.

Q: Can the medication be crushed or mixed with food if swallowing is difficult?

Regulatory guidance for the oral tablet form advises against cutting or crushing the medication. This instruction is given to support proper administration and absorption.

Q: What specific conditions or patient groups make using Герпевир not recommended?

The medicine is not recommended for patients with a known hypersensitivity (severe allergy) to the active substance or its prodrug. Use is also conditional for patients with impaired kidney function and older adults, who require close monitoring by a healthcare provider.

Q: Can the medication cause changes in mood or sleep patterns?

Reported adverse effects have included neurological symptoms, such as confusion, hallucinations, and aggressive behavior. These types of reactions are officially classified as rare or very rare and are generally reported as reversible upon stopping the treatment.

Q: Does taking Герпевир make me less contagious?

Official regulatory documents indicate that during suppressive therapy, the frequency of viral shedding is significantly reduced. However, product information clarifies that the risk of transmission to others is still possible, even while on treatment.

Q: Can Герпевир be used for viruses other than herpes?

Official regulatory documents state that the medicine is only active against herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), and varicella-zoster virus (VZV). It is not indicated for the treatment of other major viral families.

Q: Does Герпевир eliminate the virus from the body completely?

No, official regulatory documents state that the medicine does not cure the infection. Its mechanism of action is limited to active viral replication and is not effective against the non-replicating latent viral reservoir that remains in the body.

Q: Why does the virus reappear even after using Герпевир?

The medicine's mechanism of action is strictly limited to interfering with the active reproduction cycle of the virus. It is not effective against the latent viral reservoir, which resides inactive in the nerve ganglia, and is responsible for future recurrences.

Q: Can Герпевир be taken for a long time, like for a few months?

For chronic suppressive therapy for recurrent disease, the medicine is officially prescribed for up to 12 months. After this duration, the need for continued treatment is typically re-evaluated by a healthcare professional.

Q: Is there any risk of the virus becoming resistant to Герпевир over time?

Regulatory documents acknowledge that resistance of the targeted viruses can occur. This results from specific changes in the viral enzymes and has been reported, particularly in immunocompromised patients.

Q: Do food or certain drinks affect how Герпевир works in the body?

Oral tablets may be taken with or without food, as regulatory data shows its absorption is not significantly affected by food intake. For patients using the systemic forms, official guidance highlights the importance of adequate hydration.

Q: Does taking Герпевир affect kidney function?

The medicine is primarily eliminated through the kidneys. Regulatory labels note a rare risk of severe adverse events, such as acute renal failure, and emphasize the importance of adequate hydration to help minimize potential risks to the kidneys.

Q: Can Герпевир be used by children, and is there a recommended age limit?

The medicine is officially approved for use in children. The recommended dosing for specific infections varies by age and body weight, with official guidance providing dosage criteria for different pediatric age ranges.

Q: Are there any special considerations for older adults (seniors) using Герпевир?

Yes, older adults are noted to require close monitoring and may need a dose adjustment due to the likelihood of reduced kidney function. They are also at an increased risk of developing certain neurological side effects.

Q: Is Герпевир considered safe for use during pregnancy, according to official sources?

Use during pregnancy is permitted only when the potential clinical benefits are judged to outweigh the possible risks. Large registry studies that monitored pregnant individuals exposed to the medicine found no increase in the chance of birth defects.

Q: What is the official information regarding using Герпевир while breastfeeding?

Official information indicates that the medicine passes into breast milk in small amounts. Since the active ingredient is commonly given to newborns in clinical settings, it is not generally expected to cause problems for the baby.

Q: Why is my doctor concerned about my kidney health when prescribing Герпевир?

The medicine is primarily eliminated from the body via the kidneys. For patients with reduced kidney function, dose modification is required to prevent the accumulation of the drug and reduce the risk of potential toxicity.

Q: Can taking Герпевир help reduce how often outbreaks happen?

Clinical trials for chronic suppressive therapy reported that continuous administration was associated with a reduction in the frequency and/or severity of recurrences in study participants.

Q: Are there official studies comparing the cream versus the tablet form of Герпевир?

Studies examining the medicine have affirmed that the active ingredient maintains a consistent efficacy profile across its various pharmaceutical preparations. This includes both oral (tablet) and topical (cream) forms.

Q: Does the medicine interact with any common vitamins or herbal supplements?

The official interaction profile lists specific prescription medicines that affect its kidney clearance. While the label does not list common vitamins or herbal supplements, official documentation indicates that patients should disclose all products they take to their healthcare provider.

Q: Why is the medicine sometimes prescribed for a long duration, and sometimes for a short one?

The medicine is used for two distinct purposes. A short duration is prescribed for the acute treatment of an active outbreak, while a longer duration is for chronic suppressive therapy to help reduce the frequency of future recurrences.

Q: Can Герпевир be used to treat an eye infection caused by the herpes virus?

Yes, a specific ophthalmic (eye) ointment form of the active ingredient is available and is used for the treatment of acute herpetic keratitis, which is an eye infection caused by the herpes virus.

Q: What evidence exists about the safety of long-term (suppressive) use of Герпевир?

The official authorized use for suppressive therapy is for a duration of up to 12 months, followed by a re-evaluation by a healthcare professional. This time frame is the extent of continuous treatment that is officially evaluated and authorized.

Q: Is it safe to use topical Герпевир cream with other skin products?

Instructions for the topical cream note that applying other topical products should be avoided to ensure the effectiveness and proper local action of the medicine.

Q: Does the treatment work better for HSV-1 than for HSV-2?

In vitro studies show that the medicine has inhibitory activity against both HSV-1 and HSV-2. According to official data, the inhibitory concentration ranges required to block both virus types are comparable.

Q: What is the general success rate of Герпевир in clinical trials?

For chronic suppressive therapy, one clinical study reported that continuous administration was associated with preventing or reducing the frequency of recurrences in greater than 95% of patients. For acute treatment, trials consistently reported significant reductions in symptom duration and faster healing.

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How should Герпевир be stored and disposed of?

How to Store and Dispose of Герпевир? (Aciclovir)

Storage Requirements

Герпевир must be stored at controlled room temperature, typically below 25 C (77 F), and must not be frozen or refrigerated. The medicine should remain in its original container with the lid tightly closed to provide protection from light and moisture.