Aciclovir overdose
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Acute kidney injury and neurotoxicity secondary to aciclovir toxicity following an overdose of aciclovir: case report A 71-year-old woman developed acute kidney injury and neurotoxicity secondary to aciclovir toxicity following an overdose of aciclovir. The woman was admitted with a fever due to progressive herpes zoster ophthalmicus and a suspicion for VZV meningoencephalitis. Two days prior to the admission, a general practitioner had initiated valaciclovir [valacyclovir] and aciclovir [acyclovir] 3% ophthalmic cream. On admission, she was tachycardic and febrile. Laboratory findings showed decreased sodium. Consequently, she was treated with sodium chloride. Her comorbidities included obesity, Addison’s disease and chronic obstructive pulmonary disease. She had been receiving multiple concomitant medications. Due to insufficient response to valaciclovir, valaciclovir was stopped. Following the confirmation of VZV meningoencephalitis, she received IV infusion of aciclovir 10 mg/kg (950mg) every 8h according to actual body weight for over 60 minutes. Following the first two aciclovir doses, decrease in urinary production was noted, without urinary retention on bladder scan. The creatinine level measured after 6 administrations had increased from 62 µmol/L at baseline to 336 µmol/L (day 3), corresponding to an estimated glomerular filtration rate of
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