What prophylaxis is recommended to prevent crystalline nephropathy caused by Acyclovir?

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Last updated: February 19, 2025View editorial policy

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From the Guidelines

To prevent crystalline nephropathy from acyclovir, it is recommended to ensure adequate hydration by administering intravenous fluids, such as 0.9% sodium chloride, at a rate of 1 mL/kg/h for at least 2 hours before and after acyclovir administration 1.

Key Recommendations

  • The dose of acyclovir should not exceed 20 mg/kg per dose, and the infusion rate should not exceed 10 mg/kg/h 1.
  • For patients with pre-existing renal impairment, the dose of acyclovir should be adjusted according to creatinine clearance 1.
  • Monitoring of urine output, serum creatinine, and acyclovir trough levels is also recommended to minimize the risk of nephropathy 1.

Additional Considerations

  • Patients with pre-existing renal impairment are at higher risk of developing crystalline nephropathy, and therefore require closer monitoring and dose adjustment 1.
  • The use of lipid-associated formulations of amphotericin B may be considered in patients who develop nephrotoxicity with conventional amphotericin B 1.
  • Cidofovir should be used with caution in patients with pre-existing renal impairment, and the dose should be adjusted according to creatinine clearance 1.

From the FDA Drug Label

Administration of acyclovir by intravenous infusion must be accompanied by adequate hydration. To prevent crystalline nephropathy caused by Acyclovir, adequate hydration is recommended when administering the drug by intravenous infusion 2.

From the Research

Prophylaxis for Crystalline Nephropathy Caused by Acyclovir

To prevent crystalline nephropathy caused by Acyclovir, the following prophylaxis is recommended:

  • Adequate hydration of the patient 3, 4, 5, 6, 7
  • Slow intravenous infusion of Acyclovir over one hour 3
  • Adjustment of dosage in patients with preexisting impaired renal function 3
  • Ensuring hydration, frequent evaluations of renal function, and corresponding dose adjustment of intravenous Acyclovir treatment 6
  • Administering Acyclovir in a sufficient volume of fluid, with a median volume of 250 mL or more 4
  • Hydration volume of more than 2 L/day 5

Key Considerations

  • Hypertension is a predictive factor associated with nephrotoxicity 6
  • The absence of co-morbidities is protective against nephrotoxicity 6
  • Nephrotoxicity is reversible following rehydration and dose reduction or discontinuation of the drug 6
  • Crystalluria and obstructive nephropathy are mechanisms of Acyclovir-induced renal failure in humans 7

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Renal function after acyclovir intravenous injection.

The American journal of medicine, 1982

Research

Incidence and predictors of intravenous acyclovir-induced nephrotoxicity.

European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2018

Research

Acyclovir-induced renal failure. Clinical course and histology.

The American journal of medicine, 1988

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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