Heviran – indications, contraindications, dosage and side effects

Proven content

Heviran, an antiviral drug, is mainly used to treat recurrent cold sores on the lips and face caused by the herpes simplex virus. The active substance is acyclovir which inhibits the multiplication of Herpes viruses which are pathogenic for humans. What is the drug characterized by? What are the indications and contraindications for taking this preparation? How to properly dose Heviran and what side effects can its use have?

Heviran – drug characteristics

Heviran is an antiviral medicine used to treat cold sores on the lips and face caused by the herpes simplex virus.

The active substance is acyclovir responsible for inhibiting the multiplication of pathogenic herpes viruses, the so-called herpesviruses. Heviran Control tablets with an active ingredient dose of 200 mg can be purchased without a prescription, while the others, ie Heviran 400 mg and Heviran 800 mg, are available only on prescription.

Heviran 200 mg and 400 mg tablets are white, round-shaped, biconvex tablets, while Heviran 800 mg tablets are white, oblong-shaped, biconvex tablets, with a score line allowing dividing them into two equal doses.

Heviran is a drug that is eliminated from the body by the kidneys, and the time of its removal from the body in healthy patients is about 3,8 hours, and in people with chronic renal failure, about 19,5 hours.

Store below 25 ° C in the original package in order to protect from light.

The marketing authorization holder for Heviran is Zakłady Farmaceutyczne POLPHRMA SA, a leader in the Polish pharmaceutical market and one of the leading drug manufacturers in the region of Central and Eastern Europe, Central Asia and the Caucasus. The company has been operating since 1935 and thanks to dynamic development, foreign expansion and capital investments, it has become a strong, international pharmaceutical group appreciated by doctors and pharmacists. The price of the drug

Heviran price 200 mg, 25 tables range from PLN 13 to PLN 23. On the other hand, the price of Heviran in higher doses, i.e. 400 mg and 800 mg, is relatively increasing, and the drug itself is available only on prescription.

What is HSV herpes and how is it diagnosed? Check: Herpes – symptoms, treatment

Heviran – composition and action of the drug

The active substance in Heviran is acicolovir. Heviran is an antiviral medicine that stops the replication of Herpes viruses at the cellular DNA level. This happens not only through the action of acyclovir, but also thanks to the transformations of this active substance.

The action of acyclovir it is very selective about the multiplication of viruses. The process of Heviran’s action is related to the process by which the viral thymidine kinase (TK), encoded by HSV (Herpes simplex types 1 and 2) and VZV (Varicella-zoster), phosphorylates acyclovir to a monophosphate derivative, which is then phosphorylated by cellular enzymes to acyclovir diphosphate and triphosphate.

The substrate for viral DNA polymerase is acyclovir triphosphate, which is incorporated into viral DNA, which in turn causes the termination of viral DNA chain synthesis, inhibiting its replication, i.e. multiplication. In short, this process can be described as stopping the viral DNA chain reaction, which stops its further development and activity.

Depending on the package, the Heviran tablet contains, respectively, 200 mg, 400 mg or 800 mg of aciclovir, which is the active ingredient of the drug. The excipients of Heviran are microcrystalline cellulose, povidone, sodium carboxymethyl starch type A, magnesium, stearate, hypromellose, macrogol 6000, titanium dioxide, triethyl citrate and talc.

What should you know about Herpes? Check: Herpes – herpes simplex

Heviran – absorption and excretion of the drug

Thymidine kinase does not use aciclovir effectively as a substrate in virally uninfected cells, and therefore the drug is not cell-toxic. Acyclovir is partially absorbed from the gastrointestinal tract and protein binding is approximately 9 – 33%.

The concentration of Heviran in the cerebrospinal fluid is approximately 50% of that in plasma. About 10-15% of the administered dose is excreted unchanged drug with urine in the form of the metabolite 9-carboxymethoxymethylguanine.

Is herpes dangerous to our health? Read on: Herpes is more dangerous than you think

Heviran – indications for the use of the drug

Heviran is a preparation that is mainly used as a treatment for cold sores on the lips and face. The product is indicated in the treatment of infections of the skin and mucous membranes caused by the herpes simplex virus.

It is also applicable in the treatment of not only primary infection, but also recurrent herpetic infection of the genital organs (excluding herpes simplex virus infections in newborns and infants up to 3 months of age and in children with significantly reduced immunity, severely infected with the herpes simplex virus).

Heviran is also used as a medicine to prevent recurrences of herpes simplex in people with normal immunity and with lowered immunity. It is used in patients who have previously been diagnosed with herpes simplex virus infection as a preventive measure to prevent the herpes returning.

Heviran, apart from its basic application, is also used in the treatment of infections caused by varicella-zoster virus.

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Heviran – contraindications to the use of the drug

Despite its effectiveness, the drug Heviran can not be used by all patients who are struggling with herpes and its consequences.

Heviran should not be used in infants and newborns under 3 months of age and in children with severely immunocompromised disease if the infection is very severe.

The main contraindication to the use of this drug is hypersensitivity to the active substance, i.e. acyclovir or other auxiliary ingredients that are part of the preparation, as well as to valaciclovir.

Heviran is cleared from the body to a large extent through the digestive system, therefore people with impaired kidney function should avoid using this medicine. Heviran should also not be used by the elderly, pregnant and breastfeeding women, as well as people with reduced immunity, e.g. after a transplant or HIV-infected.

Consult your doctor or pharmacist each time you use Heviran, especially if:

• you are taking other medicines that can damage and disrupt the functioning of your kidneys;

• the person suffers from impaired kidney function;

• the person is elderly, ie over 65;

• the person is immunocompromised (eg has had a transplant);

• the person has very severe recurrent cold sores;

• herpes occurs frequently in a person (i.e. more than 6 times a year) and lasts longer (after 5 days of therapy there is no visible improvement), with more severe clinical symptoms (e.g. after 3 to 4 days, despite the therapy, new foci of infection appear) .

If you are not sure about the safety of using Heviran in people with a medical condition, read the leaflet or consult your doctor or pharmacist.

What should you know about side effects of drugs? Check: Adverse drug reactions

Heviran – dosage of the drug in adults

Always use Heviran according to the package leaflet or as directed by your doctor or pharmacist.

Dosage of Heviran it depends on the condition it is used for, and on the patient’s health and age.

Heviran should be used as soon as the first symptoms of infection are recognized.

You should swallow the drug whole and drink plenty of fluids while taking it to reduce the risk of kidney damage and the likelihood of side effects.

Treatment of infections in adults caused by the herpes simplex virus (HERPES simplex virus) requires a dose of 200 mg five times a day approximately every 4 hours with a night break. Heviran should be used for 5 days, and in the case of severe and difficult to treat infections, the doctor may extend the treatment.

In the case of people with reduced immunity, e.g. after bone marrow transplantation or people with impaired absorption from the gastrointestinal tract, the dose can be doubled to 400 mg.

Treatment should be started as soon as possible after the diagnosis of the infection, and in the case of recurrent infections, treatment should be started in the period before the onset of pruritus, such as itching, burning or a feeling of tightness.

It is common practice for many patients to administer Heviran 12 mg twice a day, every 400 hours. This practice is mainly due to the convenience, but also the effectiveness of the operation.

As a preventive measure, the drug is used by gradually reducing the dose to 200 mg. The preparation is then used three times a day, approximately every 8 hours, or even up to two times a day, approximately every 12 hours.

You should take breaks of up to 6-12 months in the use of the drug in order to observe any changes in the course of the disease.

Infections caused by the varicella zoster virus are treated with a dose of 800 mg of Heviran administered 4 to 5 times a day, approximately every 4 hours with a night break. The duration of treatment is about 5 to 7 days and the best therapeutic results are obtained in both cases when the drug is taken within 24 hours after the appearance of the first skin lesions.

How To Treat Herpes During Pregnancy? Read on: Herpes in pregnancy – symptoms and treatment

Heviran – drug dosage for the elderly and children

It is very important to know that Heviran is not recommended for use in children and adolescents under 18 years of age. In special cases, in children 2 years of age and above with herpes simplex virus infection, the dose of the drug is used as for adults, i.e. 200 mg, 4 times a day, approximately every 6 hours.

For the treatment of chickenpox infection in children over 6 years of age, Heviran is given at a dose of 800 mg, 4 times a day, and in children from 2 to 5 years of age at a dose of 400 mg, 4 times a day.

The dose of Heviran given to children can be more accurately determined by administering 20 mg of the drug per kg body weight without exceeding the maximum dose of 800 mg four times a day.

Treatment in children usually lasts 5 days and only a doctor can decide to extend the treatment.

Elderly patients, on the other hand, may have a variety of age-related conditions and the possibility of renal impairment should be taken into account. Elderly people in good health may take Heviran in doses such as that of an adult. In the case of elderly people struggling with various diseases, especially with impaired kidney function, ask the doctor to appoint an individually selected dose of the drug. It is also important to keep the body properly hydrated.

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Heviran – dosing of the drug in a special group of patients

A special group of patients are people with severely impaired immunity, suffering from gastrointestinal malabsorption and people suffering from severe renal dysfunction.

In the case of the first diseases, the doctor may recommend a double dose of Heviran, i.e. 400 mg administered 5 times a day. Your doctor may also suggest that you administer the active substance intravenously.

People with severe renal impairment during treatment with Heviran should be under constant medical supervision. These people should take particular care to maintain the proper level of body hydration.

Caution is recommended when using Heviran in people with impaired renal function. Treatment or prevention of herpes simplex virus in patients with moderate or severe renal impairment and the use of the recommended doses does not result in accumulation of aciclovir in the body in concentrations higher than those considered safe for intravenous administration.

Nevertheless, for people with severe renal insufficiency with a creatinine clearance less than 10 ml / min, it is recommended to reduce the dose of Heviran to 200 mg twice a day, approximately every 12 hours.

For Heviran treatment with varicella zoster, people with moderate renal insufficiency, ie creatinine clearance 10-25 ml / min, are given a reduced dose to 800 mg three times a day at approximately 8-hour intervals. In contrast, in people with severe renal insufficiency, i.e. with creatinine clearance less than 10 ml / min, the dose is reduced to 800 mg twice a day, approximately every 12 hours.

Treatment with Heviran in people with kidney problems must be associated with the intake of large amounts of fluids and be supervised by a doctor.

What kidney diseases do patients most often struggle with? Check: What are kidney diseases and how do they manifest themselves?

Heviran – the effects of overdosing or missing a dose

Heviran, like any other drug, should be used according to the instructions provided in the package leaflet or according to the doctor’s and pharmacist’s instructions.

However, it is often the case that you miss one dose of the drug. In this case, we should take it as soon as possible, unless it is time to take the next dose of the drug, then you should not double the dose and skip the missed dose.

In the case of overdose of Heviran you should immediately contact your doctor who will decide on further treatment.

The active substance of Heviran, i.e. acyclovir, is partially absorbed from the gastrointestinal tract. Usually, a single dose of up to 20 g does not cause symptoms of toxic poisoning. On the other hand, if repeated oral overdosage of Heviran lasts for several days, it may be associated with gastrointestinal complaints such as nausea or vomiting. The patient may also experience neurological symptoms such as headache, dizziness, and confusion.

In case of overdose after intravenous administration of the drug, an increase in blood urea nitrogen and creatinine levels as well as impaired renal function may be observed. The neurological disorders are usually hallucinations, hyperactivity, seizures, confusion and coma.

If an overdose of Heviran is suspected, a person should be monitored carefully for signs of toxicity, and if such symptoms develop, hemodialysis is usually considered to accelerate the removal of aciclovir from the blood.

What is dialysis and who needs it? Check: Dialysis

Heviran – side effects

Heviran, like most drugs, can cause side effects in patients. It is important to report any suspected adverse reactions after authorization of the medicinal product so that the benefit / risk balance of the medicinal product can be monitored.

The frequency classification of adverse body reactions (ADRs) is based on the following principles: very common (≥1 / 10), common (≥1 / 100 to <1/10), uncommon (≥1 / 1 to <000/1), rare (≥ 100 / 1 to <10 / 000), very rare (<1 / 1), not known (cannot be estimated from the available data). According to the above rules, when using Heviran, the following side effects may occur:

1. Common side effects (i.e. affects 1 to 10 users in 100): nausea, vomiting, stomach pain, diarrhea, headache and dizziness, fever, general fatigue, itching and rash, and sensitivity to light;
2. Uncommon side effects (ie may affect up to 1 in 10 people): hives, hair loss increased quickly;
3. Rare side effects (ie 1 to 10 out of 10 people): increase in blood creatinine and urea, anaphylactic reaction, dyspnoea, angioedema, increase in liver enzymes and serum bilirubin;
4. Very rare side effects (i.e., may affect up to 1 in 10 people): psychotic symptoms, agitation, tremor, confusion, hallucinations, impaired coordination and speech disorder, sleepiness, coma, brain damage, acute kidney failure, decreased number of platelets that affect clotting, anemia or a reduction in the number of white blood cells.

These symptoms usually disappear and occur mainly in people with impaired kidney function or other medical conditions. In case of any of the above-mentioned undesirable effects, please contact your doctor.

How to effectively treat cold sores? Read: Herpes medicine – causes of herpes, treatment

Heviran – influence on fertility, pregnancy and lactation

Studies with Heviran also included cases of its use in pregnant women. These studies did not show an increase in the number of birth defects in babies born to women who used Heviran compared to the general population.

The occurrence of defects in children has no causal relationship with the use of aciclovir, the active substance of Heviran, during pregnancy. Nevertheless, administration of Heviran to pregnant women should be conditional on the benefits of using the drug that outweigh the possible risks to the fetus. If a woman is pregnant or may be pregnant, or is planning to have a baby, she should consult her doctor before taking Heviran.

Also, caution should be exercised in administering this medication to women who are breastfeeding. Oral administration of Heviran at a dose of 200 mg five times a day causes the concentration of aciclovir in human milk to increase from 60% to 410% of the drug concentration measured in plasma. This level of aciclovir concentration in breast milk may cause the child to automatically take the drug in a daily dose of up to 0,3 mg / kg body weight, which may have a negative impact on such a small body.

There are no data on the effects of aciclovir on female fertility in the studies performed. Among the studied men, who received oral Heviran in doses of up to 1 g daily for up to 6 months, no clinically significant decrease in the number, morphology and motility of human sperm was observed. Nevertheless, it is worth consulting a doctor before planning pregnancy.

Is it safe to use drugs during pregnancy? Read on: Pregnancy and medications

Heviran – interaction with other medicinal products and substances

The active substance acyclovir in Heviran is eliminated mainly unchanged by active renal tubular secretion. When used together with other drugs, the plasma aciclovir may increase. Therefore, the use of Heviran should not be combined with the use of drugs such as:

1. probenecid – a medicine for gout;
2. cimetidine – a drug used in gastric and duodenal ulcers;
3. mycophenolate mofetil – used after organ transplants;
4. theophylline – a drug used to treat asthma and other respiratory conditions.

Heviran may cause renal dysfunction when used in conjunction with other nephrotoxic pharmacological agents. This drug should also not be combined with alcohol. The active substance of the drug is metabolized in the liver in the same way as alcohol, which may deteriorate the absorption of the preparation and put a strain on the liver. Consuming alcohol while taking Heviran may increase the occurrence of side effects.

What drugs should not be combined with drinking alcohol? Check: Eight drugs that are better not to be combined with alcohol

Before use, read the leaflet, which contains indications, contraindications, data on side effects and dosage as well as information on the use of the medicinal product, or consult your doctor or pharmacist, as each drug used improperly is a threat to your life or health. Do you need a medical consultation or an e-prescription? Go to halodoctor.pl, where you will get online help – quickly, safely and without leaving your home. Now you can use e-consultation also free of charge under the National Health Fund.