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acyclovir

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Brand names: Zovirax

Antiviral (Nucleoside Analog) Rx

Acyclovir is an antiviral medicine. It is used to treat infections caused by certain viruses.

Drug Pricing (NADAC)

Brand Price

$38.30/unit

Generic Price

$0.08/unit

Generic Savings

100%

Generic Available

Yes (43 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Acyclovir is used to treat shingles, which is caused by herpes zoster.

Common side effects

Malaise (feeling unwell), Nausea, Diarrhea

Key warnings

Acyclovir can cause nervous system problems, especially in older adults or people with kidney problems.

How It Works

Acyclovir stops the virus from growing and spreading. It does this by interfering with the virus's ability to make copies of itself. This helps your body fight off the infection.

How to Take It

Take acyclovir exactly as your doctor tells you to. For shingles, the usual dose is 800 mg every 4 hours, 5 times a day for 7 to 10 days. For genital herpes, the dose is usually 200 mg every 4 hours, 5 times a day for 10 days. You can take acyclovir with or without food.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. It is not known if acyclovir will harm an unborn baby. Talk to your doctor about the risks and benefits of taking acyclovir while breastfeeding.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store acyclovir capsules at room temperature (68° to 77°F) and keep them away from moisture.

Side Effects (from patient reports)

Based on 52,712 FDA adverse event reports.

Tiredness
7,612
Diarrhea
7,064
Using the medicine for something it's not approved for
5,797
Lung infection
5,474
Feeling sick to your stomach
5,330
Fever
4,719
Death
4,677
The medicine is not working
4,465
Skin rash
4,121
Difficulty breathing
3,453

FDA Adverse Event Report Analysis

Detailed analysis of 109,698 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.

Total Reports

109,698

Death-Related Reports

13,944

Hospitalization Reports

40,651

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 51,333 (50%)
Male 51,021 (50%)

Age Distribution

0–17 3,654
18–44 8,105
45–64 23,378
65–74 21,074
75+ 15,057

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 FATIGUE 7,612
2 DIARRHOEA 7,064
3 OFF LABEL USE 5,797
4 PNEUMONIA 5,471
5 NAUSEA 5,328
6 PYREXIA 4,719
7 DEATH 4,676
8 DRUG INEFFECTIVE 4,464
9 RASH 4,121
10 DYSPNOEA 3,452
11 ASTHENIA 3,193
12 WHITE BLOOD CELL COUNT DECREASED 3,088
13 HEADACHE 3,080
14 NEUTROPENIA 3,074
15 PLATELET COUNT DECREASED 2,964

Reactions in Death Reports

DEATH 4,656
PNEUMONIA 1,070
SEPSIS 977
OFF LABEL USE 916
DRUG INEFFECTIVE 843
PLASMA CELL MYELOMA 784
PYREXIA 728
RESPIRATORY FAILURE 677
SEPTIC SHOCK 657
MULTIPLE ORGAN DYSFUNCTION SYNDROME 536

Reactions in Hospitalization Reports

PNEUMONIA 4,416
PYREXIA 3,261
DIARRHOEA 2,437
FEBRILE NEUTROPENIA 2,197
NAUSEA 2,046
FATIGUE 2,021
OFF LABEL USE 1,955
DYSPNOEA 1,846
ACUTE KIDNEY INJURY 1,618
ASTHENIA 1,564

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Acyclovir can cause nervous system problems, especially in older adults or people with kidney problems. Tell your doctor if you have kidney problems before taking this medicine.

Known Drug Interactions

Some examples of drugs that are eliminated by active tubular secretion include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] .

Mechanism: These medications leave the body through the same kidney filters, which could lead to a buildup of the drugs in your system.

What to do: Your healthcare provider may need to check your kidney health more often while you use this combination.

Drug Interactions Probenecid Probenecid is known to interact with the metabolism or renal tubular excretion of many drugs (e.g., acetaminophen, acyclovir, angiotensin-converting enzyme inhibitors, aminosalicylic acid, barbiturates, benzodiazepines, bumetanide, clofibrate, methotrexate, famotidine, furosemide, nonsteroidal anti-inflammatory agents, theophylline, and zidovudine).

Mechanism: Probenecid is given with cidofovir and can slow down the removal of acyclovir through the kidneys. This can lead to an increase in the amount of acyclovir in your blood.

What to do: Your doctor may need to adjust your acyclovir dosage. Watch for any increased side effects while taking both medications.

Some examples include, but are not limited to, acyclovir, adefovir dipivoxil, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.3) ] .

Mechanism: These medicines are cleared from the body using the same pathway in the kidneys, which can lead to higher levels of the drugs in your system.

What to do: Your doctor should check your kidney health regularly to ensure the medications are being cleared safely from your body.

Acyclovir Clinical Impact: The concomitant use of acyclovir may increase the plasma concentrations of meperidine and its metabolite, normeperidine. Intervention: If concomitant use of acyclovir and Meperidine Hydrochloride Tablets or Oral Solution is necessary, evaluate patients for respiratory depression and sedation at frequent intervals.

Mechanism: Acyclovir can cause meperidine and its breakdown products to build up in your blood. This makes the drug's effects stronger and more likely to cause side effects.

What to do: Your doctor should check you often for slowed breathing and extreme sleepiness.

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions ( 5.2)].

Mechanism: These two drugs are both filtered out of the body by the kidneys, which can increase the risk of kidney strain when used at the same time.

What to do: Your healthcare provider should monitor your kidney health to make sure the drugs are not causing harm.

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Common Questions

Can I drive while taking acyclovir?
Acyclovir can cause dizziness or confusion in some people. If you experience these side effects, do not drive or operate machinery.
How long does it take for acyclovir to work?
Acyclovir starts working as soon as you take it, but it may take a few days for you to notice an improvement in your symptoms.
Can I drink alcohol while taking acyclovir?
It is best to avoid alcohol while taking acyclovir, as it can worsen some of the side effects.
What should I do if I have side effects?
If you experience any side effects, talk to your doctor or pharmacist.
Can I get a refill of acyclovir if I have some left over?
You will need a new prescription from your doctor for a refill of acyclovir.
Is acyclovir safe for children?
Yes, acyclovir is safe for children. The dose depends on the child's weight and the condition being treated.
Can acyclovir cure herpes?
Acyclovir cannot cure herpes, but it can help to control the symptoms and prevent outbreaks.
Does acyclovir interact with other medications?
Acyclovir can interact with some other medications. Tell your doctor about all the medicines you take.
What does acyclovir look like?
Acyclovir capsules are light blue and have "200" printed on them.
What if I can't swallow pills?
Acyclovir also comes as a liquid suspension. Ask your doctor if that is right for you.
What are the common side effects of acyclovir?
The most commonly reported side effects of acyclovir include Malaise (feeling unwell), Nausea, Diarrhea. Based on 52,712 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does acyclovir interact with other medications?
Yes, acyclovir has 7 known drug interactions. Notable interactions include bictegravir/emtricitabine/tenofovir, cidofovir, emtricitabine/tenofovir. Always inform your doctor about all medications you are taking.
What drug class is acyclovir?
acyclovir belongs to the Antiviral (Nucleoside Analog) drug class. It requires a prescription (Rx). Acyclovir is used to treat shingles, which is caused by herpes zoster.
Is there a generic version of acyclovir?
Yes, generic acyclovir is available from 43 manufacturers. The generic costs $0.08 per unit compared to $38.30 for the brand version, saving approximately 100%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is acyclovir safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if acyclovir will harm an unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has acyclovir been recalled?
There is 1 recall associated with acyclovir products. Presence of Particulate Matter: Customer complaint of dark particles found inside the vial. Check the recalls section below for full details and affected products.

Active Recalls

Class II December 28, 2022

Presence of Particulate Matter: Customer complaint of dark particles found inside the vial

Eugia US LLC

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What the FDA Data Shows for acyclovir

The FDA label for acyclovir (sold under brand names such as Zovirax) classifies it as a prescription-only medication in the Antiviral (Nucleoside Analog) class. Acyclovir is used to treat shingles, which is caused by herpes zoster. Official labeling lists 3 commonly reported side effects, including Malaise (feeling unwell), Nausea, Diarrhea.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 52,712 voluntary reports. The database also lists 7 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.08 versus $38.30 for the brand — a 100% generic savings.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 1 recall record on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: September 5, 2024

All federal data sources used on this page