Acyclovir in shingles

Acyclovir given intravenously in either low dose (5 mg/kg every 8 h) or high dose (500 mg/m² every 8 h) significantly reduced pain and accelerated skin healing in acute herpes zoster occurring in otherwise healthy adults. The higher dose also significantly reduced the duration of viral shedding. No significant effect on post-herpetic neuralgia could be demonstrated, although the higher dose showed a promising trend. No adverse effects were associated with the lower dose, but acyclovir at 500 mg/m² resulted in nausea, vomiting and transiently elevated serum creatinine in a substantial number of patients.