NEUROTOXICITY ASSOCIATED WITH ACYCLOVIR IN END-STAGE RENAL-FAILURE

Aims. To alert practitioners to the danger of acyclovir neurotoxicity occurring in the presence of renal failure. Methods. Two case reports of acyclovir neurotoxicity in the patients on continuous ambulatory pe riteneal dialysis. Results. In one case neurotoxicity resulted from th e use of a dosage regimen that would be appropriate in patients with n ormal renal function. In the other case, neurotoxicity occurred even t hough a reduced dose of acyclovir was given. Supportive management res ulted in a complete recovery. Conclusions. In patients with end stage renal failure with varicella tester infections, when acyclovir is pres cribed the loading dose should be 400 mg and the maintenance dose shou ld be 200 mg twice daily.