title: Perspectives on switching oral acyclovir from prescription to over-the-counter status: report of a consensus panel.
abstract: The proposed switching of oral acyclovir from prescription to over-the-counter (OTC) status for the 5-day episodic treatment of genital herpes was considered by a consensus panel. It was concluded that self-diagnosis/misdiagnosis, misuse, and adverse drug effects were potential problems with the OTC use of acyclovir. While acyclovir reduces asymptomatic shedding of herpes simplex virus type 2, the reduction in transmission of virus potentially resulting from increased acyclovir use was felt to be of unknown extent but likely to be of benefit overall. The availability of acyclovir would likely be improved. There were differences in opinion as to whether widespread availability of acyclovir (prescription or OTC) may speed the development of viral resistance. However, all panel members felt that granting OTC status may set an undesirable precedent for the switch from prescription to OTC use of other systemically administered antiinfective agents. The effect of this precedent, in terms of accelerating development of multidrug-resistant bacteria, was a major concern of all panel members. The consensus was that the switch of acyclovir to OTC status could not be supported.
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City 84132, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Sande
authors.forename: D
authors.initials: D
authors.lastname: Armstrong
authors.forename: L
authors.initials: L
authors.lastname: Corey
authors.forename: W L
authors.initials: WL
authors.lastname: Drew
authors.forename: D
authors.initials: D
authors.lastname: Gilbert
authors.forename: R C
authors.initials: RC
authors.lastname: Moellering
authors.forename: L G
authors.initials: LG
authors.lastname: Smith
mesh_terms: D000212:Acyclovir / Q000009:adverse effects / Q000633:toxicity; D000284:Administration, Oral; D000998:Antiviral Agents / Q000009:adverse effects / Q000633:toxicity; D003245:Consensus Statements as Topic; D003257:Consumer Product Safety; D003376:Counseling; D011307:Drug Prescriptions; D004352:Drug Resistance, Microbial; D006266:Health Education; D006291:Health Policy; D006558:Herpes Genitalis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D008403:Mass Screening; D012749:Sexually Transmitted Diseases; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir