Classes
DEA Class; Rx
Common Brand Names; Valtrex
- Antivirals, Other
Description
Oral antiviral agent; prodrug of acyclovir
Used to treat chickenpox, herpes zoster, herpes labialis (cold sores), and genital herpes
Formulated to improve oral bioavailability with less frequent dosing than oral acyclovir
Indications
Indicated for the treatment of
- Herpes Labialis
- Herpes Zoster
- Genital Herpes
Contraindications
Hypersensitivity to valacyclovir or acyclovir
Adverse Effects
- Headache (14-35%)
- Neutropenia (<18%)
- Elevated aspartate transaminase (AST) (2-16%)
- Nasopharyngitis (<16%)
- Nausea (6-15%)
- Elevated alanine transaminase (ALT) (<14%)
- Abdominal pain (2-11%)
- Dysmenorrhea (1-8%)
- Depression (<7%)
- Arthralgia (<1-6%)
- Vomiting (<1-6%)
- Dizziness (2-4%)
- Rash (≤8%)
- Rhinorrhea (<2%)
- Thrombocytopenia (<3%)
- Leukopenia (≤1%)
Warnings
Thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome (HUS) reported in patients with advanced HIV disease and in allogenic bone marrow transplant and renal transplant recipients
Acute renal failure (ARF) may occur, especially in elderly patients or those with underlying renal impairment receiving higher than recommended doses; use with caution in patients with renal impairment, the elderly, and/or patients receiving nephrotoxic drugs
Treatment should begin with the earliest symptom (tingling, burning, itching) in cold sores; for genital herpes, it should begin at the first signs and symptoms (within 72 hours of onset of first diagnosis or 24 hours of onset of recurrent episodes); for herpes zoster, it should begin within 72 hours of onset of rash; for chicken pox, it should begin with the earliest sign or symptom
Central nervous system (CNS) effects may occur (eg, agitation, hallucinations, confusion, encephalopathy); risk of CNS adverse effects is higher in elderly patients
Adequately hydrate patient; decreased precipitation in renal tubules may occur
Pregnancy and Lactation
Clinical data over several decades with valacyclovir and its metabolite, acyclovir, in pregnant women, have not identified a drug associated risk of major birth defects
Although there is no information on presence of drug in human milk, its metabolite, acyclovir, is present in human milk following oral administration of drug
Maximum Dosage
4 g/day PO for one-day treatment regimens or 3 g/day for regimens lasting longer than one day.
4 g/day PO for one-day treatment regimens or 3 g/day for regimens lasting longer than one day.
4 g/day PO for one-day treatment regimens or 3 g/day for regimens lasting longer than one day.
12 years: 4 g/day PO for one-day treatment regimens or 3 g/day for regimens lasting longer than one day.
2 to 11 years: 60 mg/kg/day PO (Max: 3 g/day).
1 year: Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Valacyclovir hydrochloride
tablet
- 500mg
- 1g
