Zovirax

Acyclovir


Bausch Health Us, Llc
Human Prescription Drug
NDC 0187-0994
Zovirax also known as Acyclovir is a human prescription drug labeled by 'Bausch Health Us, Llc'. National Drug Code (NDC) number for Zovirax is 0187-0994. This drug is available in dosage form of Cream. The names of the active, medicinal ingredients in Zovirax drug includes Acyclovir - 50 mg/g . The currest status of Zovirax drug is Active.

Drug Information:

Drug NDC: 0187-0994
The labeler code and product code segments of the National Drug Code number, separated by a hyphen. Asterisks are no longer used or included within the product code segment to indicate certain configurations of the NDC.
Proprietary Name: Zovirax
Also known as the trade name. It is the name of the product chosen by the labeler.
Product Type: Human Prescription Drug
Indicates the type of product, such as Human Prescription Drug or Human OTC Drug. This data element corresponds to the “Document Type” of the SPL submission for the listing.
Non Proprietary Name: Acyclovir
Also known as the generic name, this is usually the active ingredient(s) of the product.
Labeler Name: Bausch Health Us, Llc
Name of Company corresponding to the labeler code segment of the ProductNDC.
Dosage Form: Cream
The translation of the DosageForm Code submitted by the firm. There is no standard, but values may include terms like `tablet` or `solution for injection`.The complete list of codes and translations can be found www.fda.gov/edrls under Structured Product Labeling Resources.
Status: Active
FDA does not review and approve unfinished products. Therefore, all products in this file are considered unapproved.
Substance Name:ACYCLOVIR - 50 mg/g
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.
Route Details:TOPICAL
The translation of the Route Code submitted by the firm, indicating route of administration. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Marketing Information:

An openfda section: An annotation with additional product identifiers, such as NUII and UPC, of the drug product, if available.
Marketing Category: NDA
Product types are broken down into several potential Marketing Categories, such as New Drug Application (NDA), Abbreviated New Drug Application (ANDA), BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.
Marketing Start Date: 30 Dec, 2002
This is the date that the labeler indicates was the start of its marketing of the drug product.
Marketing End Date: 31 Dec, 2025
This is the date the product will no longer be available on the market. If a product is no longer being manufactured, in most cases, the FDA recommends firms use the expiration date of the last lot produced as the EndMarketingDate, to reflect the potential for drug product to remain available after manufacturing has ceased. Products that are the subject of ongoing manufacturing will not ordinarily have any EndMarketingDate. Products with a value in the EndMarketingDate will be removed from the NDC Directory when the EndMarketingDate is reached.
Application Number: NDA021478
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.
Listing Expiration Date: 31 Dec, 2023
This is the date when the listing record will expire if not updated or certified by the firm.

OpenFDA Information:

An openfda section: An annotation with additional product identifiers, such as NUII and UPC, of the drug product, if available.
Manufacturer Name:Bausch Health US, LLC
Name of manufacturer or company that makes this drug product, corresponding to the labeler code segment of the NDC.
RxCUI:141859
825321
The RxNorm Concept Unique Identifier. RxCUI is a unique number that describes a semantic concept about the drug product, including its ingredients, strength, and dose forms.
Original Packager:Yes
Whether or not the drug has been repackaged for distribution.
UPC:0301870994452
UPC stands for Universal Product Code.
NUI:N0000020060
N0000180187
N0000180188
N0000175468
N0000175459
Unique identifier applied to a drug concept within the National Drug File Reference Terminology (NDF-RT).
UNII:X4HES1O11F
Unique Ingredient Identifier, which is a non-proprietary, free, unique, unambiguous, non-semantic, alphanumeric identifier based on a substance’s molecular structure and/or descriptive information.
Pharmacologic Class MOA:DNA Polymerase Inhibitors [MoA]
Mechanism of action of the drug—molecular, subcellular, or cellular functional activity—of the drug’s established pharmacologic class. Takes the form of the mechanism of action, followed by `[MoA]` (such as `Calcium Channel Antagonists [MoA]` or `Tumor Necrosis Factor Receptor Blocking Activity [MoA]`.
Pharmacologic Class EPC:Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]
Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]
Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]
Established pharmacologic class associated with an approved indication of an active moiety (generic drug) that the FDA has determined to be scientifically valid and clinically meaningful. Takes the form of the pharmacologic class, followed by `[EPC]` (such as `Thiazide Diuretic [EPC]` or `Tumor Necrosis Factor Blocker [EPC]`.
Pharmacologic Class:DNA Polymerase Inhibitors [MoA]
Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]
Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]
Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]
Nucleoside Analog [EXT]
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

Packaging Information:

Package NDCDescriptionMarketing Start DateMarketing End DateSample Available
0187-0994-451 TUBE in 1 CARTON (0187-0994-45) / 5 g in 1 TUBE30 Dec, 2002N/ANo
Package NDC number, known as the NDC, identifies the labeler, product, and trade package size. The first segment, the labeler code, is assigned by the FDA. Description tells the size and type of packaging in sentence form. Multilevel packages will have the descriptions concatenated together.

Product Elements:

Zovirax acyclovir acyclovir acyclovir cetostearyl alcohol mineral oil poloxamer 407 sodium lauryl sulfate water petrolatum propylene glycol

Drug Interactions:

7 drug interactions clinical experience has identified no interactions resulting from topical or systemic administration of other drugs concomitantly with zovirax cream. due to minimal systemic absorption of zovirax cream, systemic drug interactions are unlikely. • clinical experience has identified no interactions resulting from topical or systemic administration of other drugs concomitantly with zovirax cream. due to minimal systemic absorption of zovirax cream, systemic drug interactions are unlikely. ( 7 )

Indications and Usage:

1 indications and usage zovirax cream is a herpes simplex virus (hsv) deoxynucleoside analogue dna polymerase inhibitor indicated for the treatment of recurrent herpes labialis (cold sores) in immunocompetent adults and adolescents 12 years of age and older. zovirax cream is a herpes simplex virus (hsv) deoxynucleoside analogue dna polymerase inhibitor indicated for the treatment of recurrent herpes labialis (cold sores) in immunocompetent adults and adolescents 12 years of age and older. ( 1 )

Warnings and Cautions:

5 warnings and precautions • only for topical use of recurrent hsv lesions on the external aspect of lips and the face. zovirax cream should not be applied on mucous membranes including in the eye or inside the mouth or nose. ( 5.1 ) • there is a potential for irritation and contact sensitization. ( 5.2 ) 5.1 general zovirax cream should only be applied on the affected external aspects of the lips and face in patients with herpes labialis. because no data are available, application to human mucous membranes is not recommended. zovirax cream is intended for cutaneous use only and should not be used in the eye or inside the mouth or nose. 5.2 contact sensitization zovirax cream has a potential for irritation and contact sensitization [see adverse reactions (6.1) ] . the effect of zovirax cream has not been established in immunocompromised patients.

Dosage and Administration:

2 dosage and administration zovirax cream should be applied 5 times per day for 4 days. therapy should be initiated as early as possible following the onset of signs or symptoms of herpes labialis, i.e. during the prodrome or when lesions appear. for adolescents 12 years of age and older, the dosage is the same as in adults. • apply 5 times a day for 4 days. ( 2 ) • administer immediately following the onset of cold sore lesions. ( 2 )

Dosage Forms and Strength:

3 dosage forms and strengths each gram of zovirax cream contains 50 mg (equivalent to 5% w/w) of acyclovir. • cream, 50 mg (equivalent to 5% w/w) acyclovir. ( 3 )

Contraindications:

4 contraindications zovirax cream is contraindicated in patients with known hypersensitivity to acyclovir, valacyclovir, or any component of the formulation. • zovirax cream is contraindicated in patients with known hypersensitivity to acyclovir, valacyclovir or any component of the formulation. ( 4 )

Adverse Reactions:

6 adverse reactions • the most common adverse reactions reported were local skin reactions at the application site. ( 6.1 ) • angioedema, anaphylaxis, contact dermatitis and eczema have been reported. ( 6.2 ) to report suspected adverse reactions, contact bausch health us, llc at 1-800-321-4576 or fda at 1-800-fda-1088 or www.fda.gov/medwatch. 6.1 clinical trials experience because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug, and may not reflect the rates observed in clinical practice. in five double-blind, placebo-controlled trials, 1124 patients were treated with zovirax cream and 1161 with placebo (vehicle) cream. local application site reactions were reported by 5% of patients receiving zovirax cream and 4% of patients receiving placebo. the most common adverse reactions at the site of topical application were dry
lips, desquamation, dryness of skin, cracked lips, burning skin, pruritus, flakiness of skin, and stinging on skin; each adverse reaction occurred in less than 1% of patients receiving zovirax cream and placebo. three patients on zovirax cream and one patient on placebo discontinued treatment due to an adverse event. an additional study, enrolling 22 healthy adults, was conducted to evaluate the dermal tolerance of zovirax cream compared with vehicle using single occluded and semi-occluded patch testing methodology. both zovirax cream and placebo showed a high and cumulative irritation potential. another study, enrolling 251 healthy adults, was conducted to evaluate the contact sensitization potential of zovirax cream using repeat insult patch testing methodology. of 202 evaluable subjects, possible cutaneous sensitization reactions were observed in the same 4 (2%) subjects with both zovirax cream and placebo, and these reactions to both zovirax cream and placebo were confirmed in 3 subjects upon rechallenge. the sensitizing ingredient(s) has not been identified. the safety profile in patients 12 to 17 years of age was similar to that observed in adults. 6.2 postmarketing experience in addition to adverse events reported from clinical trials, the following events have been identified during postapproval use of acyclovir cream. because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. these events have been chosen for inclusion due to a combination of their seriousness, frequency of reporting, or potential causal connection to acyclovir cream. general: angioedema, anaphylaxis. skin: contact dermatitis, eczema.

Drug Interactions:

7 drug interactions clinical experience has identified no interactions resulting from topical or systemic administration of other drugs concomitantly with zovirax cream. due to minimal systemic absorption of zovirax cream, systemic drug interactions are unlikely. • clinical experience has identified no interactions resulting from topical or systemic administration of other drugs concomitantly with zovirax cream. due to minimal systemic absorption of zovirax cream, systemic drug interactions are unlikely. ( 7 )

Use in Specific Population:

8 use in specific populations 8.1 pregnancy risk summary acyclovir is minimally absorbed systemically following topical route of administration, and maternal use is not expected to result in fetal exposure to the zovirax cream [see clinical pharmacology (12.3) ] . experience with topical acyclovir use in pregnant women over several decades, based on published literature including observational studies, has not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. animal reproduction studies with systemic exposure of acyclovir have been conducted. refer to acyclovir prescribing information for additional details. the estimated background risk of major birth defects and miscarriage for the indicated population is unknown. all pregnancies have a background risk of birth defect, loss, or other adverse outcomes. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized
pregnancies is 2% to 4% and 15% to 20%, respectively. 8.2 lactation risk summary acyclovir is minimally absorbed systemically following topical route of administration, and breastfeeding is not expected to result in exposure of the child to zovirax cream [see clinical pharmacology (12.3) ] . there are no data on the effects of zovirax on the breastfed infant or on milk production. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for zovirax cream and any potential adverse effects on the breastfed child from zovirax cream or from the underlying maternal condition. 8.4 pediatric use an open-label, uncontrolled trial with zovirax cream was conducted in 113 patients aged 12 to 17 years with recurrent herpes labialis. in this trial, therapy was applied using the same dosing regimen as in adults and subjects were followed for adverse events. the safety profile was similar to that observed in adults. safety and effectiveness in pediatric patients less than 12 years of age have not been established. 8.5 geriatric use clinical studies of acyclovir cream did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. other reported clinical experience has not identified differences in responses between the elderly and younger patients. systemic absorption of acyclovir after topical administration is minimal [see clinical pharmacology (12.3) ] .

Use in Pregnancy:

8.1 pregnancy risk summary acyclovir is minimally absorbed systemically following topical route of administration, and maternal use is not expected to result in fetal exposure to the zovirax cream [see clinical pharmacology (12.3) ] . experience with topical acyclovir use in pregnant women over several decades, based on published literature including observational studies, has not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. animal reproduction studies with systemic exposure of acyclovir have been conducted. refer to acyclovir prescribing information for additional details. the estimated background risk of major birth defects and miscarriage for the indicated population is unknown. all pregnancies have a background risk of birth defect, loss, or other adverse outcomes. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15
% to 20%, respectively.

Pediatric Use:

8.4 pediatric use an open-label, uncontrolled trial with zovirax cream was conducted in 113 patients aged 12 to 17 years with recurrent herpes labialis. in this trial, therapy was applied using the same dosing regimen as in adults and subjects were followed for adverse events. the safety profile was similar to that observed in adults. safety and effectiveness in pediatric patients less than 12 years of age have not been established.

Geriatric Use:

8.5 geriatric use clinical studies of acyclovir cream did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. other reported clinical experience has not identified differences in responses between the elderly and younger patients. systemic absorption of acyclovir after topical administration is minimal [see clinical pharmacology (12.3) ] .

Overdosage:

10 overdosage overdosage by topical application of zovirax cream is unlikely because of minimal systemic exposure [see clinical pharmacology (12.3) ] . there is no information available for overdose.

Description:

11 description zovirax is the brand name for acyclovir, a synthetic deoxynucleoside analogue active against herpes viruses. zovirax cream 5% is a formulation for topical administration. the chemical name of acyclovir is 2-amino-1,9-dihydro-9-[(2-hydroxyethoxy) methyl]-6 h -purin-6-one; it has the following structural formula: acyclovir is a white, crystalline powder with the molecular formula c 8 h 11 n 5 o 3 and a molecular weight of 225. the maximum solubility in water at 37°c is 2.5 mg/ml. the pka’s of acyclovir are 2.27 and 9.25. each gram of zovirax cream contains 50 mg (equivalent to 5% w/w) of acyclovir and the following inactive ingredients: cetostearyl alcohol, mineral oil, poloxamer 407, propylene glycol, sodium lauryl sulfate, water and white petrolatum. acyclovir chemical structure

Clinical Pharmacology:

12 clinical pharmacology 12.1 mechanism of action acyclovir is an antiviral drug active against α-herpesviruses [see microbiology (12.4) ] . 12.3 pharmacokinetics a clinical pharmacology study was performed with zovirax cream in adult volunteers to evaluate the percutaneous absorption of acyclovir. in this study, which included 6 male volunteers, the cream was applied to an area of 710 cm 2 on the backs of the volunteers 5 times daily at intervals of 2 hours for a total of 4 days. the weight of cream applied and urinary excretion of acyclovir were measured daily. plasma concentration of acyclovir was assayed 1 hour after the final application. the average daily urinary excretion of acyclovir was approximately 0.04% of the daily applied dose. plasma acyclovir concentrations were below the limit of detection (0.01 μm) in 5 subjects and barely detectable (0.014 μm) in 1 subject. systemic absorption of acyclovir from zovirax cream is minimal in adults. the systemic absorption of a
cyclovir following topical application of cream has not been evaluated in patients <18 years of age. 12.4 microbiology mechanism of action: acyclovir is a synthetic purine deoxynucleoside analogue with cell culture and in vivo inhibitory activity against hsv types 1 (hsv-1) and 2 (hsv-2) dna polymerases. it inhibits hsv-1 and hsv-2 replication in cell culture and in vivo. the inhibitory activity of acyclovir is selective due to its affinity for the enzyme thymidine kinase (tk) encoded by hsv. this viral enzyme converts acyclovir into acyclovir monophosphate, a deoxynucleotide analogue. the monophosphate is further converted into diphosphate by cellular guanylate kinase and into triphosphate by a number of cellular enzymes. in biochemical assays, acyclovir triphosphate inhibits replication of α-herpes viral dna. this inhibition is accomplished in 3 ways: 1) competitive inhibition of viral dna polymerase, 2) incorporation into and termination of the growing viral dna chain, and 3) inactivation of the viral dna polymerase. antiviral activity the quantitative relationship between the susceptibility of herpes viruses to antivirals in cell culture and the clinical response to therapy has not been established in humans, and virus sensitivity testing has not been standardized. sensitivity testing results, expressed as the concentration of drug required to inhibit by 50% the growth of virus in cell culture (ec 50 value), vary greatly depending upon a number of factors. using plaque-reduction assays on vero cells, the ec 50 values of acyclovir against herpes simplex virus isolates range from 0.09 to 59.9 μm (0.02 to 13.5 μg/ml) for hsv-1 and from 0.04 to 44.0 μm (0.01 to 9.9 μg/ml) for hsv-2. resistance in cell culture acyclovir-resistant hsv-1 and hsv-2 strains were isolated in cell culture. acyclovir-resistant hsv resulted from mutations in the viral thymidine kinase (tk; pul23) and dna polymerase (pol; pul30) genes. frameshifts were commonly isolated and result in premature truncation of the hsv tk product with consequent decreased susceptibility to acyclovir. mutations in the viral tk gene may lead to complete loss of tk activity (tk negative), reduced levels of tk activity (tk partial), or alteration in the ability of viral tk to phosphorylate the drug without an equivalent loss in the ability to phosphorylate thymidine (tk altered). in cell culture the following resistance-associated substitutions in tk of hsv-1 and hsv-2 were observed (table 1). table 1: summary of acyclovir (acv) resistance-associated amino acid substitutions in cell culture hsv-1 tk p5a, h7q, l50v, g56v, g59a, g61a, k62n, t63a, e83k, p84s, d116n, p131s, r163h, a167v, p173l, q185r, r216s, r220h, t245m, r281stop, t287m, m322k hsv-2 tk l69p, c172r, t288m hsv-1 pol d368a, y557s, e597d, v621s, l702h, n815s, v817m, g841c hsv-2 pol - in hsv-infected patients clinical hsv-1 and hsv-2 isolates obtained from patients who failed treatment for their α-herpesvirus infections were evaluated for genotypic changes in the tk and pol genes and for phenotypic resistance to acyclovir (table 2). hsv isolates with frameshift mutations and resistance-associated substitutions in tk and pol were identified. the listing of substitutions in hsv tk and pol leading to decreased susceptibility to acyclovir is not all inclusive and additional changes will likely be identified in hsv variants isolated from patients who fail acyclovir-containing regimens. the possibility of viral resistance to acyclovir should be considered in patients who fail to respond or experience recurrent viral shedding during therapy. table 2: summary of acv resistance-associated amino acid substitutions observed in treated patients hsv-1 tk g6c, r32h, r41h, r51w, y53c/d/h, y53stop, d55n, g56d/s, p57h, h58/n/r/y, g59r, g61a, k62n, t63i, q67stop, s74stop, y80n, e83k, p84l, y87h, w88r, r89q/w, e95stop, t103p, q104h, q104stop, h105p, d116n, m121l/r, s123r, q125h, m128l, g129d, i143v, a156v, d162a/h/n, r163g/h, l170p, y172c, p173l, a174p, a175v, r176q/w, r176stop, l178r, s181n, v187m, a189v, v192a, g200c/d/s, t201p, v204g, a207p, l208f/h, r216c/h, r220c/h, r221h, r222c/h, l227f, t245m/p, l249p, q250stop, c251g, r256w, e257k, q261r, t287m, l288stop, l291p/r, l297s, l315s, l327r, c336y, q342stop, t354p, l364p, a365t hsv-2 tk r34c, g39e, r51w, y53n, g59p, g61w, s66p, a72s, d78n, p85s, a94v, n100h, i101s, q105p, t131p, d137stop, f140l, l158p, s169p, r177w, s182n, m183i, v192m, g201d, r217h, r221c/h, q222stop, r223h, y239stop, r271v, p272s, d273r, t287m, c337y hsv-1 pol k532t, q570r, l583v, a605v, a657t, d672n, v715g, a719t/v, s724n, f733c, e771q, s775n, l778m, e798k, v813m, n815s, g841s, i890m, g901v, v958l h1228d hsv-2 pol e250q, d307n, k533e, a606v, c625r, r628c, e678g, a724v, s725g, s729n, i731f, q732r, m789k/t, v818a, n820s, y823c, q829r, t843a, m910t, d912n/v, a915v, f923l, t934a, r964h note: additional substitutions to acyclovir resistance may exist. cross-resistance cross-resistance has been observed among hsv isolates carrying frameshift mutations and resistance-associated substitutions, which confer reduced susceptibility to penciclovir (pcv), famciclovir (fcv), and foscarnet (fos) [table 3]. table 3: summary of amino acid substitutions conferring cross-resistance to pcv, fcv or fos cross-resistant to pcv/fcv hsv-1 tk g6c, r32h, r51w, y53c/h, h58n, g61a, s74stop, e83k, p84l, t103p, q104stop, d116n, m121r, i143v, r163h, l170p, y172c, a174p, r176q/w, q185r, a189v, g200d, l208h, r216c, r220h, r222c/h, t245m, q250stop, r256w, r281stop, t287m, l315s, m322k, c336y cross-resistant to pcv/fcv hsv-1 pol a657t, d672n, v715g, a719v, s724n, e798k, n815s, g841s cross-resistant to pcv/fcv hsv-2 tk g39e, r51w, y53n, r177w, r221h, t288m cross-resistant to pcv/fcv hsv-2 pol k533e, a606v, c625r, r628c, s729n, q732r, m789k/t, v818a, n820s, f923l, t934a cross-resistant to fos hsv-1 pol d368a, a605v, d672n, l702h, v715g, a719t/v, s724n, l778m, e798k, v813m, n815s, v817m, g841c/s, i890m cross-resistant to fos hsv-2 pol k533e, a606v, c625r, r628c, a724v, s725g, s729n, i731f, q732r, m789k/t, v818a, y823c, d912v, f923l, t934a, r964h

Mechanism of Action:

12.1 mechanism of action acyclovir is an antiviral drug active against α-herpesviruses [see microbiology (12.4) ] .

Pharmacokinetics:

12.3 pharmacokinetics a clinical pharmacology study was performed with zovirax cream in adult volunteers to evaluate the percutaneous absorption of acyclovir. in this study, which included 6 male volunteers, the cream was applied to an area of 710 cm 2 on the backs of the volunteers 5 times daily at intervals of 2 hours for a total of 4 days. the weight of cream applied and urinary excretion of acyclovir were measured daily. plasma concentration of acyclovir was assayed 1 hour after the final application. the average daily urinary excretion of acyclovir was approximately 0.04% of the daily applied dose. plasma acyclovir concentrations were below the limit of detection (0.01 μm) in 5 subjects and barely detectable (0.014 μm) in 1 subject. systemic absorption of acyclovir from zovirax cream is minimal in adults. the systemic absorption of acyclovir following topical application of cream has not been evaluated in patients <18 years of age.

Nonclinical Toxicology:

13 nonclinical toxicology 13.1 carcinogenesis, mutagenesis, impairment of fertility systemic exposure following topical administration of acyclovir is minimal. dermal carcinogenicity studies were not conducted. results from the studies of carcinogenesis, mutagenesis and fertility are not included in the full prescribing information for zovirax cream due to the minimal exposures of acyclovir that result from dermal application. information on these studies is available in the full prescribing information for zovirax capsules, tablets, and suspension and zovirax for injection.

Carcinogenesis and Mutagenesis and Impairment of Fertility:

13.1 carcinogenesis, mutagenesis, impairment of fertility systemic exposure following topical administration of acyclovir is minimal. dermal carcinogenicity studies were not conducted. results from the studies of carcinogenesis, mutagenesis and fertility are not included in the full prescribing information for zovirax cream due to the minimal exposures of acyclovir that result from dermal application. information on these studies is available in the full prescribing information for zovirax capsules, tablets, and suspension and zovirax for injection.

Clinical Studies:

14 clinical studies 14.1 adult subjects zovirax cream was evaluated in two double-blind, randomized, placebo (vehicle)-controlled trials for the treatment of recurrent herpes labialis. the average patient had five episodes of herpes labialis in the previous 12 months. in the first trial, the median age of subjects was 37 years (range 18 to 81 years), 74% were female, and 94% were caucasian. in the second trial, median age of subjects was 38 years (range 18 to 87 years), 73% were female, and 94% were caucasian. subjects were instructed to initiate treatment within 1 hour of noticing signs or symptoms and continue treatment for 4 days, with application of study medication 5 times per day. in both studies, the mean duration of the recurrent herpes labialis episode was approximately one-half day shorter in the subjects treated with zovirax cream (n = 682) compared with subjects treated with placebo (n = 703) for approximately 4.5 days versus 5 days, respectively. no significant difference
was observed between subjects receiving zovirax cream or placebo in the prevention of progression of cold sore lesions. 14.2 pediatric subjects an open-label, uncontrolled trial with zovirax cream was conducted in 113 patients aged 12 to 17 years with recurrent herpes labialis. in this trial, therapy was applied using the same dosing regimen as in adults and subjects were followed for adverse events. the safety profile was similar to that observed in adults.

How Supplied:

16 how supplied/storage and handling each gram of zovirax cream contains 50 mg (equivalent to 5% w/w) of acyclovir in an aqueous cream base. zovirax cream is supplied as follows: ndc 0187-0994-45: 5 g tubes store at or below 25°c (77°f); excursions permitted to 15° to 30°c (59° to 86°f) [see usp controlled room temperature].

Information for Patients:

17 patient counseling information advise the patient to read the fda-approved patient labeling (patient information). general patients should be informed that zovirax cream is a prescription topical cream for the treatment of cold sores (recurrent herpes labialis) that occur on the face and lips. zovirax cream is not a cure for cold sores. patients should be instructed that zovirax cream is intended for cutaneous use only for herpes labialis of the lips and around the mouth. patients should be advised that zovirax cream should not be used in the eye, inside the mouth or nose, or on the genitals. patients should be instructed to avoid applying other topical products to the affected area while using zovirax cream. do not use if you are allergic to zovirax cream or any of the ingredients in zovirax cream. before you use zovirax cream, tell your doctor if you are pregnant, planning to become pregnant, or are breast-feeding. instructions for use treatment should be initiated at the earliest
sign or symptom of recurrence. instruct patients to wash hands prior to application and ensure the face and/or lips are clean and dry. advise patients to apply zovirax cream topically 5 times per day for 4 days. instruct patients to topically apply a quantity of zovirax cream sufficient to cover the affected area, including the outer margin. advise patients to avoid unnecessary rubbing of the affected area to avoid aggravating or transferring the infection. instruct patients to wash their hands with soap and water after using zovirax cream. keep out of reach of children. possible side effects common skin-related side effects that occurred when zovirax cream was applied include application site reactions. zovirax cream has the potential for irritation and contact sensitization.

Spl Patient Package Insert:

Patient information zovirax (zho-vahy-rex) (acyclovir) cream important information: zovirax cream is for use on cold sores on the lips and around the mouth only. zovirax cream should not be used in your eyes, mouth, nose, or on your genitals. what is zovirax cream? • zovirax cream is a prescription medicine used to treat cold sores (herpes labialis) that are recurring in adults and children 12 years of age and older, and who have normal immune systems. • zovirax cream is not a cure for cold sores. it is not known if zovirax cream is safe and effective in children less than 12 years of age. do not use zovirax cream if you are allergic to acyclovir, valacyclovir, or any of the ingredients in zovirax cream. see the end of this leaflet for a complete list of ingredients in zovirax cream. what should i tell my healthcare provider before using zovirax cream? before using zovirax cream, tell your healthcare provider about all of your medical conditions, including if you: • beco
me sick very easily (have a weak immune system). • are pregnant or plan to become pregnant. it is not known if zovirax cream will harm your unborn baby. • are breastfeeding or plan to breastfeed. it is not known if zovirax cream passes into your breast milk. talk to your healthcare provider about the best way to feed your baby if you use zovirax cream. tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. how should i use zovirax cream? • use zovirax cream exactly as your healthcare provider tells you to use it. • use zovirax cream as soon as you have the first symptoms of a cold sore such as itching, redness, burning or tingling, or when the cold sore appears. • wash your hands with soap and water before and after applying zovirax cream. • the affected area should be clean and dry before applying zovirax cream. • apply zovirax cream to the affected area 5 times each day for 4 days, including the outer edge. • you should not apply other skin products to the affected area during treatment with zovirax cream. • avoid unnecessary rubbing of the cold sore because this may cause the cold sore to spread to other areas around your mouth or make your cold sore worse. what are the possible side effects of zovirax cream? the most common side effects of zovirax cream are skin reactions at the treatment site and may include: dry or cracked lips, peeling, flaking or dryness of the skin, a burning or stinging feeling, and itching. these are not all the possible side effects of zovirax cream. call your doctor for medical advice about side effects. you may report side effects to fda at 1-800-fda-1088. how should i store zovirax cream? • store zovirax cream at room temperature between 68° to 77°f (20° to 25°c). keep zovirax cream and all medicines out of reach of children. general information about the safe and effective use of zovirax cream. medicines are sometimes prescribed for purposes other than those listed in a patient information leaflet. do not use zovirax cream for a condition for which it was not prescribed. do not give zovirax cream to other people, even if they have the same symptoms you have. it may harm them. you can ask your pharmacist or healthcare provider for information about zovirax cream that is written for health professionals. what are the ingredients in zovirax cream? active ingredient: acyclovir inactive ingredients: cetostearyl alcohol, mineral oil, poloxamer 407, propylene glycol, sodium lauryl sulfate, water, and white petrolatum distributed by: bausch health us, llc bridgewater, nj 08807 usa manufactured by: bausch health companies inc. laval, quebec h7l 4a8, canada zovirax is a trademark of glaxosmithkline llc used under license. © 2021 bausch health companies inc. or its affiliates for more information, call 1-800-321-4576. this patient information has been approved by the u.s. food and drug administration. revised: 02/2021 9462203

Package Label Principal Display Panel:

Principal display panel - 5g tube carton zovirax ® (acyclovir) cream 5% ndc 0187-0994-45 net wt. 5 g each gram contains: 50 mg (equivalent to 5% w/w) acyclovir, cetostearyl alcohol, mineral oil, poloxamer 407, propylene glycol, sodium lauryl sulfate, water and white petrolatum. use only for cold sores. for cutaneous use only. ortho dermatologics rx only carton


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* Data of this site is collected from www.fda.gov. This page is for informational purposes only. Always consult your physician with any questions you may have regarding a medical condition.