Zoviduo is the brand name of Zoviduo, a synthetic purine nucleoside with inhibitory activity against herpes simplex virus(HSV-1 & HSV-2) and varicella-zoster virus (VZV). The activity of Zoviduo is highly selective due to its affinity for the enzyme thymidine kinase encoded by HSV and VZV. This viral enzyme converts Zoviduo into Zoviduo monophosphate, a nucleotide analogue. The monophosphate is further converted into diphosphate and finally triphosphate by a number of cellular enzymes. In vitro, Zoviduo triphosphate stops replication of herpes viral DNA. This is accomplished in 3 ways: 1) Competitive inhibition of viral DNA polymerase, 2) Incorporation into and termination of the growing viral DNA chain and 3) Inactivation of the viral DNA polymerase.
• Herpes Zoster
• Genital Herpes
• Herpes Simplex Infections
• Herpes Simplex Encephalitis
The total daily dosage of Zoviduo should be based on the type or severity of infection and given in equally divided doses based on consideration of degree of susceptibility of the pathogens, renal function and body-weight.
• Acute Herpes Zoster:
800 mg every 4 hours, 5 times daily for 7 to 10 days.
• Genital Herpes:
Initial Genital Herpes: 200 mg every 4 hours, 5 times daily for 10 days.
Chronic suppressive therapy for recurrent disease: 400 mg 2 times daily for up to 12 months.
Intermittent therapy: 200 mg every 4 hours, 5 times daily for 5 days.
Children (2 years of age and older): 20 mg/kg/dose 4 times daily (80 mg/kg/day) for 5 days.
Adults and Children (>40 kg): 800 mg 4 times daily for 5 days.
The required dose of Zoviduo IV should be administered by slow intravenous infusion over a one-hour period.
• Herpes Simplex (HSV-1 and HSV-2) Infections:
Adults and Adolescents (≥12 years): 5 mg/kg, 8 hourly for 7 days.
Pediatrics (<12 years): 10 mg/kg 8 hourly for 7 days.
• Severe Initial Herpes Genitalis:
Adults and Adolescents (≥12 years): 5 mg/kg 8 hourly for 5 days.
• Herpes Simplex Encephalitis:
Adults and Adolescents (≥12 years): 10 mg/kg 8 hourly for 10 days.
Pediatrics (3 months to 12 years of age): 20 mg/kg 8 hourly for 10 days.
• Neonatal Herpes Simplex (Birth to 3 months):
10 mg/kg 8 hourly for 10 days.
• Varicella Zoster:
Adults and Adolescents (≥12 years): 10 mg/kg 8 hourly for 7 days.
Pediatrics (<12 years): 20 mg/kg 8 hourly for 7 days.
Dose adjustment of Tablet for patients with acute or chronic renal impairment, based on Creatinine Clearance, Cr Cl (mL/min/1.73 m2):
For Cr Cl= > 25 : 800 mg 4 hourly 5 times daily
For Cr Cl = 10 to 25 : 200 mg 4 hourly 5 times daily or 400 mg 12 hourly or 800 mg 8 hourly
For Cr Cl = 0 to 10 : 200 mg 12 hourly or 400 mg 12 hourly or 800 mg 12 hourly
Dose adjustment of IV for patients with acute or chronic renal impairment, based on Creatinine Clearance, Cr Cl (mL/min/1.73 m2):
For Cr Cl = > 50 : 100% of recommended dose, 8 hourly
For Cr Cl = 25 to 50 : 100% of recommended dose, 12 hourly
For Cr Cl = 10 to 25 : 100% of recommended dose, 24 hourly
For Cr Cl = 0 to 10 : 50% of recommended dose, 24 hourly
Caution: Rapid or bolus intravenous injection must be avoided. Intramuscular or subcutaneous injection must be avoided.
Reconstitution procedure of IV infusion
Vial containing 250 mg Zoviduo will be reconstituted with 50 ml infusion solution and vial containing 500 mg Zoviduo will be reconstituted with 100 ml infusion solution. Besides, Vial containing 1 gm Zoviduo will be reconstituted with 250 ml infusion solution. 10 ml of the infusion solution will be added to the vial containing 250 mg, 500 mg and 1 gm Zoviduo. Shake well and transfer the required amount of solution to the infusion container. The final concentration of Zoviduo will be not more than 5 mg/ml.
The reconstituted solution should be used within 12 hours. Refrigeration of reconstituted solution may result in the formation of a precipitate which will re-dissolve at room temperature.
Compatible infusion fluids
Sodium Chloride Intravenous Infusion BP (0.45% and 0.9% w/v)
Sodium Chloride (0.18% w/v) and Glucose (4% w/v) Intravenous Infusion BP
Sodium Chloride (0.45% w/v) and Glucose (2.5% w/v) Intravenous Infusion BP
Rash, gastro-intestinal disturbances, rises in bilirubin and liver-related enzymes, increase in blood urea and creatinine, decreases in hematological indices, headache, neurological reactions, fatigue.
Zoviduo should be administered with caution in patient with renal impairment and doses should be adjusted according to creatinine clearance.
Pregnancy & Breastfeeding use
Pregnancy category B & caution should be exercised when it is administered to a lactating mother.
Interaction with other Medicine
Probenecid reduces Zoviduo excretion and so increases plasma concentration and risk of toxicity.
Keep in a cool & dry place away from light. Keep drugs out of the reach of children.
What is Zoviduo used for?
Zoviduo is primarily used for the treatment of herpes simplex virus infections, chickenpox, and shingles. Other uses include prevention of cytomegalovirus infections following transplant and severe complications of Epstein–Barr virus infection.
How safe is Zoviduo?
It is concluded that long-term suppression with Zoviduo is safe and effective for patients with recurrent genital herpes.
How does Zoviduo work?
Zoviduo works by preventing viruses from multiplying, and this reduces the severity of the infection and stops it from spreading.
What are the common side effect of Zoviduo?
Common side effects of Zoviduo include:
- feeling dizzy.
- feeling or being sick (nausea or vomiting)
- skin being sensitive to sunlight.
Is Zoviduo safe during pregnancy?
Use of Zoviduo in the first trimester does not increase birth defects, and it should be the antiviral drug of choice in early pregnancy.
Is Zoviduo safe during breastfeeding?
Zoviduo does accumulate in breast milk but they also showed that there were no problems seen in the infants. The American Academy of Pediatrics considers Zoviduo to be safe during breastfeeding, according to the researchers
Can I drink alcohol with Zoviduo?
Yes, you can drink alcohol while taking Zoviduo.
Can I drive after taking Zoviduo?
Some people feel dizzy when taking Zoviduo tablets or liquid. This may make it more difficult to concentrate and react. Do not drive or use any tools or machines if you're affected.
When should be taken of Zoviduo ?
Zoviduo are usually taken with or without food two to five times a day for 5 to 10 days, starting as soon as possible after your symptoms begin.
How long does Zoviduo take to work?
Zoviduo begins to work within 24 to 48 hours after you start taking it. It may take four or five days for symptoms to reduce, but you should continue consuming the medication until the prescribed course is complete.
How long does Zoviduo stay in my system?
Zoviduo has a half-life of 2.5 to 3.3 hours in people with normal renal function. This means that a single dose of Zoviduo, after conversion into Zoviduo by your body, will reduce in concentration every 2.5 hours to 3.3 hours.
How long can I take Zoviduo?
Zoviduo is usually taken two to five times a day for up to 12 months.
Who should not take Zoviduo ?
You should not take acyclovir buccal tablets if you are allergic to milk proteins. Tell your doctor if you have ever had kidney disease; or. a weak immune system (caused by disease or by using certain medicine).
What happens if I miss a dose?
If you miss a dose of Zoviduo, take the missed dose as soon as you remember it, and take the remaining doses for the day at evenly spaced intervals. If it is time or almost time for your next dose, however, do not double dose. Get to the next dose and stay on schedule.
What happen If I stop taking Zoviduo?
If you stop taking the Zoviduo suddenly or don't take it at all: The symptoms of your infection may not get better or may get worse.
What happen if I take too much Zoviduo?
If you take too much you could have dangerous levels of the drug in your body. Symptoms of an overdose of this Zoviduo can include more severe side effects, such as: headache, nausea.
Is it bad to take too much Zoviduo?
Taking too much Zoviduo by accident is unlikely to harm you, unless you take too much over several days. Talk to your doctor or pharmacist if you're worried that you have had too much Zoviduo.
Can Zoviduo affects my kidney?
It can present in clinical practice as acute kidney injury, crystal-induced nephropathy, acute tubulointerstitial nephritis, and rarely, as tubular dysfunction.
Can Zoviduo affects liver?
Despite widespread use, there is little evidence that when given orally causes significant liver injury. Serum enzyme levels generally do not change during oral acyclovir therapy.
Can Zoviduo affect my heart?
Increased heart rate Seizures. Encephalopathy (a disorder of the brain) Decreased number of blood platelets.