Influence of hemodialysis on acyclovir pharmacokinetics in patients with chronic renal failure

Am J Med. 1982 Jul 20;73(1A):202-4. doi: 10.1016/0002-9343(82)90091-2.


The pharmacokinetic disposition of acyclovir was studied in six patients with chronic renal failure (CRF) and anuria. At the end of a one-hour intravenous infusion (2.5 mg/kg), the mean peak acyclovir plasma level (+/- SD), determined by radioimmunoassay, was 37.5 +/- 24.2 microM (8.4 +/- 5.4 microgram/ml), twice the level found at this dose in patients with normal renal function (NRF). In the CRF volunteers, significant plasma levels (3.0 +/- 1.4 microM) persisted at 47 hours after drug administration (before hemodialysis) whereas in the NRF patients levels dropped to less than 1 microM by 11 hours. Hemodialysis was started 47 hours after infusion and was continued for six hours. The pre-dialysis plasma drug level was reduced by 61.5 percent at 0.25 to 1.5 hours after the end of dialysis. The mean plasma t 1/2 during dialysis of 5.4 hours, the extraction ratio of 0.44, and the dialysis clearance for plasma of 113 ml/min indicate that acyclovir is efficiently removed by hemodialysis. One-half the suggested intravenous dose for a particular indication can be given every 24 hours and a similar replacement dose should be given after each dialysis.

Publication types

  • Comparative Study

MeSH terms

  • Acyclovir
  • Antiviral Agents / blood*
  • Anuria / blood*
  • Guanine / analogs & derivatives*
  • Guanine / blood
  • Humans
  • Kidney Failure, Chronic / blood*
  • Kinetics
  • Renal Dialysis*


  • Antiviral Agents
  • Guanine
  • Acyclovir