Which acyclovir to choose

Posted on by admin

Which manufacturer of Acyclovir is better?

Manufacturers of Acyclovir are represented by both foreign and domestic pharmaceutical companies. The pharmacological action of medications is aimed at achieving one goal - blocking the viral DNA chain and eliminating herpes and all its clinical manifestations.

Table of contents:

But the effectiveness and pricing policy of the drug is somewhat different for all manufacturers. In the materials of the presented review, we will briefly consider Acyclovir, produced in Switzerland, Croatia and Russia.

Acyclovir Sandoz (Switzerland)

The Swiss pharmaceutical company produces the drug Acyclovir Sandoz in the form of a 5% ointment and cream of the same concentration, as well as in tablet form. You can buy this drug either through a network of retail pharmacies or order it online with free home delivery.

The average cost of cream varies from 80 to 150 rubles. The ointment can be purchased in rubles. The ointment is available in aluminum tubes of 5 and 2 grams. Tablets in a cardboard package of 25 pieces, each of which contains 200 mg of active acyclovir.

Acyclovir Belupo

The country of origin of Acyclovir Belupo is Croatia. Release form: tablets, ointment and cream. The tableted drug is produced in cardboard packages of 20 and 30 pieces. One dragee may contain 200 or 400 mg of the active ingredient.

Ointments and cream each contain 50 mg of active substance and are available in aluminum tubes of 3, 5, 10 and 30 grams.

The pricing policy for the tableted drug varies from 300 to 360 rubles. The ointment can be purchased for rubles, and the cream for 50 to 60 rubles.

Acyclovir Akos and Acyclovir-Akrikhin

The manufacturers of the drug Acyclovir Akos and its analog Acyclovir-Akrikhin represent the largest network of pharmaceutical companies in Russia - CJSC Vertex and OJSC Sintez.

Acyclovir Akos tablets can be purchased at the pharmacy for rubles, but Acyclovir Akrikhin costs a little more. With a concentration of 200 mg, this medicine can be purchased in rubles, and with a concentration of 400 mg, in rubles.

Similarities and differences between different manufacturers

The release form, composition, pharmacokinetics, pharmacodynamics, indications for use and contraindications for this drug from different manufacturers are the same. The difference lies in the name of each drug, pricing policy and the end result.

According to reviews from real users, Acyclovir AKOS, which is produced by Vertex CJSC (Russia), is different:

  • low level of efficiency;
  • practically does not help get rid of herpetic eruptions on the red border of the lips and skin;
  • does not help accelerate the regeneration processes of affected tissues.

But Acyclovir Akrikhin from the AKRIKHIN chemical and pharmaceutical plant in the city of Kurgan has a completely different effect. When applied to the affected area after the first signs of itching, all clinical manifestations of herpetic pathology disappear within 24 hours. And when used during a rash that has already appeared, the lesions immediately begin to heal and already on the second day they become covered with a crust, under which the skin quickly recovers.

Acyclovir Belupo and Sandoz are also highly effective in the treatment of herpetic pathologies; it is important to follow all recommendations for use specified in the attached instructions; the pricing policy of these drugs is several times higher than domestic Acyclovir.

Therefore, in order to answer the question of which manufacturer of Acyclovir is better, you need to understand by what criteria to consider this drug. If we take into account only the pricing policy, then the most budget option would be Acyclovir AKOS, but if we consider the level of effectiveness, then it is better to take a closer look at foreign manufacturers of the drug.

Found a mistake? Select it and press Ctrl + Enter

Comments on the article

We recommend reading

IMPORTANT. The information on the site is provided for informational purposes only. Do not self-medicate. At the first sign of disease, consult a doctor.

Source: http://pillsman.org/25258-proizvoditeli-aciklovir.html

Acyclovir is the main weapon in the fight against herpes viruses

Acyclovir is an antiviral drug for herpes. It only acts on herpes virus infections - herpes itself, cytomegalovirus, Epstein-Barr virus, herpes zoster.

Many drugs are produced based on this active substance. Acyclovir comes in the form of anti-herpes tablets, ointments, ampoules or creams. The medicine stops the reproduction of the herpes virus and stops its harmful effect on the body.

Not everyone realizes how much acyclovir means to public health. But for people suffering from herpes and related diseases, this drug is a real salvation.

This article will tell you the most important things about acyclovir: what kind of drug it is, principles of operation, analogues of acyclovir, side effects, history of invention, forms of medication and treatment regimens.

Briefly about herpes

Various types of herpes have been known since ancient times - many people have suffered and continue to suffer from herpes infections. According to statistics, in Russia the number of people with “herpes simplex” every year exceeds 2.5 million people.

This virus got its name from the Greek “herpain” - that is, “creeping”. Indeed, this word well reflects the rapid spread of the disease.

But the saddest thing is that until 1977, no medications could help patients with severe manifestations of herpes and other herpes viral diseases.

Without treatment, herpes caused in patients:

people in Russia suffer from herpes every year

  • joint damage;
  • kidney damage;
  • herpetic hepatitis;
  • herpetic pneumonia;
  • damage to the nervous system;
  • eye lesions;
  • diseases of the stomach and intestines;
  • herpetic cystitis.

You can read more about herpes and related diseases in the “Herpes viruses” section.

How was acyclovir invented?

Everything changed in 1977. Since this year, millions of people around the planet have had a chance to relieve symptoms and successfully combat complications.

The creator of acyclovir, Gertrude Bell Elion, was an American pharmacologist, scientist, and candidate of chemical sciences. During her life, Gertrude never married and had no children or family. After graduating from New York University, she devoted herself entirely to science. And her works brought real results - they made the lives of a huge number of people easier.

Working at Burroughs-Wellcome (now Glaxo Smith Klein ) on purine and pyrimidine nucleotides, Gertrude Elyon and her associates were able to synthesize a nucleotide analogue that could fight the herpes virus. Later it received its current name - acyclovir.

This discovery was a real breakthrough. Acyclovir is the first herpes drug in history that can selectively act on cells infected with the virus without damaging healthy ones.

Its use gives a pronounced effect:

  • the medicine relieves rashes;
  • stops the development of the disease;
  • prevents herpetic infections from becoming severe;
  • reduces the risk of complications.

Diseases that are affected by acyclovir

There are currently 8 known types of herpes. Acyclovir acts against the five most common of them:

  • The first and second types of herpes are called the Herpes Simplex virus (Herpes simplex 1 and 2). They are designated as “HSV-1” and “HSV-2”. These viruses cause the familiar blistering rashes on the lips, face and body. These types of viruses can also affect: the oral mucosa (herpetic stomatitis), the genitals (genital herpes), the eyes (ophthalmoherpes) and the brain (herpetic meningoencephalitis).
  • The third type of human herpes virus (HHV-3) is the Varicella zoster virus. It is the causative agent of varicella (chickenpox) and herpes zoster.
  • The fourth type of herpes virus is known as Epstein-Barr virus (EBV). Causes infectious mononucleosis and can provoke cancer.
  • The fifth type of herpes virus is called Cytomegalovirus (CMV). Causes various diseases of the respiratory system, gastrointestinal mucosa and eyes.

    • How does acyclovir work?

    How acyclovir acts on herpes is a particularly interesting point. Once in the cells of the body, acyclovir undergoes a series of chemical transformations and turns into the active substance - triphosphate.

    Such a transformation is possible only in cells infected with herpes, because the chemical reaction requires a viral enzyme - thymidine kinase. This is the amazing property of acyclovir: it acts selectively on virus-infected cells.

    The active substance acyclovir stops the growth of viral DNA. It also blocks the enzyme needed to copy the virus, DNA polymerase. Moreover, the drug suppresses the viral enzyme tens of times stronger than the human one.

    As a result, treatment of herpes with acyclovir stops the multiplication of the virus, the harmful effects of the infection stop, and the symptoms of herpes go away.

    Is it possible to use acyclovir during pregnancy?

    Acyclovir is prescribed to pregnant women with caution. Although no cases have yet been identified in which the drug adversely affected the fetus, the safety of using acyclovir during pregnancy has also not been proven.

    Only a doctor can prescribe acyclovir to pregnant women.

    The drug is prescribed only if the expected benefit from it is greater than the possible risk to the fetus. The course and treatment regimen for herpes are selected individually - the doctor takes into account the condition of the fetus and the disease of the mother.

    For mild forms, preference is given to local treatment: ointments and creams; for severe cases: tablets or intravenous administration.

    Acyclovir for herpes: ointment, cream, tablets or ampoules?

    There is no clear answer which is better - acyclovir in the form of injections, ointments or tablets. The choice of form of acyclovir for the treatment and prevention of herpes depends on the severity of the disease and its manifestations.

    5% ointment or cream against herpes - used locally, for rashes on the lips, skin, genitals. Ointment for herpes on the lips (price depends on the manufacturer) delivers acyclovir only to the affected area. Also, with genital herpes, acyclovir in the form of an ointment helps only with mild manifestations. Treatment of moderate and severe forms is supplemented with tablets or injections - so that the drug penetrates the blood and destroys the virus in all areas of the body.

    Ointments for herpes are good for treating rashes on the face - the drug is applied 5 times a day, in a thin layer to the affected area. They are recommended to have in the home medicine cabinet for everyone who suffers from recurrent herpes.

    There is no need to search through articles and reviews in search of the best remedy for genital herpes. All antiherpetic drugs are based on acyclovir, and are suitable even for the genital area.

    The only exception is for people who have developed resistance to the regular acyclovir formula. They already need backup drugs (more on this below).

    Ointments against herpes help prevent the appearance of herpetic blisters even at the itching stage

    Acyclovir tablets are used for moderate and severe forms of herpes. They are sold in dosages of 200, 400 and 800 mg. The choice of dosage of acyclovir tablets for herpes depends on the treatment regimen. The doctor takes into account the severity of the herpes itself and systemic diseases of the body. When taking tablets, local therapy is prescribed at the same time - ointment or cream.

    Eye ointment 3% - used to treat corneal herpes. Ointments for herpes are placed behind the conjunctival sac 5 times a day. For the eyes, they produce ointments such as Zovirax, Acyclovir, Fenistil-Pentsivir and almost all other brands.

    Lyophilisate - used to make a composition for intravenous infusions. Used to treat severe forms of infection. The dose is calculated depending on age, indications and severity of the disease.

    How to take acyclovir for herpes?

    Instructions for using acyclovir in tablets or other forms are only general rules. For each person, the course of treatment and dosage depend entirely on how severe the herpes is.

    The treatment regimen with acyclovir for herpes follows certain rules:

    • The duration of treatment is on average 5–10 days;
    • drink tablets and apply ointments 5 times a day;
    • the dosage depends on how active the virus is - the more of it in the blood, the higher the concentration;
    • It is recommended to take immunomodulators along with the main medication to activate the immune system.

    Read about the last point in detail in the article Immunomodulators for herpes viruses.

    Are there any contraindications?

    The only contraindication is hypersensitivity to the active substance, i.e. acyclovir. But there are certain recommendations that must be followed during treatment:

    • The drug should be taken with caution if the patient has kidney disease, liver disease or neurological disorders. In these cases, regular monitoring of the condition of these organs is necessary.
    • During treatment for genital herpes, you must temporarily abstain from sexual intercourse or use a condom.
    • During treatment of herpetic keratitis, temporarily stop wearing contact lenses.

    Interaction with other drugs

    The main criteria that are important to consider when taking acyclovir:

    • Other medications: The drug may increase the negative effects of other medications on the kidneys.
    • Immunostimulants: any immunostimulants enhance the antiviral activity of acyclovir.
    • Alcohol: no data have been obtained on the effect of alcohol on the effect of the drug. But it is better to refrain from drinking alcohol during illness, as it lowers the immune system. Also, with high doses of alcohol, acyclovir can prevent the body from removing alcohol, which will worsen the hangover and generally increase the harmful effects of what you drink.

    Acyclovir analogues - which one to choose?

    Each drug has several names: one international - for the active substance, and many trade names - those given to the drug by manufacturers.

    Acyclovir is the active substance, and there are many variations of its trade names:

    They differ from each other in form and dosage, but the active substance and effectiveness of the drugs are the same.

    It is impossible to clearly indicate how much acyclovir costs for herpes. The price of acyclovir depends on the manufacturer. There are tablets and ointment for herpes, the price of which is quite affordable, and there are also expensive versions of acyclovir.

    Zovirax is the first trade name for acyclovir

    For example, the price of acyclovir in tablets under the brand name “Zovirax” in a dosage of 200 mg of 25 tablets is about 830 rubles, and for the similar “Acicovir SANDOZ DD” - 150 rubles. Acyclovir in the same dosage, but in quantities of 20 tablets, is produced under the trade names: “Acyclovir” - with an average cost of 30 rubles, “Acyclovir ACRI” - 50 rubles, “Virolex” - 220 rubles.

    The main advantages of acyclovir: its relative safety, low toxicity, and the ability to prescribe tablets and other forms of acyclovir for herpes in children under 12 years of age.

    But there is also a serious drawback: the drug must be taken 5 times a day.

    Therefore, a new drug, valacyclovir, was developed based on acyclovir. Compared to acyclovir, it has greater bioavailability - that is, it is better absorbed by the body.

    Due to this, valacyclovir needs to be taken less often: two to three times a day. Valacyclovir works against all types of herpes. Tablets and other forms of the drug are sold under the following trade names: Valtrex, Valaciclovir, Valvir, Valacyclovir Canon, Vayrova, Valavir, Valcicon Valogard .

    Herpes resistance to acyclovir

    It is important to know: if you often skip taking pills during treatment, sooner or later the herpes virus may become resistant to acyclovir. When the concentration of the drug in the blood is insufficient, the virus “trains” on small doses of the substance and gradually mutates. And eventually acyclovir will stop helping.

    Therefore, for example, you should not stop taking acyclovir immediately after the symptoms disappear - it is important to drink the entire course to the end. Also, you should not take only one or two tablets - to prevent the development of herpes on the lip or genitals. It is better to apply ointment to the affected area.

    If you often skip taking pills, sooner or later the herpes virus may become resistant to acyclovir

    To address the problem of resistance, “spare” drugs have been developed.

    If herpes becomes resistant to acyclovir, then other antiherpetic drugs are prescribed: Famciclovir (Famvir), Penciclovir (Fenistil-Pentsivir) . These are highly effective drugs with a longer duration of action. They are active against herpes simplex virus and Varicella Zoster.

    Famciclovir is taken orally, the number of doses is 2 times a day. Penciclovir is applied externally and is effective even in the later stages of herpes.

    However, it is best to take your pills responsibly and prevent your cold sore from becoming resistant. After all, the third “line of defense”—substitutes for famciclovir and penciclovir—does not yet exist.

    People who are lucky enough to never have herpes often underestimate the value of acyclovir. Meanwhile, this medicine has restored normal life and health to millions of people. It is difficult to imagine how much damage herpes viruses would have caused to society under modern free morals - if not for Gertrude Elion.

    In order for acyclovir to help well and not contribute to the mutation of the virus, you need to take a responsible approach to treatment:

    • consult a doctor about how to take acyclovir for herpes - on the lip or in another area;
    • strictly adhere to the prescribed regimen.

    See also:

    TOP 13 public places where sexually transmitted diseases await

    What to do in the first two hours after sex without a condom

    TOP 10 most ridiculous methods of treating sexually transmitted infections

    The defense failed: what to do if the condom breaks

    Gynecologist, venereologist or urologist: which doctor to contact and when to contact

    Proper genital hygiene: how, when and why

    What sexually transmitted infections go away without treatment?

    How are sexually transmitted infections treated?

    More on the topic:

    Herpes in the intimate area: what do sexually transmitted infections and colds on the lips have in common?

    Immunomodulators for herpes

    Cytomegalovirus: what it is, symptoms, treatment and consequences of infection

    Epstein-Barr virus and related diseases

    ©2016 polovye-infekcii.ru — All about sexually transmitted infections

    When copying materials, an active hyperlink to polovye-infekcii.ru is required.

    At the first signs of illness, contact a medical facility.

    Source: http://polovye-infekcii.ru/gerpes/atsiklovir

    Acyclovir /

    Acyclovir is a white crystalline powder, maximum solubility in water (at 37 °C) 2.5 mg/ml, molecular weight 225.21. Acyclovir sodium salt - maximum solubility in water (at 25 °C) exceeds 100 mg/ml, molecular weight 247.19; the prepared solution (50 mg/ml) has a pH of approximately 11.

    For systemic use: primary and recurrent infections of the skin and mucous membranes caused by the herpes simplex virus (types 1 and 2), including genital herpes, herpetic lesions in patients with immunodeficiency (treatment and prevention); herpes zoster, chicken pox.

    For external use: herpes simplex of the skin and mucous membranes, genital herpes (primary and recurrent); localized herpes zoster (auxiliary treatment).

    For local use in ophthalmology: herpetic keratitis.

    Hypersensitivity to acyclovir or valacyclovir.

    Restrictions on use:

    With intravenous administration: dehydration, renal failure (risk of nephrotoxicity), neurological disorders or neurological reactions to taking cytotoxic drugs, incl. in the anamnesis.

    When taken orally: dehydration, renal failure.

    Use during pregnancy and breastfeeding:

    Pregnancy. It is possible if the expected effect of therapy exceeds the potential risk to the fetus (there are no adequate and strictly controlled studies of the safety of use in pregnant women). Acyclovir passes through the placenta. Data on pregnancy outcomes in women taking systemic acyclovir in the first trimester of pregnancy did not show an increase in the number of birth defects in children compared to the general population. Since the observation included a small number of women, reliable and definite conclusions about the safety of acyclovir during pregnancy cannot be made.

    Lactation. Acyclovir passes into breast milk. After oral administration of acyclovir, it was determined in breast milk in concentrations, the ratio of which to plasma concentrations was 0.6–1.4. At these concentrations in breast milk, breastfed infants can receive acyclovir at a dose of 0.3 mg/kg/day. Given this, acyclovir should be prescribed to nursing women with caution, only if necessary.

    For systemic use:

    From the gastrointestinal tract: with intravenous administration - anorexia, nausea and/or vomiting; when taken orally - nausea and/or vomiting, diarrhea, abdominal pain.

    From the nervous system: with intravenous administration - dizziness, signs of encephalopathy (confusion, hallucinations, convulsions, tremor, coma), delirium, depression or psychosis (neurological disorders are usually observed in patients with predisposing conditions); when taken orally - malaise, headache, dizziness, agitation, drowsiness.

    From the cardiovascular system and blood: with intravenous administration - anemia, neutropenia/neutrophilia, thrombocytopenia/thrombocytosis, leukocytosis, hematuria, disseminated intravascular coagulation syndrome, hemolysis, decreased blood pressure.

    From the genitourinary system: with intravenous administration - a transient increase in the level of urea nitrogen in the blood and the level of creatinine in the blood serum (associated with the Cmax value in plasma and the state of the patient’s water balance), acute renal failure (more often with rapid intravenous injection ).

    Other: anaphylactic reactions, allergic skin reactions (itching, rash, Lyell's syndrome, urticaria, erythema multiforme, etc.), blurred vision, fever, leukopenia, lymphadenopathy, peripheral edema, transient increase in the activity of liver transaminases and bilirubin levels; with i.v. administration - reactions at the i.v. injection site: phlebitis or local inflammation (pain, swelling or redness), necrosis (if the drug gets under the skin); when taken orally - myalgia, paresthesia, alopecia.

    For external use: pain, burning, itching, skin rash, vulvitis.

    When using ophthalmic ointment: burning at the site of application, blepharitis, conjunctivitis, punctate superficial keratopathy.

    When treating with acyclovir, it is recommended to take large amounts of fluid (to prevent the formation of acyclovir sediment in the renal tubules).

    Caution should be exercised when administered intravenously to patients with neurological disorders, impaired liver function, electrolyte imbalance, severe hypoxia, as well as impaired renal function (and when administered orally). To reduce the risk of kidney damage when administered intravenously, the drug should be administered slowly over 1 hour. If symptoms of nephropathy appear, the drug should be discontinued.

    The toxic effect of acyclovir on the central nervous system is more likely in patients with impaired immunity, in elderly patients, and when using high doses.

    During therapy with acyclovir, thrombocytopenic purpura and/or hemolytic uremic syndrome, in rare cases with a fatal outcome, have been reported in clinical practice in patients with clinically significant forms of HIV infection.

    It is not recommended for use in children for the treatment of chickenpox if the disease is mild.

    When treating genital herpes, you should avoid sexual intercourse or use condoms, because the use of acyclovir does not prevent transmission of the virus to a partner.

    Cream and ointment for external use (5%) are not recommended for application to the mucous membranes of the mouth and eyes, because the development of severe local inflammation is possible.

    When treating with eye ointment, you should not wear contact lenses.

    Source: http://xn--80avnr.xn--p1ai/%D0%9C%D0%B5%D0%B4%D0%B8%D1%86%D0%B8%D0%BD%D0%B0/% D0%90%D1%86%D0%B8%D0%BA%D0%BB%D0%BE%D0%B2%D0%B8%D1%80/%D0%9E%D1%82%D0%B7%D1 %8B%D0%B2%D1%8B/

    Valaccilovir and Acyclovir: what is better, what are the differences, analogues

    How does Valaciclovir and Acyclovir work?

    Acyclovir, after entering the systemic bloodstream, attacks viral cells. As a result of the specific effect of the drug, a transformation of a special enzyme, thymidine kinase, into triphosphate is observed. When this substance penetrates the pathogenic DNA, the virus is completely paralyzed, thanks to which the infection stops spreading.

    Valaciclovir can be considered a second generation drug; it was developed on the basis of the drug Acyclovir. The mechanism of its action differs - upon penetration into pathogenic cells, two components with antiviral activity are formed (valic acid and acyclovir). Valacyclovir is absorbed much better by the body, and accordingly, the therapeutic effect occurs faster.

    Main differences

    Antiviral drugs differ in a number of parameters:

    • Dosage form
    • Active ingredient
    • Duration of antiviral treatment
    • Frequency of medication use.

    The release form of Acyclovir is tablets, injection solution, ointment. The medicine can be used to relieve symptoms of herpes simplex, chicken pox and shingles. The use of pills and ointments is quite often prescribed. Typically, the duration of antiviral treatment is about 10 days, but long-term treatment therapy is also allowed. The difference between Acyclovir and Valacyclovir is the occurrence of addiction with prolonged use of ointments or tablets. The drug can be prescribed to children and also during pregnancy.

    Valacyclovir is available only in tablet form, but contains an increased concentration of the active component. The drug is classified as a semi-medicine, since the main transformations of L-valine ester occur in the liver cells, where acyclovir itself is formed. Thanks to this special property, the drug has a prolonged antiviral effect and is not addictive.

    Valacyclovir is taken 1 tablet. dosage of 500 mg twice a day. The regimen for taking Acyclovir is significantly different, the daily dose of the drug is 6 tablets. dose 200 mg. It is worth noting that Valaciclovir is taken for only 5-7 days, during which time a pronounced therapeutic effect appears.

    What is better to choose

    Today, doctors are increasingly recommending the use of Valaclovir, since it is part of the group of modified antiviral drugs and does not have the disadvantages characteristic of the first generation of drugs. The main advantage is a high rate of digestibility - 75% (Acyclovir has only 15%), this effect is achieved due to the transformation of L-valine ester under the influence of liver enzymes (after absorption in the intestines) directly into acyclovir, as well as valine amino acid.

    Valaciclovir is available in various dosages, which allows you to choose the optimal treatment regimen. Moreover, the drug is taken less often than its analogue, which reduces the likelihood of missing a medication. At the same time, the risk of developing side symptoms in the form of headaches, as well as disruption of the gastrointestinal tract, is minimal.

    Valaciclovir is not prescribed for:

    • Hypersensitivity to the main component
    • Childhood (child under 12 years old)
    • Pregnancy and lactation period.

    Acyclovir ointment can be prescribed to pregnant women and children under 3 years of age.

    The main disadvantage of Valaciclovir is its cost - 313 - 3840 rubles. and one dosage form - tablets.

    Analogs

    There are several analogues of antiviral drugs that have similarities and differences with the drugs discussed above.

    Famciclovir

    It is prescribed to eliminate the manifestations of herpes zoster, as well as herpes simplex. The active ingredient is penciclovir.

    The main benefits of Famciclovir:

    • High bioavailability – 77%
    • When using the cream, rapid healing of wounds on the lips is observed
    • In the case of genital herpes, it shortens the stage of crust formation.

    Famciclovir, like Famvir, is much more effective than Acyclovir and is affordable due to its low cost.

    Valtrex

    This drug is a complete analogue of Valacyclovir, as it contains the same active ingredient. The medicine is produced in the UK, so the price of the tablets is quite high - rub. If you choose between Acyclovir or Valtrex, then, of course, you should give preference to the latter, since it is much more effective.

    Valvir

    Valvir is another drug based on valacyclovir hydrochloride hydrate, which quickly eliminates manifestations on the skin and mucous membranes of herpes zoster, labial and genital herpes. It can also be used prophylactically to prevent the development of cytomegalovirus infection. The advantages of Valvir are reasonable price (RUB), convenient dosage regimen.

    Source: http://lekhar.ru/lekarstva/dermatologicheskie-sredstva/aciklovir-i-valaciklovir-sravnenie/

    Acyclovir is a powerful word in antiviral therapy

    The creation of Acyclovir was perceived in the medical world as a new era in the treatment of viral diseases. Due to its high selectivity along with low toxicity, Acyclovir has become one of the most popular antiviral drugs.

    Before you continue reading: If you are looking for an effective method of getting rid of a runny nose, pharyngitis, tonsillitis, bronchitis or colds, then be sure to look at this section of the site after reading this article. This information has helped so many people, we hope it will help you too! So, now back to the article.

    In the 21st century, Acyclovir marked the beginning of a whole group of drugs that successfully cope with viruses. Despite the fact that current competitors have some advantages over Acyclovir, the parent drug is still widely used.

    Acyclovir's popularity is undoubtedly enhanced by the fact that external dosage forms are sold without a prescription. Belonging to the OTC group (from the English expression Over the Counterе - over the counter) once again proves the high safety of the medicine.

    Let's try to figure out how Acyclovir works and how effective different dosage forms of this drug are.

    The drug comes from the sea

    Few people know that the active substance Acyclovir is of natural origin. The basis for the synthesis of the drug was nucleosides isolated from the Caribbean sponge Cryptotethya Crypta, living in the Caribbean Sea.

    Interestingly, substances were isolated from the same Caribbean sponge that were used to synthesize some anticancer drugs. But let's return to our antiviral medicine.

    The inventor of Acyclovir is considered to be the American scientist Schaffer, who patented a new medicine for herpes in 1979. Another American, pharmacologist Elion, played a major role in studying the drug. In 1988, the researcher was awarded the Nobel Prize in Medicine, including for the study of Acyclovir.

    Composition and release forms of Acyclovir

    The active ingredient of the drug with the trade name “Acyclovir”, as well as its numerous analogues, is acyclovir.

    The drug is available in a variety of dosage forms.

    External dosage forms

    • Acyclovir eye ointment with a concentration of 3%;
    • Cream, active ingredient concentration 5%;
    • Acyclovir ointment 5%.

    Note that different manufacturers produce ointment weighing 5, 10, 15 grams.

    Some cosmetics manufacturers produce lipsticks containing Acyclovir. Such products are not classified as drugs, although they still have some antiviral effects.

    Oral, that is, tablet dosage forms

    Parenteral (injection) dosage forms

    • Acyclovir powder for injection 250 mg.

    The parenteral form is used to treat severe viral infections. As a rule, such pathologies require inpatient treatment, so outpatients usually do not encounter the injection form of release.

    Acyclovir cream and ointment - is there a difference?

    When purchasing topical Acyclovir, some patients face a dilemma. The fact is that the drug is produced in two external dosage forms at once, the difference between which is sometimes difficult for even pharmacists to clearly explain.

    Therefore, it’s probably time to explain how the cream differs from the ointment. So, the main difference between these two dosage forms is the base.

    In anticipation of readers' questions, we immediately note that the base is a pharmacologically inert substance, which is necessary for the uniform and stable distribution of the medicinal substance. That is, the base of the ointment, cream or liniment is devoid of pharmacological effect.

    The basis of the ointment is fatty substances, for example, lanolin, petroleum jelly and other components. Creams contain a much smaller amount of fatty substances, so the cream is sometimes called a “soft” ointment. Due to the different content of fatty components in cream and ointment, these dosage forms differ in pharmacokinetics, that is, the rate of absorption and distribution.

    Thus, ointments are absorbed slowly and can remain on the skin for quite a long time, distributing gradually. Creams are absorbed quickly, leaving no greasy marks on the skin and clothes.

    When choosing between Acyclovir cream and ointment, it is worth assessing the surface on which you will apply the drug. For the treatment of open inflamed elements, it is usually preferable to use an ointment. It will perform two functions at once: antiviral and moisturizing, preventing damage to the healing elements.

    If the rashes are located on areas of the body that come into contact with clothing, you should use a non-greasy cream.

    Pharmacological action of Acyclovir: explanation of instructions

    It is no secret that often the stumbling block in the instructions for a medicine is the clause on pharmacological action, and Acyclovir is no exception to the rule. It can be difficult for the average patient to understand the numerous terms that describe complex biochemical processes. Let's try to explain how the drug works.

    So, the medicine first penetrates the blood, after which it enters the cells affected by the virus. Viruses sensitive to Acyclovir produce their own special enzyme that ensures vital activity - thymidine kinase. Under the action of the enzyme, the drug undergoes a slight chemical transformation, turning into Acyclovir phosphate.

    In this transformed form, the new substance can be integrated into the viral DNA chain. Having made his way into the very lair of the enemy, Acyclovir conducts subversive activities there, which, as a rule, ends in victory. The drug, which contains DNA, blocks further synthesis of the main molecule of the virus, which provides its genetic program.

    Thus, Acyclovir stops further replication (multiplication) of sensitive viruses.

    Activity spectrum of Acyclovir

    Among the viruses sensitive to the action of the drug are species from the herpesvirus family. Let's try to list them in descending order of sensitivity to Acyclovir: herpes simplex virus type I (HSV-1), type II (HSV-2), varicella zoster virus, Epstein-Barr virus and cytomegalovirus (CMV).

    Resistance to Acyclovir is quite rare. Most often, drug resistance is observed in immunocompromised patients. You should not unfoundedly classify yourself in this category if you have recurrent herpes relapses three times a year. Or you get sick from every draft.

    As a rule, immunocompetent patients include people who have had an organ or bone marrow transplant, are HIV-infected, or are taking special medications that suppress the immune system.

    In cases of severe immunodeficiency, viruses produce very small amounts of thymidine kinase. As a result, the entire biochemical chain that ensures the pharmacological activity of Acyclovir is disrupted, and the drug simply does not work.

    Herpes viruses are everywhere, or where does this nasty herpes come from?

    About 60% of the world's population is infected with the herpes virus. As a rule, we become infected with the herpes simplex virus type 1, which causes cold sores, in childhood. HSV type 2, responsible for a rather serious disease, genital herpes, is transmitted mainly through sexual contact. Therefore, the total number of people infected with HSV-2 is not so impressive.

    Other pests of the herpesvirus family are also widespread. The same 60% of the population is infected with cytomegalovirus, despite the fact that the mode of transmission is usually sexual.

    The leader in these statistics is undoubtedly the chickenpox virus with the beautiful Latin name Varicella zoster. After all, almost 100% of children suffer from common childhood chickenpox. And after recovery, the smallpox virus enters the nerve ganglia, where it continues to “sleep” throughout our lives. So it turns out that every first person on the planet is infected with the chickenpox virus.

    Decreased immunity as the first step to activation of herpes

    However, despite this frightening ubiquity, the situation is not so sad. In most cases, the immune system independently copes with herpes viruses, which persist in a latent, that is, inactive state.

    But when immunity decreases, viruses can quickly become active, and then we may need treatment with Acyclovir.

    When does this happen? Immunosuppression may be due to:

    For example, hormonal changes in adolescents, pregnancy or breastfeeding are accompanied by some decrease in immunity.

    It is known that minor immunosuppression affects young children and the elderly.

    - pathological reasons, namely:

    • condition after organ or bone marrow transplantation;
    • HIV infection;
    • uncontrolled diabetes mellitus;
    • malignant neoplasms.

    - use of drugs that reduce immunity (immunosuppressants).

    As a rule, such drugs are taken after organ or bone marrow transplantation, as well as in the treatment of cancer.

    In healthy adults, immunity may be temporarily reduced by:

    • poor quality nutrition;
    • stress;
    • hard physical labor;
    • hypothermia and exposure to other adverse factors.

    So, in general, there are plenty of opportunities for the activation of herpes viruses. Let's look separately at the use of Acyclovir as an effective antiviral agent for each specific disease.

    Acyclovir for the treatment of herpes simplex of the mucous membranes, eyes and systemic herpes

    Herpes of the mucous membranes, especially recurrent ones, is a fairly common disease that causes a lot of trouble. Note that sometimes stomatitis and gingivitis - inflammation of the oral mucosa and gums - are also caused by activation of HSV-1. Usually, for mild herpes of the mucous membranes, external Acyclovir ointment or cream is sufficient.

    In case of pathology of moderate severity, as a rule, oral therapy with Acyclovir in the form of tablets with a dosage of 200 or 400 mg is added to external dosage forms.

    Severe forms of herpes, including systemic herpes, which develops with severe immunosuppression, are treated in hospitals using injectable Acyclovir.

    Acyclovir tablets and eye ointment are used to treat keratitis (inflammation of the cornea) associated with the herpes simplex virus in HIV-infected patients.

    In addition, tablet dosage forms are used to prevent relapses of ophthalmic diseases caused by HSV in immunocompetent adults and children over 12 years of age. As a rule, the drug is indicated for patients with a history of herpetic blepharitis (inflammation of the eyelids), conjunctivitis, keratitis or iritis (inflammation of the iris) within the previous 12 months.

    According to standard protocols for the treatment of HSV, Acyclovir is considered the drug of choice for the treatment of herpes encephalitis (inflammation of the brain).

    In pediatrics, the medicine is used as a first-line treatment for congenital herpes in newborns. Manifestations of the disease include lesions of the eyes, skin and oral mucosa, as well as disseminated, that is, widespread infection.

    Acyclovir: a treatment for genital herpes

    Labial herpes, which affects the paranasal area, will seem like a minor nuisance compared to the manifestations of genital herpes. The classic symptom of the disease is the appearance of small itchy rashes on the mucous membrane of the genitals and anus, the elements of which contain a colorless liquid.

    Treatment of genital herpes usually includes a serious regimen aimed at improving the immune status in general and at combating type 2 HSV. Adequate therapy can reduce the number of relapses of the disease to a minimum. Unfortunately, no doctor can guarantee that the manifestations of genital herpes will leave you forever.

    So, Acyclovir tablets are used to treat all stages of the disease, from the initial stages to chronic recurrent infection, namely:

    — initial episodes of genital herpes in adults and adolescents, including HIV-infected people;

    - initial episodes of genital herpes, manifested in the form of proctitis (inflammation of the rectum);

    - repeated episodes of genital herpes in adults and adolescents.

    Many experts recommend as the drugs of choice not only tableted Acyclovir, but also its derivatives - tablets Famciclovir and Valacyclovir.

    Acyclovir for chickenpox

    Mild chickenpox usually does not require any specific drug therapy. Even creative daily drawings on the body, which many adults love so much and all children hate so much, rather serve as a sedative for parents. After all, almost every first mother and every second father cannot look calmly at the “torment” of a child covered with a thick rash, frantically scratching his colorful pimples.

    So parents draw intricate patterns every morning. Moreover, the color of these arts can be brilliant green, if brilliant green is used as paint, or poisonous crimson, when the doctor prefers fucorcin. And the child, by the way, recovers completely independently, and the outcome of the disease is predetermined - chickenpox is doomed from the very beginning.

    Therefore, if the doctor prescribed Acyclovir to your child for simple, mild chickenpox, you should think about it. The need to use any antiviral drugs or its derivatives in immunocompetent, that is, generally healthy children and adolescents, is highly questionable.

    However, in some cases, the course of chickenpox still requires special attention from an infectious disease doctor. As a rule, the average degree of the disease is recorded in weakened children. Cases of chickenpox in adults are almost always a severe infection, which is often treated in hospitals using modern antiviral drugs.

    So, Acyclovir is a first-line drug for the treatment of chickenpox in:

    • children and adolescents with weakened immune systems;
    • adults;
    • HIV-infected patients.

    Hello from childhood: herpes zoster

    Few people know that both chickenpox and shingles are caused by the same varicella zoster virus, Varicella zoster. The virus, which persists in the nerve ganglia after chickenpox in childhood, can make itself known again after 40–60 years.

    Most often, herpes zoster, or shingles, develops in older people over the age of 60. Despite the fact that the disease, like chickenpox, goes away on its own, infectious disease specialists prefer to use antiviral and immunomodulatory therapy. You may ask, why take extra medications?

    The fact is that drug treatment of herpes zoster minimizes the possibility of complications, which can be quite serious, including muscle paralysis. In addition, antiviral therapy promotes rapid recovery, as well as a decrease in the severity of the clinical manifestations of the disease.

    Acyclovir is the drug of choice for severe or widespread cases of herpes zoster in immunocompetent adults and in HIV-infected patients. In addition, Acyclovir is widely used for the treatment of herpes zoster in adults and children with a normal immune response, as well as in weakened patients.

    Infectious mononucleosis

    Despite data on the activity of Acyclovir against the causative agent of infectious mononculosis, the Epstein-Barr virus, the drug is rarely used to treat this disease.

    This is due to the fact that the Epstein-Barr virus is eliminated on its own and usually does not require any specific treatment.

    Information about the effectiveness of Acyclovir therapy for uncomplicated, severe or chronic infectious mononucleosis, as well as other manifestations of viral carriage (for example, oral hairy leukoplakia) is very contradictory.

    Does acyclovir help with cytomegalovirus infection?

    The prevalence of cytomegalovirus is eloquently demonstrated by data provided by the World Health Organization. They claim that 90% of the world's population over the age of 80 has serological evidence of infection. That is, if we live to such an advanced age, then CMV infection is almost inevitable.

    And there's nothing wrong with that. After all, the disease, like other infections caused by herpes viruses, usually occurs latently, that is, without clinical manifestations. And it doesn't cause us any trouble.

    Cytomegalovirus infection is dangerous if a pregnant woman becomes infected with it for the first time, especially in the early stages of pregnancy. Then the virus infects the fetus, and this is fraught with the development of various defects in the child.

    In addition, CMV, safely kept from activation by our immune system, can wake up if the immune system fails. In this case, the disease can develop rapidly and requires correct treatment.

    It is difficult to answer the question whether Acyclovir helps with active CMV infection. But it is definitely ineffective for current active disease.

    However, Acyclovir is indicated for the prevention of cytomegalovirus infection in patients after organ or red bone marrow transplantation. However, in practice, more powerful derivatives of the drug are more often used; in particular, Ganciclovir is the drug of choice.

    Acyclovir cream and ointment - how to use?

    External dosage forms of Acyclovir are considered very safe. And first of all, this is due to the fact that the medicine, when applied to the skin or mucous membranes, is practically not absorbed into the blood. And, therefore, it does not enter the body and does not have a systemic effect.

    There is one rule for using external forms of the drug for both children and adults. A cream or ointment containing 5% Acyclovir is applied to the affected areas five times during the day at regular intervals.

    I would like to note that the effectiveness of the ointment or cream does not depend at all on what layer you apply the medicine. An opinion based on a direct relationship between the thickness of the ointment layer and its effectiveness does not stand up to criticism. After all, our skin is not a bottomless barrel. Only a strictly defined amount of the active substance is absorbed into the dermis.

    Therefore, pharmacists warn that the cream or ointment should be applied to the affected areas of the skin in a thin layer.

    I would like to note that external forms of Acyclovir - cream and ointment, including ophthalmic, intended for the treatment of herpetic keratitis and blepharitis, are sold without a doctor's prescription. OTC drugs sold in the public domain also include external preparations of Acyclovir derivatives. Among the most effective and popular external antiviral agents, we note the drug containing Penciclovir - Fenistil Pencivir.

    Acyclovir tablets: pharmacokinetic data

    Tablet forms of any medicine are not as safe as external ones. This is understandable: after all, the drug enters the intestines, where it is absorbed into the blood.

    This axiom fully applies to Acyclovir. Therefore, unlike ointments or creams, you will need a doctor's prescription to purchase tablets. Note that only the doctor and no one else should write down the regimen for using the medicine.

    Acyclovir tablets have a fairly low bioavailability, which is only 15–30%. However, the drug penetrates perfectly into the organs and biological fluids of the body. Note that neither the blood-brain nor the placental barrier is an obstacle to the active substance. This means that when taken orally, Acyclovir penetrates into the cerebrospinal fluid, into the circulatory system of the fetus, and into breast milk.

    I would like to note that during treatment with Acyclovir you can take it at any time, regardless of meals. The medicine is absorbed at the same rate regardless of whether you drink it on an empty stomach or after a heavy dinner.

    Acyclovir tablets: standard dosages for children

    The treatment regimen with Acyclovir depends on the specific disease. So, let's figure out how to dose Acyclovir for children with herpes virus infection.

    Labial herpes (lesions of the perioral area)

    For children with weakened immune systems, it is recommended to use 1 gram of Acyclovir per day, divided into 3-5 doses, at regular intervals. The course of treatment depends on the severity of the infection and usually lasts 7–14 days.

    Herpetic gingivostomatitis (damage to the oral mucosa and gums)

    For HIV-infected children with severe gingivostomatitis, a dosage of 20 mg of Acyclovir per kilogram of body weight is recommended three times a day, the duration of treatment is from 7 to 14 days. The maximum dosage of the drug according to the instructions is 400 mg of Acyclovir per day.

    The dosage is slightly lower for immunocompetent, that is, generally healthy children: 15 mg per kilogram of body weight per day. Moreover, the frequency of use is five times a day, and the course of treatment for stomatitis or gingivitis with Acyclovir is a week.

    I would like to note that stomatitis and gingivitis are not always of a viral nature. Often the disease is caused by bacteria or fungi. Therefore, taking Acyclovir without a doctor’s recommendation is a big mistake, possibly delaying recovery.

    Prevention of recurrence of herpetic ophthalmic infections

    For periodically recurring episodes of herpetic blepharitis, keratitis, iritis in children over 12 years of age, it is recommended to take 400 mg of Acyclovir twice a day. In some cases, doctors prefer to dose 80 mg per kilogram of body weight, divided into three doses.

    The optimal course of treatment is still unclear. Most often, treatment is long-term and lasts 12–18 months.

    For immunocompetent children over two years of age, the therapeutic dose of Acyclovir is 20 mg per kilogram of body weight four times a day. The course of treatment is short - only five days.

    For children weighing more than 40 kg, it is recommended to take 800 mg of Acyclovir four times a day, again for 5 days.

    Treatment of chickenpox with Acyclovir is most effective if it begins simultaneously with the first early symptoms of the disease (within 24 hours after the appearance of the rash).

    Treatment should begin within 48 hours after the initial rash.

    Immunocompetent children over 12 years of age are recommended to take Acyclovir 800 mg tablets five times a day for 5–10 days.

    Acyclovir dosage for adults

    Just as in the treatment of children, for herpetic infections in adults, the course of Acyclovir therapy depends on the disease.

    Herpetic rashes on the skin and mucous membranes

    When the elements of the rash are localized on the mucous membranes of the mouth and skin, the dosage is 400 mg of Acyclovir every four hours (that is, five times a day). The course of treatment is one to two weeks.

    The treatment regimen for the most common manifestation of herpes - on the lips and perioral area - is very simple. You can reduce the intensity of the rash and speed up its healing by taking 400 mg of Acyclovir five times a day. The average course of treatment is five days.

    Herpetic keratitis and other ophthalmic manifestations

    Treatment of ophthalmic manifestations includes the use of 400 mg of Acyclovir five times daily. The peculiarity of the therapeutic course is its duration, which is very important for preventing relapses.

    Prevention of eye infections includes the use of 400 mg of Acyclovir twice daily for 12–18 months.

    — Treatment of the first episode.

    According to the manufacturer's recommendations, the course of treatment for newly appeared rashes is 200 mg of Acyclovir every four hours (five times a day) for 10 days.

    However, most experts adhere to an alternative regimen - 400 mg three times a day or 200 mg five times a day for 7-10 days. If symptoms persist at the end of the course, treatment with Acyclovir can be continued.

    - Treatment of recurrent episodes.

    According to the instructions for use of oral Acyclovir, the course of treatment is 400 mg three times a day or 800 mg twice a day for 3–5 days.

    The sooner treatment for recurrent genital herpes is started, the higher the effectiveness of therapy. Therefore, Acyclovir should be taken immediately after the first signs of relapse appear.

    The dosage of Acyclovir for chickenpox in adults is 20 mg per kilogram of body weight per day, divided into 4 doses. The course of treatment is five days. The effectiveness of therapy depends on early initiation of treatment. Therefore, when the first signs of chickenpox appear, you should start taking Acyclovir.

    The dosage of Acyclovir for herpes zoster is 800 mg every four hours for 7-10 days. Treatment should begin within the first 48 hours after the rash appears.

    When should you not use Acyclovir?

    Contraindications to the use of Acyclovir cream and ointment:

    We have already mentioned that external dosage forms have a high level of safety. This is also confirmed by the fact that there are simply no contraindications to the use of Acyclovir cream or ointment. Of course, except for one thing:

    1. the presence of individual sensitivity to Acyclovir.

    As a rule, an individual reaction is highly unlikely. If you have never experienced an allergy (for example, allergic rhinitis and other symptoms) to medications, as well as petroleum jelly, lanolin and other components of ointments, then you can safely use topical Acyclovir.

    Contraindications to the use of Acyclovir tablets:

    2. breastfeeding period.

    It has been proven that the drug penetrates perfectly into breast milk. Therefore, it is better to avoid using Acyclovir tablets during lactation.

    3. individual hypersensitivity.

    The chance of an allergic reaction is less than 1%.

    Can Acyclovir be used during pregnancy?

    The effect of Acyclovir on pregnancy in humans has not been sufficiently studied. The lack of full-fledged studies is not due to the omission of the manufacturer, but to the ethical component of such tests. However, experiments on animals confirmed the absence of a negative effect of Acyclovir on the fetus.

    In addition, post-marketing trials also did not reveal any negative effects of this drug on pregnancy. Therefore, to the question whether it is possible to be treated with Acyclovir during pregnancy, we will answer this way: the drug belongs to category B and can be used under the supervision of a doctor.

    Adverse events during treatment with Acyclovir: what to expect?

    Side effects of external forms of Acyclovir

    • local reaction.

    It is very short-lived and manifests itself as redness, itching or tingling in the areas of application. Goes away on its own within a few minutes;

    Possible in less than 0.1% of cases in sensitized, that is, sensitive patients.

    Side effects of Acyclovir tablets and injections

    very often (more than 12% of cases)

    often (1-10% of cases)

    The likelihood of nausea is much higher with long-term treatment with high doses of Acyclovir;

  • vomiting (less than 3% of patients).

    If vomiting occurs, you should notify your doctor. You may have to switch to parenteral use of Acyclovir;

  • diarrhea (2-3% of cases).

    An adequate response to stool disorders is the addition of antidiarrheal drugs containing loperamide to the treatment regimen;

  • headache (2% of cases).

    The use of analgesics can neutralize this adverse effect.

    • rare (less than 1% of cases)

    Acyclovir analogues: what to choose?

    In any, even the most seedy pharmacy, you can easily find several analogues of Acyclovir. Large chain pharmacies can provide you with dozens of generics. Interestingly, the price of different analogues can fluctuate by two times or even more.

    Let's try to list the most common analogues of Acyclovir:

    1. Zovirax is the highest quality and most expensive drug produced by Glaxo. Zovirax is available as ophthalmic ointment, 5% cream or tablets containing 200 mg Acyclovir. In addition, the drug is available in powder form for injection.

    Reviews from doctors indicate that Zovirax is one of the most effective analogues of Acyclovir.

    2. Virolex is also a very high-quality and quite expensive generic of Acyclovir produced by the Slovak company KRKA. There are eye ointment, cream and 200 mg tablets.

    3. Acyclovir-Hexal is a more affordable option produced by the German company Hexal. Sold as a 5% cream.

    4. Acyclovir-Akos produced by the Russian company Synthesis is presented in the form of 5% ointment and 200 mg tablets.

    5. Acyclovir Akri, which is produced by the Russian association Akrikhin, is available in the form of 5% ointment and tablets of 200 and 400 mg.

    6. The “Forte” version produced by the Obolenskoye company is tablets containing 400 mg of Acyclovir.

    Let us note that traditionally Russian-made drugs are distinguished by fairly high quality and affordable prices.

    And finally, let us remind you: both external and internal forms of Acyclovir should be stored in a dark place at room temperature.

    The article above and comments written by readers are for informational purposes only and do not encourage self-medication. Consult a specialist regarding your own symptoms and illnesses. When taking any medicine, you should always use the instructions that come with the medicine and your doctor's advice as a guide.

    In order not to miss new publications on the site, it is possible to receive them by email. Subscribe.

    Do you want to get rid of your nose, throat, lung and cold diseases? Then be sure to check it out here.

    It is also worth paying attention to other medications:

    I have been on high doses of Acyclovir for 2 months for EBV and at least henna.

    Acyclovir in the form of ointment/cream helped me well with episodes of genital herpes. The pain and itching subsided before our eyes.

    For a secondary bacterial infection, I sprinkled it with streptocide powder. I just crushed a streptocide tablet.

    Join, speak out and discuss. Your opinion may be very important to many readers!

    Copying materials without written permission and an open link is prohibited.

    Source: http://cc-t1.ru/preparaty/aciklovir.html