Can pregnant women use acyclovir? Features of dosage forms

Acyclovir is an antiviral medicine for the treatment of herpes in its various manifestations. Often such an infection affects the body of expectant mothers. Acyclovir should be used with caution during pregnancy.

The drug enters the body by injection (intravenously), externally (ointment and cream) and preorally (gastrointestinal tract).

The most common for use during pregnancy are Acyclovir cream and ointment.

The infection site is constantly treated with the agents every 3-4 hours for 6-7 days.

Often these are areas of skin and mucous membranes damaged by herpes. The cream is unlikely to have a strong toxic effect on the female body and the child’s immunity - its concentration in the blood will be too low.

An advanced herpes infection, especially of a widespread localization, will cause more harm to the future baby. If the affected area is large, then it is better to apply the ointment with gloves. The correct time to start treatment is the key to a quick recovery. Therapy should be carried out until the inflamed blisters completely disappear - this will help avoid relapses of the disease.

If planning to use the cream in the 1st trimester of pregnancy, you should definitely consult a doctor. Many medications are dangerous in the first weeks of pregnancy, because before 8-9 weeks many vital organs are formed in the fetus, and some drugs can negatively affect this process.

Intravenous use of Acyclovir during pregnancy is prohibited.

In tablet form, the drug is allowed to be taken in the 3rd trimester of pregnancy and after the recommendations of the treating gynecologist.

Acyclovir eye ointment is used for herpes of the outer shell of the eye - it is placed under the conjunctiva once every 4-5 hours.

During lactation, the use of Acyclovir is prohibited; its active ingredients can easily penetrate into mother's milk, which is fraught with negative consequences for the health of the newborn.

How the drug works

The main effect of the drug is to inhibit the division of viral cells in the body. Penetrating into the body, Acyclovir changes until it reaches the source of infection and weakens it. The remaining virus is no longer able to reproduce and dies under the influence of the body’s immunity. The result is the disappearance of herpes symptoms.

Acyclovir is prescribed against:

• herpes virus type 1;
• herpes virus type 2;
• Epstein-Barr virus;
• cytomegalovirus.

In relation to the above-mentioned viruses, the product is able to act at the maximum level.

Indications for use

Acyclovir is used in cases of herpes group viral infections. They can cause the following diseases:

• infectious manifestations of herpes on the skin and mucous membranes;
• genital herpes;
• shingles;
• chickenpox;
• inflammation of the cornea of ​​the eye;
• herpes infection in immunodeficiency.

When treating the above ailments, it is important to choose the right form of the drug. For minor inflammations of the skin and mucous membrane, it is recommended to use Acyclovir cream or ointment. When herpes is localized in several areas of the body, tablets will be the best solution. If there is a herpes virus on the outer membrane of the eye, Acyclovir eye ointment is prescribed.

Side effects

The drug is well tolerated by pregnant women, but in some cases side effects are observed:

1. From ointment and cream therapy:
   – burning at the site of application;
   – redness;
   – rash;
   – vulvitis (on the genitals);
   – conjunctivitis, blepharitis (in ophthalmology).
2. As a result of treatment with tablets:
   - nausea;
   - dizziness;
   – migraine;
   - weakness;
   – temperature increase;
   - muscle pain.

If any of the above symptoms occur, you should consult a doctor to adjust the dosage of the drug.

Intravenous Acyclovir is not prescribed during pregnancy, even when herpes manifests itself in a complex form. The prescription of any form of the drug during pregnancy must be justified, and therapy must be carried out under the strict supervision of the attending physician.

Contraindications for use

Acyclovir is prohibited for use during pregnancy if you are allergic to any of the components of the drug. If you notice any allergy symptoms (rash, itching, fever, headache), you should immediately stop using Acyclovir.

Once in the body, the product passes through the kidneys, liver and gastrointestinal tract; there are restrictions on its use:

• renal failure;
• dehydration of the body;
• disorders of the liver;
• neurological disorders.

If you are simultaneously taking medications that affect the kidneys, then you should wait to use Acyclovir so as not to cause complications.

Rules for using medication during pregnancy

To get the maximum effect from treatment with Acyclovir, you should follow simple rules:

• Drink plenty of fluids during the course of treatment. This will make it possible to improve kidney function and remove drug metabolites without affecting the urinary system;
• If any unusual reactions are detected, consult a doctor;
• Treatment should be carried out under the strict supervision of a doctor; if necessary, a specialist will prescribe additional blood and urine tests;
• delay sexual intercourse in case of genital infections;
• Avoid using contact lenses during eye treatment.

Pregnancy is an important and responsible period in the life of every woman. Any disease should not be neglected; you should not be afraid of it. Improper treatment of herpes can harm the body of the mother and child; therapy should be carried out under the strict guidance of the attending physician.

No matter how carefully women prepare for a future pregnancy, the risk of infection or exacerbation of herpes is extremely high. The reason for this is a slightly weakened immune system and, as a consequence, a woman’s strong vulnerability to diseases during this period. If herpes takes a woman by surprise, treatment must be started immediately, since the virus is extremely dangerous for the fetus. In this case, Acyclovir or other antiviral agents are often prescribed. How effective is Acyclovir against the herpes virus and how can treatment affect pregnancy? Acyclovir in the gestational period is the main topic of today's article.

If the virus wandered through the female body before conception, then there is probably a sufficient amount of antibodies in the blood that will help protect the baby. But if the virus first enters the body during pregnancy, the treatment process becomes much more difficult. In this case, a strong antiviral drug is prescribed - Acyclovir.

This drug is quite popular in obstetric practice. It has a detrimental effect on all types of viruses, including simple and genital herpes, as well as chickenpox and shingles.

Scientific studies have established that the component acyclovir during pregnancy is able to reach the baby by overcoming the placental barrier. But it does not have any effect on the development of anomalies in the embryo.

To fully confirm the safety of the drug for women and babies, an experiment was conducted in Denmark with the participation of pregnant women. Two samples of women were formed: those who took the antiherpetic drug and those who refused it. The results exceeded all expectations. It turned out that the percentage of congenital anomalies of the baby is much higher in women who did not undergo antiviral therapy.

Most doctors believe that the development of a herpes infection is much more dangerous than taking antiviral drugs. And they are partly right. After all, herpes directly affects the development of the baby’s organs, as well as the outcome of pregnancy as a whole. An untreated disease can cause disruption of the structure of internal organs, provoke miscarriage or premature labor.

But no matter how dangerous herpes is, Acyclovir is prescribed to women only as a last resort and taking into account the trimester of pregnancy.

Acyclovir during pregnancy - 1st trimester

The first 12-14 weeks are a contraindication to the use of Acyclovir, but, as a rule, during this period an exacerbation of herpes occurs. If the test results show an unsatisfactory antibody titer, you can take the tablet form of the drug. But such treatment is prescribed only for severe forms of the disease. In most cases, treatment comes down to local action on herpes using ointment or gel in the form of external applications. Injectable forms of the drug are not used in the first trimester.

Acyclovir during pregnancy - 2nd trimester

During this period, the baby has already matured and become stronger, but the effect of herpes on his condition is still detrimental. This period already allows for more radical methods of treatment using standard doses of Acyclovir tablets. It is also possible to relieve the symptoms of herpetic rashes by applying ointment. In parallel, immunostimulating drugs are prescribed.

Acyclovir during pregnancy 3rd trimester

Treatment of herpes at this stage is carried out if a primary infection has occurred, since chronic exacerbation by this period has already subsided. For treatment, tablets and ointments are used, less often - injections.

Composition and effect on the body of the drug Acyclovir during pregnancy

Acyclovir is an antiviral drug for systemic use. The main active ingredient is acyclovir. The list of auxiliary agents depends on the pharmaceutical form of the drug. The tablets contain cellulose, silicon dioxide, magnesium stearate, capovidone. Alcohol, paraffin, propylene glycol, as well as sodium lauryl sulfate and water are added to creams and gels.

The drug is a synthetic analogue of a purine nucleoside, which reduces the activity of all types of herpes viruses, including cytomegalovirus and Epstein-Barr virus.

The effectiveness of the drug lies in the fact that the active substance penetrates the affected cells and is completely integrated into the herpes DNA, breaking the chain of viral DNA synthesis. At the same time, acyclovir does not exhibit toxic effects on the cells of the human body.

With long-term or repeated treatment, there is a gradual decrease in the effectiveness of the drug, as the sensitivity of some pest viruses to acyclovir decreases.

Pharmaceutical forms of Acyclovir and indications for their use during pregnancy

Depending on the type of virus and its location, different forms of the drug Acyclovir are prescribed. It can be used for external applications, in the form of tablets or injections.

Below we will consider all the available types of Acyclovir and the reasons for their use.

Acyclovir - eye ointment during pregnancy

During pregnancy, herpes can affect the eyes, resulting in the development of herpetic keratitis (inflammation of the cornea). To eliminate pain, restore the cornea and prevent the spread of the virus to other mucous membranes, Acyclovir is used in the form of 3% eye ointment.

The ointment is available in a tube with an applicator, with which you need to apply a thin strip of the drug into the conjunctival sac of the lower eyelid. After application, the drug is actively absorbed into the stratum corneum and spreads throughout the eyeball and vitreous body. In microdoses it penetrates the placental barrier and is also concentrated in breast milk.

Acyclovir ointment, according to the instructions during pregnancy, should be used with caution by women who are prone to allergic reactions to medications. In general, the drug is well tolerated, but sometimes the following side effects occur:

• Burning sensation in the eyes.
• Conjunctivitis.
• Keratopathy of the upper layer of the cornea.
• Allergic manifestations.

Acyclovir - cream during pregnancy

The drug in the form of a 5% cream is intended for the treatment of herpetic rashes exclusively on the face and lips. The cream should not be used for application to the eyes, genitals or mouth, since the cream exhibits an aggressive effect if it comes into contact with mucous membranes.

Treatment should begin at the first signs of exacerbation, but even after the appearance of bubbles, the cream is also effective, but requires longer use.

In this form, acyclovir practically does not enter the bloodstream and has only a local effect. Therefore, there is no need to talk about a possible teratogenic effect on the fetus.

Acyclovir - tablets during pregnancy

Tablets are available with different dosages of the active substance. The concentration of acyclovir can be 200 mg, 400 mg and even 800 mg. Prescribing the drug in tablets is justified in case of ineffectiveness of the use of means for external use and in the case of a severe progressive form of herpes against the background of poor immunity.

Acyclovir tablets during pregnancy can be prescribed in the following situations:

• For the treatment of herpes simplex, as well as genital herpes in primary or recurrent form.
• Prevention of relapse of herpes in patients with reduced immunity.
• Treatment of chicken pox.
• Treatment of herpes zoster.

Acyclovir injections during pregnancy

Acyclovir in the form of a lyophilisate for the preparation of injections during the gestational period is prescribed in case of infection with herpes zoster or strains of the virus resistant to other forms of the drug. The solution is administered intravenously or through a dropper.

Acyclovir: instructions for pregnancy

Calculation of dosage and duration of use

How long the treatment will last is determined by the attending physician. The dosage of the drug and the choice of its pharmaceutical form are determined taking into account the overall picture of the disease.

• Eye ointment. 4-5 procedures are performed per day with an interval of 4 hours. Treatment is carried out until the herpetic “bubbles” disappear and for another three days after that.
• Cream. The drug should be applied to the affected areas 3-4 times a day, except during sleep. The average course of treatment is 4 days; if there is no improvement, treatment is continued for up to 10 days.
• Pills. To treat type I herpes virus, Acyclovir 200 mg tablets are prescribed five times a day. The duration of treatment is 5 days or more. For severe manifestations of the disease, the dosage is doubled to 400, and in some cases to 800 mg.
• Injections. Injections are given three times a day. The dose is calculated taking into account the patient’s weight: 5 mg of acyclovir is taken for each kilogram.

Possible risks and contraindications

A contraindication to the use of Acyclovir during pregnancy is acute individual intolerance to one of the components of the drug.

But the list of adverse reactions, regardless of the form of the drug, is much longer:

• Disorders of the lymphatic system and blood - anemia, leukopenia, symptomatic thrombocytopathy.
• The immune system reaction is anaphylaxis.
• Psycho-emotional disorders and problems in the functioning of the central nervous system - dizziness, shortness of breath, migraine, tremor, disorientation in space, convulsions, coma, hallucinations.
• From the digestive tract - diarrhea, pain in the epigastric region, vomiting.
• Disorders of internal organs - drug-induced hepatitis, renal failure.
• On the part of the skin - urticaria, hyperemia, itching.

Analogues of the drug Acyclovir during pregnancy

If a woman “catch” herpes during pregnancy, Acyclovir is not the only cure for this disease. There are many analogue drugs that are also allowed during this period:

• Zovirax.
• Cyclovir.
• Acyclovir hexal.
• Gerpevir.
• Acyclostad.
• Virolx et al.

These drugs differ from each other in the concentration of the active ingredient, the form of packaging and the list of additional substances. And the indications and method of use are the same for everyone.

Acyclovir during pregnancy: reviews

The numerous reviews about the use of Acyclovir and a number of other antiviral drugs during pregnancy are mostly positive. Women extremely rarely noticed any adverse reactions and, on the contrary, noted a significant improvement in their well-being.

Rare cases of poor tolerability of the drug are usually associated with an overdose or individual intolerance to the drug. There is also no information about congenital anomalies of the baby that would be associated with taking Acyclovir.

True, there are also opponents of treatment during pregnancy. But here the woman has a choice: treat herpes or refuse therapy, hoping that the virus will not harm her child.

Pregnancy is a condition that requires a woman to make only thoughtful decisions. Before starting treatment, consider all the risks and consequences, and only then make your choice. Remember that Acyclovir can be taken during pregnancy, but only a doctor can prescribe such treatment.

Herpes and pregnancy. Video

During pregnancy, every expectant mother should be especially careful when using any medications - even those that seem completely safe. After all, medications that cause virtually no harm to a woman’s body can negatively affect the development of her child. Acyclovir during pregnancy is in some cases prescribed by doctors. It should be remembered that only a specialist can realistically assess the risks and benefits of prescribing a particular drug during pregnancy.

Acyclovir is an antiviral drug that is primarily used to treat infections caused by the herpes simplex and herpes simplex viruses. The herpes simplex virus (HSV) can also cause herpetic keratitis, blepharitis and encephalitis, and neonatal herpes. The virus causes chickenpox and shingles.

In addition, Acyclovir has activity against the Epstein-Barr virus. The drug prevents the multiplication of viruses, thereby reducing the severity of the infection and stopping its spread.

Although Acyclovir is an antiviral drug, it cannot completely cure infections. These viruses continue to live in the body between exacerbations of the disease. Acyclovir reduces the severity and duration of these exacerbations. It helps rashes heal faster, prevents the formation of new blisters, and reduces pain and itching.

This drug may also reduce the long-term pain that remains after shingles. Additionally, in people with weakened immune systems, Acyclovir may reduce the risk of the virus spreading to other parts of the body, preventing more severe illness.

There are several forms of release of the drug:

1. Injection.
2. Tablets, capsules and oral solution.
3. Ointment and cream for external local use.
4. Eye ointment.

The intravenous route of administration is most effective, which is why it is used for severe infections caused by herpes simplex and chickenpox viruses. When taken orally, only 15-30% of the drug is absorbed in the intestines. After entering the body through a series of chemical reactions, the drug is converted into acyclovir triphosphate, which suppresses the formation of viral DNA without affecting normal cellular processes.

Ointment or cream is used in the mildest cases of herpetic infection - for mild labial and genital herpes. Eye ointment is used to treat eye diseases caused by HSV.

Taking Acyclovir during pregnancy

Herpes is a fairly common infectious disease in women during pregnancy. Most of them give birth to completely healthy children. In rare cases, a newborn may develop neonatal herpes, a very serious disease that can cause the death of the child. It is the danger of developing this pathology that explains the use of Acyclovir during pregnancy.

Scientific studies have failed to find an association between use of this drug during pregnancy and the development of birth defects in the baby, premature birth, or stillbirth. These data are valid for taking Acyclovir during pregnancy, both in the early and late stages. However, it is strongly recommended that pregnant women use this drug only as prescribed by a doctor and strictly adhere to the dosage.

Indications and contraindications for taking Acyclovir during pregnancy

• prevention of neonatal herpes in a child;
• treatment of primary genital herpes in pregnant women;
• treatment of relapses of genital herpes in pregnant women;
• treatment of other diseases caused by HSV - for example, herpetic keratitis or encephalitis;
• treatment of severe pneumonia caused by the varicella zoster virus.

The risk of transmitting HSV from mother to child depends on when the woman was infected:

• If a herpes infection enters a woman’s body before pregnancy, antibodies develop in it, which are transmitted through the placenta to the child. These antibodies protect the baby from infection during childbirth and for several months after it. However, some women with recurrent genital herpes during pregnancy may need to take Acyclovir tablets starting at 36 weeks of gestation to reduce the risk of transmitting the disease to the baby during childbirth.
• If HSV infects a woman in the 1st and 2nd trimester, the risk of miscarriage and the risk of transmitting the virus to the child increases. In this case, the expectant mother may need to take Acyclovir throughout the entire pregnancy.
• The highest risk of transmission of the herpes virus from mother to child is observed when a woman is infected in the 3rd trimester. This is due to the fact that her body does not have time to produce antibodies to the virus and pass them on to the baby. In this case, the expectant mother needs to take Acyclovir during the last 4 weeks of pregnancy. To reduce the risk of infection in a child, it may be necessary.

Acyclovir is contraindicated during pregnancy if a woman has a hypersensitivity or allergy to it or other auxiliary components of the drug. It is also prescribed with caution to patients with kidney disease and impaired immunity (HIV, bone marrow transplantation, kidney transplantation), since in these cases the risk of side effects increases.

Instructions for use during pregnancy

Women should strictly follow their doctor's recommendations for the use of Acyclovir tablets or ointment during pregnancy. The injection form is used only for severe illnesses; treatment in such cases is carried out in a hospital setting.

Acyclovir capsules and tablets during pregnancy should be taken with meals or on an empty stomach. It is best to take the drug with a glass of water. When taking the suspension, you should use special measuring spoons to accurately measure each dose. During treatment, you should drink enough water to avoid dehydration.

Oral dosage:

• For the treatment of primary genital herpes - 200 mg 5 times a day for 7-10 days.
• For the treatment of recurrent genital herpes - 400 mg three times a day for 3-5 days.
• For suppressive treatment of genital herpes - 400 mg twice daily.
• For the treatment of chickenpox - 800 mg 4 times a day for 5 days.
• For the treatment of herpes zoster - 800 mg 5 times a day for 7-10 days.

Instructions for using Acyclovir ointment during pregnancy indicate that it should be applied to areas affected by herpes 5 times a day. It is better to do this every 4 hours during the day - for example, at 7 am, and then at 11.00, 15.00, 19.00 and 23.00.

Acyclovir ointment should not be rubbed in during pregnancy as this may damage the blisters and spread the virus to neighboring areas. Before applying the ointment and afterward, wash your hands thoroughly and wipe them dry. Do not apply the drug to the oral or vaginal mucosa, or near the eyes, as it may irritate them.

Side effects

Like any medicine, Acyclovir can cause side effects.

Side effects from using the drug:

Acyclovir analogues that can be used during pregnancy

There are two analogues of Acyclovir that are used to treat herpes infections.