Novel insights to enhance therapeutics with acyclovir in the management of herpes simplex encephalitis.
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Data
2021
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Resumo
Acyclovir is an antiviral drug poorly absorbed in the gastrointestinal tract due to its hydrophilicity, with
low oral bioavailability (~20%). Although acyclovir is prescribed in the management of herpes simplex
encephalitis (HSE), the disease has a poor prognosis, particularly if the treatment is delayed, reaching
mortality rates of 70% if left untreated. Thus, high acyclovir doses are administered by intravenous (IV)
infusion, usually at a dosage of 10 mg kg1 8-hourly in adults with normal renal function. However, the
mortality related to HSE treated with acyclovir remains high (~20%) and permanent sequelae are
commonly reported after 1 year (~50%). This review analyzed clinical trials following IV acyclovir
administration. Novel insights aiming to improve drug bioavailability were reviewed, including acyclovir
or its prodrugs, leading to the systemic distribution of the drug or drug targeting. Much research effort
has been made to improve antiviral therapy, searching for delivery systems increasing acyclovir
bioavailability by non-invasive pathways, such as oral and nasal pathways, or parenterally administered
nanotechnology-based systems leading to drug targeting. Nanocarriers administered by non-invasive
pathways represent feasible alternatives to treat HSE, even though not be industrially manufactured yet.
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Absorption enhancer, Bioavailability, Clinical trial, Drug delivery system, Drug targeting
Citação
ASSIS, M. S. G. et al. Novel insights to enhance therapeutics with acyclovir in the management of herpes simplex encephalitis. Journal of Pharmaceutical Sciences, v. 110, p. 1557-1571, 2021. Disponível em: <https://www.sciencedirect.com/science/article/abs/pii/S0022354921000083>. Acesso em: 11 out. 2022.