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Aciclovir renal dosing — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentAciclovir renal dosingGPhC CRA

A 78-year-old man with eGFR 18mL/min/1.73m2 is prescribed aciclovir 800mg five times daily for shingles. He takes ramipril and furosemide and has had poor oral intake for 2 days. The prescription has no renal dose adjustment. What is the most appropriate action?

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Correct answer: C — contact the prescriber to adjust aciclovir dosing and assess hydration and renal risk

Aciclovir requires dose adjustment in significant renal impairment and can worsen renal function, particularly with dehydration. This patient has advanced CKD and poor intake, so the prescription should be queried before supply. Hydration advice and clinical assessment may be needed. Increasing the dose or adding nephrotoxic medicines would increase harm.

Reference: BNF; NICE CKS: Shingles