Overview
Acyclovir is an antiviral medication primarily used to treat infections caused by the herpes simplex virus (HSV), including cold sores and genital herpes, as well as the varicella-zoster virus, which causes chickenpox and shingles.

Mechanism of Action
It is a guanosine analogue that is selectively converted into its active form by viral thymidine kinase. Once activated, it inhibits viral DNA polymerase and incorporates itself into the growing viral DNA chain, effectively terminating viral replication.

Dosage and Administration
Available in oral, topical, and intravenous forms. For oral treatment of shingles, the dose is typically 800 mg five times a day. For cold sores, topical cream is applied 5 times daily. Adequate hydration is essential during systemic therapy.

Side Effects
Oral acyclovir is generally well-tolerated, with occasional nausea, diarrhoea, or headache. Intravenous use carries a risk of reversible renal toxicity, especially in dehydrated patients or those with pre-existing kidney issues.

Contraindications
Contraindicated in patients with known hypersensitivity to aciclovir or valaciclovir. Dose adjustments are required for patients with renal impairment.