Talk:Aciclovir

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iochemically inaccurate - the Aciclo-GTP form is an inhibitor because it is incorporated into nascent DNA resulting in chain termination. SOMETIMES w hile the residue incorporated will be the GM--68.45.23.238 (talk) 03:44, 24 March 2013 (UTC)P form, it is the GTP form that will be the substrate for the reaction (to drive it forward through pyrophosphate release). Cheers! --163.1.176.254 12:40, 30 April 2007 (UTC)

Great page, guys. Can we move it to the INN aciclovir and have acyclovir redirect there?

Consider it done. JFW | T@lk 20:32, 21 Dec 2004 (UTC)

Drugs of this class are also

Needs a structure image

Needs a proper structure representation rather than just a 3D image--ChemSpiderMan (talk) 17:41, 26 January 2008 (UTC)

The image was removed by someone who probably thought "aciclovir" was a misspelling :P Fvasconcellos (t·c) 22:11, 26 January 2008 (UTC)

Wrong tautomer?

The tautomer depicted in the figures of this article is different from the one listed by CAS. Which one is wrong? --Itub (talk) 14:52, 12 February 2008 (UTC)

? positive urine drug screens

Will short term use of Acyclovir cause positive urine drug screens?--Lndbwn (talk) 17:43, 17 July 2008 (UTC)

thymidylate kinase

is acyclovir's inhibitory action through impairment of thymidylate kinase and acts as a competitive inhibitor of normal triphosphate nucleotides thus, can someone clear this up for me? —Preceding unsigned comment added by 193.1.229.15 (talk) 17:21, 31 May 2009 (UTC)

Pregnancy

"Since acyclovir can also be incorporated into cellular DNA, it is a chromosome mutagen, therefore, its use should be avoided during pregnancy". I don't think this is correct. I happen to know that physicians do prescribe aciclovir during pregnancy because an herpes infection can be lethal to the newborn child. Also, aciclovir has a pregnancy category B3 (Au), B (VS) which means it's relatively safe. —Preceding unsigned comment added by 130.89.139.9 (talk) 15:00, 8 October 2009 (UTC)

http://www.ncbi.nlm.nih.gov/pubmed/8308511 http://www.cdc.gov/mmwr/preview/mmwrhtml/00022071.htm http://pregnancyregistry.gsk.com/acyclovir.html - seems to be effectively the case that it's fine if the benefits outweigh the risks and there isn't much (if any) real evidence of risk even in very high doses. Maybe somebody should fix that. --Streaky (talk) 01:08, 8 June 2012 (UTC)

Please make molecule picture orientation similar to guanine.

This chemical is a guanine analogue, and acts like guanine with some bio-molecules, thus it's action in repressing the virus. It would assist visualizing the structure of both, if the orientation were presented with the same as that presented for guanine in this encyclopedia. Please just flip it around so the hex and penta sections can be superimposed on the guanine representations. This would more clearly indicate the distinctions as well as the similarities between the molecules.

Isolated from a sponge?

This chemical was originally synthesized by Gerty Elion. I'm pretty sure it wasn't isolated from a sponge. — Preceding unsigned comment added by 96.244.146.76 (talk) 01:49, 4 March 2012 (UTC)

Pricing

I moved this here for discussion, as I do not understand how this content derives from the sources:

lead

The wholesale cost is between 0.03 and 0.12 USD per dose. In the United States it is not very expensive at about 0.50 USD per dose.

body - Cost subsection

The wholesale cost is between 0.03 and 0.12 USD per dose. In the United States it is not very expensive at less than 25 USD per course of treatment.

References

Can somebody please explain? Thanks. Jytdog (talk) 18:49, 7 March 2016 (UTC)

Sure and I have restored it.

If you look at the source "Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition" it gives the cost in the USA as less than 25 USD for a course of treatment.

If you look at this source[1] it gives you a range of prices internationally. Price per tab is between 0.03 and 0.12USD. You have the wrong ref listed above. Doc James (talk · contribs · email) 02:16, 8 March 2016 (UTC)

not comfortable with this, per the note left on the article; the drug retails at 13.5 cents per pill at walmart and target. when we start talking about "price" concretely like this, we really risk losing credibility when there is public information that is very different, and that everyday people actually make transactions about. Talking about things like wholesale price (with limitations of for whom, and when) does make some sense to me. But "price" is problematic. I've amended the US price with "0.13 to xxxx" and added the target price list as a source. that feels spammy to me but I don't know how else to get content that reflects the RW. Jytdog (talk) 02:38, 8 March 2016 (UTC)

Have adjusted it to 0.22 to 0.50 USD. 400 mg is a single dose (so two tabs). Price is 90 200 mg tabs for 10 USD = 0.22 per 400 mg

What do you not like about "less than 25 USD per course of treatment"? Doc James (talk · contribs · email) 03:16, 8 March 2016 (UTC)

to calculate cost for treatment you have to bring in dosing, and i understand we don't go there... Jytdog (talk) 03:22, 8 March 2016 (UTC)

We can just say typical dose. Doc James (talk · contribs · email) 03:33, 8 March 2016 (UTC)

Breastfeeding

Did you look at the source in question? Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 59. ISBN 9781284057560. Doc James (talk · contribs · email) 02:24, 8 March 2016 (UTC)

But this is the easier to access source "Even with the highest maternal dosages, the dosage of acyclovir in milk is only about 1% of a typical infant dosage and would not be expected to cause any adverse effects in breastfed infants" http://www.drugs.com/breastfeeding/acyclovir.html Doc James (talk · contribs · email) 02:27, 8 March 2016 (UTC)

thanks that is great. I don't have acess to that pocket guide not even through a university medical library. appears very handy tho! Jytdog (talk) 02:41, 8 March 2016 (UTC)

Good to have a second source to back these things up and one which is easier for our readers to check. Doc James (talk · contribs · email) 03:14, 8 March 2016 (UTC)

Cream vs. Ointment - source for consideration

I found an interesting article in The Los Angeles Times that speaks to the distinction between Zovirax cream and Zovirax ointment. It also speaks to Canadian vs. American pricing. Something to consider for inclusion. This is from Newspapers.com and comes in two parts:

• Lazarus, David (March 6, 2015). "$2500 for cold-sore cream? Now that stings". Business. The Los Angeles Times. p. C1 – via Newspapers.com (Publisher Extra).
• Lazarus, David (March 6, 2015). "High cost of cold-sore cream leaves bad taste". Business. The Los Angeles Times. p. C2 – via Newspapers.com (Publisher Extra).

--User:Ceyockey (talk to me) 03:30, 24 June 2018 (UTC)

Neurotoxicity

I've been trying to find a good reference for the diagnosis of neurotoxicity of aciclovir (particularly in people with renal impairment). Today I heard of the utility of the determination of 9-carboxymethoxymethylguanine in blood and CSF as a marker, and the fact that this seems not be removed by haemofiltration. JFW | T@lk 08:26, 29 May 2019 (UTC)

Doc James has confirmed that doi:10.1097/MJT.0000000000000093 discusses the role of 9-CMMG and I was going to add the reference back but Winged Blades of Godric beat me to it. I do think we should preserve doi:10.1016/j.jcv.2014.09.001 which is technically a case report but it shows the role of measuring 9-CMMG, something that the first source does not do. JFW | T@lk 09:57, 14 June 2019 (UTC)

:-) I re-inserted the ref, roughly an hour after your removal! By the way, is there any new literature on how exactly 9CMMG leads to the disorders? I guess it is not discovered yet but my last corpus-review in the area, was quite back. ∯WBG^converse 10:34, 14 June 2019 (UTC)

This book also covers it[2]

This one discusses CMMG[3]

Doc James (talk · contribs · email) 15:27, 14 June 2019 (UTC)