Gerpevir

Gerpevir has immunostimulating activity. Contains the component acyclovir, which is an analogue of the DNA element deoxyguanidine (purine nucleoside). The greatest efficiency is demonstrated with respect to herpes zoster viruses and herpes simplex.

In the case of herpes, acyclovir prevents the formation of new elements of the rash, reduces the risk of epidermal dissemination and visceral complications, increases the rate of crusts and reduces pain during the active stage of herpes zoster. Also demonstrates activity in relation to CMV and EBV. [1]

Indications Gerpevir

It is used for such problems:

• infection of the epidermis and mucous membranes associated with the activity of the herpes simplex virus ( types 1 and 2) - for example, the primary or recurrent form of genital herpes;
• preventing the development of the above diseases in people with impaired immunity;
• in persons with healthy immunity with herpes zoster;
• chickenpox .

Release form

The release is sold in the form of tablets with a volume of 400 mg, 10 pieces inside a cell package (inside a box - 1 package). Also produced in tablets with a volume of 200 mg - 10 pieces inside a contour pack, 2 packs inside a package.

Pharmacodynamics

Due to the structural similarity of acyclovir to deoxyguanidine, the former gets the opportunity to interact with the enzymes of the virus, which interrupts its reproduction. [2]

Once inside a herpes-infected cell, acyclovir, under the influence of viral MC, is transformed into acyclovir monophosphate. Cellular enzymes of the body convert it first into acyclovir-2-phosphate, and then into acyclovir-3-phosphate, which has activity, selectively blocking the binding of virus DNA. This component has almost no effect on the processes of cellular DNA replication. [3]

Pharmacokinetics

When administered orally, the drug is partially absorbed (approximately 20%). Consumption with food hardly alters absorption. It is rather poorly synthesized with plasma protein (by 9-33%).

Gerpevir passes well into fluids with tissues, overcomes the placenta and the BBB, and is excreted in breast milk. The Cmax values are noted after 1.5-2 hours.

The half-life after oral administration is approximately 3 hours; in case of failure of kidney function, it is extended to 19.5 hours.

Excretion is mainly realized through the kidneys, in an unchanged state; part is excreted in the form of the metabolic component 9-carboxymethoxymethylguanine.

Dosing and administration

Gerpevir must be administered orally. Therapy should be started when the first symptoms of the disease develop. During the period of treatment, you need to consume large amounts of liquid.

For children from 3 years of age and adults, for the treatment of primary infections associated with common herpes of types 1-2, a daily dosage of 1 g is prescribed, which is used for 5 uses. The therapeutic cycle lasts 5 days.

For lesions caused by herpes zoster, the size of the daily portion is: children 3-6 years old - 1600 mg; persons over 6 years of age - 3200 mg. Divide the dosage into 4 doses. The treatment cycle should last at least 5 days.

For persons with immunodeficiency (also after transplantation of bone marrow or organs, or in the case of intestinal absorption disorders), 0.4 g of the drug is used 5 times a day; the treatment cycle lasts at least 5 days, if necessary, it can be extended up to 10 days.

For adults with healthy immunity, to prevent the development of infection associated with the herpes simplex virus type 1-2, the daily dosage is 0.8 g (0.2 g 4 times a day with a 6-hour interval or 0.4 d 2 times a day with a 12-hour interval). Sometimes the daily portion can be reduced to 0.6 g (in 2-3 uses). People with severe immunodeficiency take 0.4 g of the medication 4 times a day. The duration of the preventive treatment cycle is selected individually.

Adults with healthy immunity with lesions caused by herpes zoster are prescribed 4000 mg of the drug per day (0.8 g 5 times per day). The cycle of therapy lasts 1 week.

Elderly people or with disorders of secretory renal activity need to reduce the dosage of drugs, taking into account the CC indicators:

• for infections associated with Herpes simplex, with a CC level below 10 ml / minute, the daily portion is 0.4 g in 2 doses with a minimum of 12-hour break;
• in case of lesions caused by the herpes zoster, as well as in the maintenance treatment of persons with significantly weakened immunity (CC level - within 10-25 ml / minute), 2400 mg of the substance is used per day in 3 doses, with an 8-hour interval;
• people with a CC level of less than 10 ml / minute need to reduce the daily dosage to 1600 mg in 2 applications, with a 12-hour break.

Application for children

It is forbidden to use the medication in tablet form of release in persons under 3 years of age.

Use Gerpevir during pregnancy

Prescribing a medicine during pregnancy is possible only with strict indications. For the period of therapy, you need to stop breastfeeding.

Contraindications

The main contraindications:

• severe intolerance to valacyclovir, acyclovir or other elements of the drug;
• dehydration;
• severe forms of renal dysfunction.

Side effects Gerpevir

Among the side symptoms:

• disorders of the gastrointestinal tract: vomiting, colic in the intestines, diarrhea and nausea;
• allergy manifestations: itching, fever, epidermal rash and swelling;
• disorders of the NS function: fatigue, cephalalgia and dizziness;
• changes in these analyzes: an increase in urea, liver transaminases, bilirubin and creatinine;
• others: worsening of hematological reactions; anorexia is occasionally observed; alopecia develops singly.

Overdose

Manifestations of intoxication: nausea, dyspnea, cephalalgia and diarrhea, convulsions, vomiting, kidney failure, coma and lethargy.

Procedures are performed that support the work of organs important for life; hemodialysis is performed.

Interactions with other drugs

Combined use with probenecid leads to a decrease in the rate of excretion of the drug.

The combination of Gerpevir and nephrotoxic drugs potentiates their nephrotoxic activity, especially in renal dysfunctions.

Storage conditions

Gerpevir should be stored in a place protected from the penetration of small children, sunlight and moisture. Temperature values are within 8-15 ° С.

Shelf life

Gerpevir can be used for a 36-month term from the date of manufacture of the drug substance.

Analogs

The analogs of the drug are the drugs Geviran and Acyclovir.