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dc.contributor.authorAlmond, M.K.
dc.contributor.authorFan, S.
dc.contributor.authorDhillon, S.
dc.contributor.authorPollock, A.M.
dc.contributor.authorRaftery, M.J.
dc.identifier.citationAlmond , M K , Fan , S , Dhillon , S , Pollock , A M & Raftery , M J 1995 , ' Avoiding acyclovir neurotoxicity in patients with chronic renal failure undergoing haemodialysis ' , Nephron , vol. 69 , no. 4 , pp. 428-432 .
dc.identifier.otherPURE: 1850276
dc.identifier.otherPURE UUID: 77b01252-fed5-4131-80ea-8fdd2795b1bb
dc.identifier.otherScopus: 0028930520
dc.description.abstractAcute neurotoxicity following the administration of the recommended oral dose of acyclovir (800 mg twice daily) to dialysis-dependent patients is increasingly recognised. This suggests that the recommended dose is too high. Little is known of the pharmacokinetics of oral acyclovir in dialysis patients. We studied 7 patients with oliguric end stage renal failure receiving haemodialysis. Following haemodialysis, each patient received a single 800-mg tablet of acyclovir. Plasma acyclovir levels were monitored over the next 48 h as well as before and after the next routine dialysis. Peak plasma levels were achieved at 3 h (12.54 ± 1.76 μM, range 8.5 - 17.5 μM) with the half-life calculated to be 20.2 ± 4.6 h. Mean plasma levels of 6.29 ± 0.94 μM were within the quoted range to inhibit herpes tester virus (4-8 μM) at 18 h. Haemodialysis (4-5 h) eliminated 51 ± 11.5% of the acyclovir which remained at 48 h. Computer modelling of various dose modifications suggests that a loading dose of 400 mg and a maintenance dose of 200 mg twice daily is sufficient to maintain a mean plasma acyclovir level of 6.4 ± 0.8 μM A further loading dose (400 mg) after dialysis would raise the residual acyclovir concentration by 6.1 ± 1.0 μM. Such a dose modification should prevent neurotoxicity, whilst the rapid elimination of acyclovir by a single haemodialysis treatment provides both a diagnostic and therapeutic tool when toxicity is suspected.en
dc.titleAvoiding acyclovir neurotoxicity in patients with chronic renal failure undergoing haemodialysisen
dc.contributor.institutionCentre for Clinical Practice, Safe Medicines and Drug Misuse Research
dc.contributor.institutionPatient and Medicines Safety
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionHealth & Human Sciences Research Institute
dc.contributor.institutionDepartment of Pharmacy
dc.description.statusPeer reviewed
rioxxterms.typeJournal Article/Review

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