Acyclovir for sore throat: effective treatment of herpetic infection

The mucous membranes of the tonsils can be affected by bacteria or fungi, as well as viruses. And in all cases, the disease will be called the same - angina, or tonsillitis - and the treatment will be different. For example, Acyclovir for angina is prescribed only for viral lesions: if the inflammatory process was provoked by bacteria or fungi, then this drug will be simply useless.

Viral tonsillitis is a disease no less common than bacterial tonsillitis. It can be caused by influenza viruses, as well as the ECHO and Coxsackie viruses.

Does Acyclovir help with tonsillitis?

At the first signs of tonsillitis, it is necessary to determine the origin of the disease as soon as possible: whether it is caused by a virus or bacteria. The prescribed treatment depends primarily on this. Since Acyclovir is an antiviral drug, its use is inappropriate for bacterial tonsillitis, and vice versa - antibiotics will not help with herpetic tonsillitis.

Most often, the doctor does not waste time on conducting a diagnostic smear for bacterial culture: waiting for its results will take a long time, and treatment must be carried out immediately (although such diagnostics are the best option for optimal effectiveness of therapy). Most doctors act according to two principles. The first principle is the simultaneous prescription of both an antibiotic and Acyclovir (or another antiviral drug). This approach is not entirely correct, since it gives the patient's body an additional and strong drug load. The second principle is a thorough analysis of the symptoms: the doctor tries to understand from the nature of the clinical picture what kind of sore throat is being discussed - viral or bacterial. So, if the patient has symptoms such as high temperature, enlarged tonsils and lymph nodes, headaches and throat pain, but does not complain of a cough or runny nose - then most likely he has a viral sore throat. An additional sign is the appearance of a red rash and ulcers on the tonsils.

With bacterial tonsillitis, the temperature is present, but insignificant, rhinitis, cough, and voice changes appear. Also, with microbial disease, in many cases there is a white coating on the tonsils, and the lymph nodes do not increase.

A similar approach to determining the etiology of the disease may take place, but there are also cases of atypical progression of the disease: in such a situation, it is difficult to guess the affiliation of the pathogen.

Taking into account the above, we can only confirm that the only accurate method for determining the viral or bacterial origin of tonsillitis is laboratory diagnostics and bacterial culture.

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Indications Acyclovir for a sore throat

Acyclovir for viral tonsillitis promotes a faster cure for the disease, reduces the likelihood of the spread of the inflammatory process and the development of complications in the internal organs, and reduces sore throat in the acute stage of tonsillitis.

Acyclovir also exhibits an immunostimulating effect in herpetic sore throat (aimed at stimulating the body's protective response to the introduction of the virus).

In addition to viral tonsillitis, Acyclovir can be used for other herpes simplex virus infections, shingles, and to prevent viral diseases in patients with impaired immune function.

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Acyclovir for purulent tonsillitis

We have already said that tonsillitis can be viral or microbial. When speaking about purulent tonsillitis, they usually mean a disease of microbial origin, which is most often caused by streptococcus pyogenes, and somewhat less often by staphylococcus, hemophilic bacillus or neucheria. The listed microorganisms are exclusively bacterial flora, which Acyclovir does not have the slightest effect on. Treatment of purulent tonsillitis should be carried out only with antibacterial medications: therapy is prescribed in a course, after a preliminary analysis to identify the pathogen and determine its sensitivity to antibiotics.

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Release form

Today, there are several different forms of the drug Acyclovir on pharmacy shelves. These are tablets, eye ointment, ointment for external use, and lyophilisate for making a solution for subsequent intravenous administration:

• White tablets contain 0.2 g of active acyclovir per tablet.
• Acyclovir ointment 5% for external use, 5 or 10 g in an aluminum tube. Acyclovir throat ointment is used by lubricating the affected tonsils for 5-10 days.
• Acyclovir lyophilisate powder for the preparation of infusion solution (vials of 250 mg, 500 mg and 1000 mg).

Before choosing a specific form of medication, you need to assess the patient's condition. For example, if the treatment of angina is carried out on an outpatient basis, then it is allowed to use tablets and ointment.

If the disease is severe and has a high risk of complications, then treatment is carried out in a hospital, using injections of the drug.

The drug is produced by many pharmaceutical companies, so it can have double names that correspond to the manufacturer's brand. Thus, the most famous are: Acyclovir acriquine, Darnitsa, Stada, Astrapharm, Farmak, Vishfa, Belupo, ZhFF, Belmed, etc.

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Pharmacodynamics

Acyclovir is a synthetic purine nucleoside analog and has in vivo/in vitro inhibitory activity against human herpes viruses. These include herpes simplex virus type 1 and type 2, varicella-zoster virus, cytomegalovirus, and Epstein-Barr virus. Acyclovir has highly selective inhibitory activity against the above-mentioned infectious agents. The enzyme thymidine kinase in a healthy, uninfected cell does not consider acyclovir as a substrate, so the toxic effect on the body's cells is always minimal. However, thymidine kinase, which is encoded in viral cells, transforms acyclovir into acyclovir monophosphate. This substance is an analog of a nucleoside, which is subsequently converted stepwise into a diphosphate, and then into a triphosphate. The latter interacts with viral DNA polymerase immediately after the introduction of acyclovir into viral DNA. As a result of these processes, the synthesis of the viral DNA chain is blocked.

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Pharmacokinetics

Absorption of Acyclovir in the intestinal cavity is only partial.

In adult patients, the final half-life of intravascular administration of the drug can be 2.9 hours. Most of the administered Acyclovir leaves the body unchanged through the kidneys. Renal clearance rates significantly exceed creatinine clearance rates: this indicates that the drug is excreted by the kidneys not only through glomerulofiltration, but also due to tubular secretion.

A significant metabolite of Acyclovir is considered to be 9-carboxymethoxymethylguanine, the share of which is 10-15% of the total amount of the drug found in urine. If Acyclovir is taken 60 minutes after taking one gram of probenecid, the final half-life and the area under the concentration/time curve increase by 18% and 40%, respectively.

If the patient suffers from chronic renal failure, the average half-life may be 19½ hours. The average half-life of the drug during hemodialysis is 5.7 hours. The content of Acyclovir in the blood serum during hemodialysis decreases by 60%.

The drug content in the cerebrospinal fluid may be about 50% of the corresponding content in the blood serum. The degree of binding to plasma albumins is relatively small (9-33%).

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Dosing and administration

Acyclovir in tablet form is taken to treat viral tonsillitis immediately after meals, with water. The dosage is coordinated by the attending physician. The standard treatment regimen is as follows: adult patients take 200-400 mg of the drug every four hours, five times a day (the drug is not taken at night). The duration of treatment is 7 days.

Patients with impaired renal function should adjust the dose and regimen, monitoring the creatinine clearance value and taking into account the type of viral infection. If the pathogen is Herpes simplex, and creatinine clearance is less than 10 ml/minute, then the daily amount of the drug should be reduced to 400 mg (in two doses with an interval of 12 hours).

Acyclovir ointment for the throat is used up to 6 times a day, at equal time intervals, lubricating the affected tonsils. It is very important to begin treating the tonsils at the earliest stages of the onset of tonsillitis. Treatment is continued until the blisters heal (from five to ten days).

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Acyclovir for sore throat in children

Viral sore throat in young children can cause the development of such a dangerous condition as false croup. The condition is accompanied by swelling of the larynx, narrowing of its lumen, and suffocation. To prevent complications, it is recommended to start treatment as early as possible - in particular, use Acyclovir.

For children under one year of age, antiviral treatment is carried out using rectal suppositories (suppositories such as Viferon or Genferon Light are suitable).

Throat treatment can be practiced starting from the age of 4.

Pediatricians prescribe Acyclovir tablets for sore throat in the following dosages:

• for a child from 1 to 2 years old – 100 mg (half a tablet) every 4 hours for five days;
• children from 2 to 5 years old – 200 mg 4 times a day;
• children over six years old – 200-400 mg 4 times a day.

The duration of treatment is determined by the doctor, assessing the dynamics of the baby’s recovery.

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Use Acyclovir for a sore throat during pregnancy

Until now, no negative impact of Acyclovir on the course of pregnancy and the development of the future baby has been found. But doctors still advise to be careful with the drug and take it only in case of extreme necessity, and only under the supervision of a doctor.

Acyclovir for sore throat is prescribed to expectant mothers if the possible harm from the drug is minimal compared to the danger posed by the viral infection.

According to pharmacists, after oral administration of 200 mg of Acyclovir five times a day, the active ingredient of the drug enters breast milk. Its concentration is from 0.6 to 4.1%, based on the corresponding content of the drug in the blood serum.

It is believed that an infant can absorb the drug in an amount of no more than 0.3 mg per kg of weight per day. Based on this, before prescribing Acyclovir for sore throat to a nursing mother, it is necessary to carefully assess the possible risks and benefits.

Contraindications

Acyclovir should not be used for treatment of angina if the patient has a high sensitivity to similar antiviral drugs, including Valaciclovir, Gancicloair, etc.

It is highly undesirable to take Acyclovir during breastfeeding, as well as in children under 3 years of age.

Particular caution should be exercised if the drug is to be taken during pregnancy, in old age, and in cases where the patient is dehydrated, or suffers from renal failure, neurological disorders, or exhibits a neurological reaction to treatment with cytotoxic drugs.

In case of sore throat of bacterial origin, it is unreasonable and inappropriate to take Acyclovir.

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Side effects Acyclovir for a sore throat

The occurrence of side effects is not a common occurrence when treating sore throat with Acyclovir. However, sometimes they can occur in the form of one or more signs:

• anemia, leukopenia, thrombocytopenia;
• allergic reaction;
• headaches, dizziness, irritability, hand tremors, convulsions, drowsiness;
• dyspnea;
• nausea, vomiting, diarrhea, abdominal pain;
• jaundice;
• itching, rash, photosensitivity;
• lower back pain;
• increased fatigue.

The listed symptoms are transient and disappear completely after the end of treatment with Acyclovir. In addition, their occurrence is more often associated with the presence of renal failure or other background diseases in the patient.

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Overdose

The antiviral drug Acyclovir is not completely absorbed in the digestive system. There are known cases where patients did not experience any toxic effects after accidentally taking up to 20 g of the drug. But after a repeated accidental overdose, patients experienced the following symptoms over several days:

• from the digestive tract - nausea with vomiting;
• from the central nervous system – headaches, impaired consciousness.

In case of intravascular overdose, the content of creatinine in plasma and urea nitrogen increases: renal insufficiency develops. From the nervous system, disturbances of consciousness, agitation, convulsions, and a comatose state are observed.

Treatment is carried out in a hospital, after assessing the severity of intoxication. It is recommended to perform gastric lavage as soon as possible, use symptomatic drugs. Acyclovir is well eliminated, so hemodialysis can and should be used in case of confirmed overdose.

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Interactions with other drugs

Acyclovir can be taken for sore throat without any concerns: no clinically significant interactions with other medications have been found.

The active ingredient is excreted predominantly unchanged via the kidneys, so it is possible that any medicinal products with the same excretion pattern may affect the serum concentrations of acyclovir.

In combination with immunosuppressive drugs, the serum acyclovir content may also increase. However, no adjustments to the dosage and treatment regimen for sore throat with Acyclovir are required.

Storage conditions

Acyclovir can be stored in normal room conditions with an average temperature of about +25°C, away from sunlight and heating devices. The storage area should not be accessible to children.

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Shelf life

Store the sealed, undamaged medicinal product Acyclovir for three years, counting from the date of manufacture.

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Analogues

Complete analogues of Acyclovir, which can also be used to treat viral sore throat, are:

• Provirsan;
• Meadovir;
• Herpetad;
• Zovirax;
• Herpevir;
• Geviran;
• Acivir;
• Biociclovir;
• Acigerpin;
• Virolex;
• Acik.

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Derinat for herpetic sore throat

While treating angina with Acyclovir, you can also use other auxiliary medications, such as Derinat. This drug is based on the action of sodium deoxyribonucleate and is an effective immunomodulator that stimulates the reaction of cellular and humoral immunity. It enhances the effectiveness of Acyclovir by activating the immune defense response to the introduction of a viral infection.

For sore throat, Derinat is used in the form of nasal drops, 2-3 drops, or 2 sprays in each nostril once every 1-1.5 hours during the first day. Then the frequency is reduced to 3-4 times a day. Duration of treatment is up to one month.

The drug can be used at any age, starting from the neonatal period.

Lugol's solution for herpetic sore throat

Lugol's solution is an antiseptic solution based on iodine and potassium iodide, used to treat tonsils in cases of bacterial sore throat. Herpetic sore throat is not a direct indication for the use of the drug, so combining the solution with Acyclovir is not always advisable. However, this drug can be used to prevent the development of secondary infections and complications of bacterial etiology.

Lugol's solution has a bactericidal property, destroying gram-positive and gram-negative microbes (streptococcus, staphylococcus, E. coli, Proteus vulgaris, Klebsiella). The product does not affect viral infections.

Reviews

The vast majority of reviews indicate the good effectiveness of Acyclovir for sore throat caused by a virus. The main point is the timely start of treatment at the first signs of the inflammatory process. This approach will help avoid complications, quickly reduce the manifestation of unpleasant symptoms, and shorten the overall period of the disease.

Many doctors recommend taking other medications in addition to taking Acyclovir to achieve a comprehensive effect on the problem:

• non-steroidal anti-inflammatory drugs, which will speed up the relief of the inflammatory process and relieve pain (Ibuprofen, Nimesil);
• mucolytic agents to eliminate irritation of mucous tissues;
• antihistamines to relieve swelling in the throat.

During the entire period of therapy, you need to stay in bed, drink warm vitamin-rich drinks - for example, tea with lemon, rosehip infusion. You should not warm up your throat with compresses: with a viral disease, this can only worsen the situation.

If you treat the problem in a comprehensive manner, you will soon be able to forget about the disease. The additional drugs listed above will help to smooth out the basic manifestations of the disease, and Acyclovir for sore throat will be able to destroy the causative virus directly.