| [Member (365WT)]answers [Chinese ] | Time :2018-10-09 | Oral dosage
1 genital herpes initial treatment and immunodeficiency skin mucosa, herpes simplex oral 200mg, one day
Acyclovir acyclovir
5 times, a total of 10 days; or oral 400mg, 3 times a day for 5 days; recurrent infection and chronic inhibition therapy, oral 200mg every 8 hours, a total of 6 months, if necessary, the dose can be added to 5 times a day, 200mg each time, a total of 6 months.
3 renal dysfunction, creatinine clearance rate is less than 10ml / min, 150mg every 24 hours; creatinine clearance rate of 10-15ml / min, every 12-24 hours 300mg; creatinine clearance rate ＞ 50ml / min every 8 hours 300mg. Pediatric doses have not been established.
Intravenous drip dosage
1 severe genital herpes initial treatment, according to the weight of 5mg / kg every 8 hours, a total of 5 days. 2 Immunodeficiency skin herpes simplex or severe herpes zoster, 5mg/kg every 8 hours, intravenous infusion for more than 1 hour, a total of 7-10 days.
3 herpes simplex encephalitis, 10mg/kg every 8 hours, a total of 10 days.
4 adult acute or chronic renal insufficiency should not use this product intravenously, because the drip rate is too fast can cause renal failure.
5 The maximum daily dose for adults is 30mg/kg by weight, or 1.5g/m2 by body area.
Children:
1 severe genital herpes initial treatment, infants and children under 12 years old, body surface area of 250mg / square meter every 8 hours, a total of 5 days.
2 immunodeficiency skin and mucous membrane herpes simplex, infants and children under the age of 12, body surface area of 250mg / square meter every 8 hours, a total of 7 days, 12 years of age or older by adult.
3 herpes simplex encephalitis, body weight 10mg / kg every 8 hours, a total of 10 days.
The highest dose for 4 children is 500 mg/m 2 of body surface area per 8 hours.
Partial external use
The body surface area is 1.25 cm long with a grease of 25 cm 2 . Topical medication, adults and children are once every 3 hours, 6 times a day for a total of 7 days.
(1) Once herpes symptoms and signs appear, it should be administered as soon as possible.
(2) Oral capsules can be eaten at the same time, and have no significant effect on absorption. Genital recurrent herpes infections are effective with intermittent short-course therapy. Since animal experiments have found effects on fertility and mutagenicity, oral doses and treatments should not exceed recommended standards. Long-term therapy for genital recurrent herpes should also not exceed 6 months.
(3) intravenous administration:
1 acyclovir sodium for intravenous infusion, the drug solution is instilled at least evenly within 1 hour, to avoid rapid instillation or intravenous bolus injection, because such drug administration occurs in the renal tubular drug crystal deposition, causing renal damage Up to 10%;
2 2 hours after intravenous infusion, the concentration of urine is the highest. At this time, sufficient water should be given to the patient to prevent the drug from depositing in the renal tubule;
3 Hemodialysis can reduce the blood concentration by 60%, so the dose should be repeated once every 6 hours of hemodialysis;
4 dosing method: first add 1ml of water for injection to dissolve, then add appropriate amount of solution (such as glucose injection), so that the concentration is not higher than 7mg / ml, if the concentration is too high (10mg / ml) can cause phlebitis, spillover Inflammation occurs at the injection site. Newborns should not prepare intravenous drip with benzyl alcohol-containing diluents, otherwise it may cause fatal syndrome, including acidosis, central inhibition, dyspnea, renal failure, hypotension, epilepsy and intracranial hemorrhage.
(4) Ointment is only used on the skin and cannot be used on the eyes. Wear finger cots or gloves when applying.
(5) Carcinogenicity and mutagenicity: In vitro cell transformation assay has a tumor-causing report, but the end point of animal experiments is carcinogenic. Some animal experiments have shown that high concentrations of drugs can cause mutations, but there is no basis for chromosomal changes. The carcinogenicity and mutagenicity of this product is not yet clear.
(6) Fertility and pregnant women: Large doses of oral administration can reduce the number of sperm in animals. However, the human daily oral administration of 400 mg and 1000 mg for 6 consecutive months has not seen a similar situation. The drug can pass through the placenta, and animal experiments have confirmed no effect on the embryo.
(7) Lotion: The concentration of the drug in the milk is 0.6-4.1 times the blood concentration, but no abnormality in the baby is found.
(8) Follow-up examination: Because most patients with genital herpes are likely to cause cervical cancer, patients should be examined at least once a year for early detection. Intravenous medication may cause nephrotoxicity. Renal function should be checked before or during medication. After eye drops Occasionally mild stimulation, but can adapt quickly. The product is poorly water-soluble, easy to precipitate crystals in cold climate, need to dissolve when used. Intravenous injection requires a large amount of glucose and sodium chloride injection to dilute, pH is alkaline, intravenous drip should be slow Do not let it leak out of the blood vessels, so as not to cause pain and phlebitis. Because the sodium salt of this product is alkaline, it should not be used in combination with other drugs. This product is easy to cause herpes virus resistance, when serious cases are found to be resistant. Need to change other drugs.Drink more water during medication; creatinine clearance rate of renal insufficiency ＞0.835ml/1.73 square meters·second, 5mg/kg, once every 8h; creatinine clearance rate 0.167~0835ml/1.73 square meters·second, 5mg/kg, Every 12~24h; creatinine clearance rate ＜0.167ml/1.73 square meters·second, the dose is reduced to 2.5mg/kg, once every 24h; after hemodialysis should be supplemented once. Eye, moderate, daily 5 Second, apply antibacterial drugs at the same time..
Eye drops: 1~2 drops each time, 3~5 times a day, and then used for 3 days. A total of 5 days. |
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