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Antiviral renal dosing — GPhC CRA MCQ

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HardInfectionsAntiviral renal dosingGPhC CRA

An 80-year-old man with creatinine clearance 22 mL/min is prescribed aciclovir 800 mg five times daily for shingles. He is frail and takes furosemide. The rash began 36 hours ago. What is the most appropriate alternative?

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Correct answer: C — Query the dose because renal adjustment is likely required

Aciclovir is renally cleared and dose adjustment is required in significant renal impairment. Frailty and diuretic use increase concern about dehydration and renal adverse effects. Antiviral treatment may still be indicated, but the dose and hydration advice should be clarified.

Reference: BNF