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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Acyclovir is an antiviral for herpes simplex and varicella-zoster viruses that compounding pharmacies prepare as topical creams, oral suspensions, capsules and other forms by prescription.
Acyclovir is a synthetic purine nucleoside analogue antiviral. In cells infected with herpes simplex or varicella-zoster virus, a viral enzyme (thymidine kinase) activates it, and the activated form blocks the virus's DNA polymerase and ends the growing DNA chain, so the virus cannot copy itself; uninfected cells activate very little of it. Manufactured products include generic acyclovir tablets, capsules and oral suspension, Zovirax cream and ointment, Sitavig buccal tablets, and acyclovir injection. The oral products are FDA-approved for herpes zoster (shingles), initial and recurrent genital herpes, and chickenpox; Zovirax ointment for initial genital herpes and limited mucocutaneous HSV in immunocompromised patients. A prescriber may order acyclovir compounded when a patient needs a different topical strength or base, a combination with another ingredient, or a flavored or sugar-free oral liquid. Compounded acyclovir preparations are not FDA-approved and require a prescription.
Acyclovir carries no boxed warning. The oral label warns that kidney failure, sometimes fatal, has occurred, especially with dehydration, kidney disease or other kidney-toxic drugs, so adequate hydration matters; thrombotic thrombocytopenic purpura/hemolytic uremic syndrome has occurred in immunocompromised patients; and severe skin reactions have been reported, so a painful rash with mouth sores means stop and get help. It is contraindicated with a significant allergy to acyclovir or valacyclovir. Probenecid raises acyclovir levels. Older adults and people with reduced kidney function are more prone to confusion and hallucinations. The ointment must not be used in the eye. There are no adequate pregnancy studies; a registry found birth defect rates similar to the general population, and the label advises use only if the benefit justifies the risk. Milk levels are far below an infant dose, and acyclovir is considered a treatment of choice for herpes during breastfeeding. Common side effects are nausea, vomiting, diarrhea and malaise. Acyclovir does not clear the virus from the body or fully prevent spreading it. For decreased urination, confusion or blistering skin, talk to your prescriber or pharmacist.
Acyclovir is phosphorylated by viral thymidine kinase to the monophosphate, then by cellular kinases to acyclovir triphosphate, which competitively inhibits viral DNA polymerase and causes chain termination; selectivity arises from preferential activation in infected cells. Oral bioavailability is 10 to 20 percent and decreases with increasing dose; protein binding is 9 to 33 percent; plasma half-life is 2.5 to 3.3 hours with normal renal function and can extend up to tenfold in renal impairment. Elimination is largely unchanged by glomerular filtration and tubular secretion, so dose adjustment follows creatinine clearance. Systemic absorption after topical ointment is minimal. Labeled indications: acute herpes zoster, initial and recurrent genital herpes, and varicella (oral acyclovir); initial genital herpes and limited non-life-threatening mucocutaneous HSV in immunocompromised patients (Zovirax ointment); HSV encephalitis, neonatal HSV, mucocutaneous HSV in immunocompromised patients, severe initial genital herpes and zoster in immunocompromised patients (acyclovir injection). Prescribers have ordered compounded acyclovir for mucocutaneous HSV, HSV keratitis and prophylaxis in transplant recipients, uses StatPearls describes beyond the oral label; recurrent herpes labialis is the labeled indication of Sitavig buccal tablets. Dosing is per prescriber. Monitor renal function, hydration status and neurologic changes, particularly in older adults, obese patients and those receiving vancomycin or other nephrotoxins. Acyclovir is not a controlled substance.
Wash your hands. Apply the amount on your label to clean, dry skin and rub it in gently. For a metered pump, each press delivers a set amount; your label states how many presses. For transdermal creams, apply to the area your label names and let it dry before dressing. Wash your hands afterward and avoid skin-to-skin contact with others at the application site until it has absorbed. Do not apply to broken skin unless told to.
Creams are aqueous. Under USP <795>, a preserved cream usually carries a beyond-use date of up to 35 days at room temperature or refrigerated, and an unpreserved one 14 days refrigerated. Follow the storage line on your label, keep from freezing, keep out of reach of children, and discard after the beyond-use date.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Apply topically to affected area(s)
