Acyclovir (Zovirax)

Antiviral prophylaxis started at the time of AML diagnosis (approximately November 2025). Used to prevent herpes simplex virus (HSV) and varicella-zoster virus (VZV) reactivation during immunosuppressive chemotherapy with Azacitidine + Venetoclax.

Clinical Context

Acyclovir prophylaxis is standard of care for patients on venetoclax-based regimens due to the profound immunosuppression and increased risk of viral reactivation. The patient has been on acyclovir continuously since diagnosis. Source: patient report, 2026-04-15.

[!important] Prior VZV reactivation history
Patient has a documented history of herpes zoster (shingles) — see Herpes Zoster. This makes acyclovir prophylaxis even more critical, as prior reactivation confirms latent VZV with demonstrated ability to reactivate. A zoster vaccine (presumed Zostavax) was given ~2016, but efficacy has likely waned after ~10 years.

Dose

Dose not documented. Typical prophylactic dosing is 400 mg PO BID or 800 mg PO BID for VZV prophylaxis. Prescription documents needed to confirm actual dosing.

Monitoring

• Renal function (acyclovir is renally cleared; creatinine 0.6 mg/dL as of 2026-04-13 — normal)
• Signs of viral reactivation despite prophylaxis

Exact dose and frequency are not available in current raw sources. Prescription records should be obtained and ingested.