Pharmacokinetics and safety of high-dose oral acyclovir for suppression of cytomegalovirus disease after renal transplantation

Courtney V. Fletcher, Barbara J. Chinnock, Beverly Chace, Henry H. Balfour

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27 Scopus citations

Abstract

The pharmacokinetics and safety of high-dose oral acyclovir for suppression of cytomegalovirus disease were evaluated in 12 patients undergoing renal transplantation. A 12-week course beginning 24 hours before transplantation was administered in doses of 800 to 3200 mg/day based on renal function. Acyclovir plasma concentrations were measured by RIA on posttransplant days 1 or 2 and 5, 6, or 7. Mean peak and trough concentrations on days 5, 6, or 7 were 25 and 18 μmol/L, respectively. The pharmacokinetic model predicted acyclovir concentrations with a precision of 4.1 μmol/L and bias of -1.19 μmol/L. Estimates of individual pharmacokinetic parameters were consistent with literature and a priori values. Two of six adverse events were attributable to acyclovir; both resolved with dose modification. The dosage adjustment scheme and pharmacokinetic model performed well, allowing us to safely administer high-dose oral acyclovir immediately after renal transplantation. We are proceeding with a placebo-controlled study to assess efficacy for suppression of posttransplant cytomegalovirus disease.

Original languageEnglish (US)
Pages (from-to)158-163
Number of pages6
JournalClinical Pharmacology and Therapeutics
Volume44
Issue number2
DOIs
StatePublished - Aug 1988

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ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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