What is the maximum dose of acyclovir for a 34kg individual?

Maximum Dose of Acyclovir for a 34kg Individual

For a 34kg individual, the maximum dose of acyclovir is 800mg per dose given 4 times daily for oral administration, which is based on the recommended dosage of 20mg/kg body weight (maximum 800mg/dose) per dose. 1, 2

Dosing Recommendations Based on Weight

• For a child weighing 34kg, the weight-based dosing calculation would be:

  • 20mg/kg × 34kg = 680mg per dose 1
  • Since this is below the maximum single dose of 800mg, 680mg per dose would be appropriate 2

• For treatment of chickenpox:

  • Oral acyclovir: 20mg/kg (680mg) 4 times daily for 5-7 days (not to exceed 800mg per dose) 2
  • This falls in the weight category of >23-40kg, which typically receives 60mg/kg twice daily for influenza antivirals, but acyclovir follows different dosing guidelines 3

Indication-Specific Dosing

• For herpes zoster (shingles):

  • 800mg every 4 hours, 5 times daily for 7-10 days 2

• For herpes simplex virus infections:

  • Mild symptomatic gingivostomatitis: 20mg/kg (maximum 400mg/dose) orally 3 times daily for 5-10 days 3
  • Genital herpes in children <45kg: 20mg/kg (maximum 400mg/dose) orally 3 times daily for 5-14 days 3

• For varicella (chickenpox):

  • Children (2 years and older): 20mg/kg per dose orally 4 times daily for 5 days 2
  • The Centers for Disease Control and Prevention recommends 20mg/kg (maximum 800mg/dose) 4 times daily for 7-10 days or until no new lesions for 48 hours 1

Route of Administration Considerations

• For oral administration:

  • Maximum dose: 800mg per dose 2
  • Frequency: 4-5 times daily depending on indication 2

• For intravenous administration (if needed for severe infections):

  • For CNS or disseminated disease: 10mg/kg body weight IV 3 times daily 3
  • For immunocompromised patients: Some experts base IV dosing on body surface area (500mg/m²/dose IV every 8 hours) for children >1 year 1

Special Considerations

• Renal function should be considered when dosing acyclovir, as the drug is primarily eliminated by the kidneys 2, 4

• For patients with renal impairment, dose adjustment is necessary:

  • Normal renal function: standard dosing as above
  • Creatinine clearance >25 mL/min: 800mg every 4 hours, 5 times daily
  • Creatinine clearance 10-25 mL/min: 800mg every 8 hours
  • Creatinine clearance <10 mL/min: 800mg every 12 hours 2

• Treatment should be initiated at the earliest sign or symptom of infection for maximum efficacy 2

• For chickenpox specifically, there is no information about efficacy of therapy initiated more than 24 hours after onset of signs and symptoms 2

Remember that these dosing recommendations are based on established guidelines and the FDA-approved drug labeling, prioritizing patient safety while ensuring therapeutic efficacy.