Valacyclovir: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
===[[HSV-1]]=== | ===[[HSV-1]] / [[Herpes labialis]]=== | ||
*Acute episode: | *Acute episode: 2g PO BID x 1 day | ||
*Suppression: 500mg PO Qday | *Suppression (immunocompetent): | ||
**>9 recurrences/year: 1g PO Qday | |||
**<=9 recurrences/year: 500mg PO Qday | |||
===Genital HSV=== | ===Genital HSV=== | ||
*1st episode: 1000mg PO BID x 7-10 days, start within 48-72 hour of symptoms | *1st episode: 1000mg PO BID x 7-10 days, start within 48-72 hour of symptoms | ||
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B | ||
*Lactation: | *Lactation: Excreted in breastmilk | ||
*Renal Dosing | *Renal Dosing | ||
** | **CrCl <10 mL/min: 500 mg/day PO | ||
*Hepatic Dosing: not defined | |||
*Hepatic Dosing | |||
==Contraindications== | ==Contraindications== | ||
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==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*TTP, HUS (reported in advanced HIV and transplant patients) | |||
*Acute renal failure (especially if elderly or underlying renal disease) | |||
*Agitation, hallucinations, encephalopathy (higher risk in elderly) | |||
===Common=== | ===Common=== | ||
*Headache, dizziness | |||
*Nausea/vomiting, abdominal pain | |||
*Neutropenia, thrombocytopenia, leukopenia | |||
*Elevated LFTs | |||
*Nasopharyngitis | |||
*Dysmenorrhea | |||
*Depression | |||
*Rash | |||
*Alopecia | |||
*EM | |||
*Hypertension | |||
*Tachycardia | |||
*Tremor | |||
*Visual disturbance | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 2-3.3hr | ||
*Metabolism: | *Metabolism: Hepatic | ||
*Excretion: | *Excretion: Urinary | ||
*Mechanism of Action: | *Mechanism of Action: converted to acyclovir, which competes with deoxyguanosine triphosphate for viral DNA polymerase to inhibit DNA synthesis and viral replication | ||
==Indications by Disease== | |||
''The following table is automatically generated from disease/condition pages across WikEM.'' | |||
{{#ask:[[Has DrugName::Valacyclovir]] | |||
|?Treats disease=Disease | |||
|?Has Dose=Dose | |||
|?Has Context=Context | |||
|?Has Population=Population | |||
|format=table | |||
|headers=plain | |||
|mainlabel=- | |||
|sort=Treats disease | |||
|limit=50 | |||
}} | |||
==See Also== | ==See Also== | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:ID]] | |||
Latest revision as of 22:10, 20 March 2026
General
- Type: Antiviral, inhibits DNA polymerase
- Dosage Forms: 500, 1000
- Common Trade Names: Valtrex
Adult Dosing
HSV-1 / Herpes labialis
- Acute episode: 2g PO BID x 1 day
- Suppression (immunocompetent):
- >9 recurrences/year: 1g PO Qday
- <=9 recurrences/year: 500mg PO Qday
Genital HSV
- 1st episode: 1000mg PO BID x 7-10 days, start within 48-72 hour of symptoms
- recurrence: 500mg PO BID x 3 days, alternative: 1000mg PO qday x 5 days
Shingles
- 1000mg PO TID x 7 days
Pediatric Dosing
Genital HSV
- ≥12 yrs same as adult dosing for adolescents
Special Populations
- Pregnancy Rating: B
- Lactation: Excreted in breastmilk
- Renal Dosing
- CrCl <10 mL/min: 500 mg/day PO
- Hepatic Dosing: not defined
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- TTP, HUS (reported in advanced HIV and transplant patients)
- Acute renal failure (especially if elderly or underlying renal disease)
- Agitation, hallucinations, encephalopathy (higher risk in elderly)
Common
- Headache, dizziness
- Nausea/vomiting, abdominal pain
- Neutropenia, thrombocytopenia, leukopenia
- Elevated LFTs
- Nasopharyngitis
- Dysmenorrhea
- Depression
- Rash
- Alopecia
- EM
- Hypertension
- Tachycardia
- Tremor
- Visual disturbance
Pharmacology
- Half-life: 2-3.3hr
- Metabolism: Hepatic
- Excretion: Urinary
- Mechanism of Action: converted to acyclovir, which competes with deoxyguanosine triphosphate for viral DNA polymerase to inhibit DNA synthesis and viral replication
Indications by Disease
The following table is automatically generated from disease/condition pages across WikEM.
| Disease | Dose | Context | Population |
|---|---|---|---|
| Bell's palsy | 1000mg TID x1 week | Antiviral | Adult |
| Herpes Simplex Virus-2 | 1g PO q12hrs x 7-10 days | Initial Episode | Adult |
| Herpes Simplex Virus-2 | 500mg PO q12hrs x 3 days or 1g PO qd x 5 days | Recurrence | Adult |
| Herpes Simplex Virus-2 | 500mg-1g PO daily (500mg may be less effective) | Suppressive | Adult |
| Herpes gingivostomatitis | 2g PO q12h x 1 day | Normal host | Adult |
| Herpes gingivostomatitis | 500mg PO BID x 5-10 days | Immunocompromised | Adult |
| Herpes labialis | 2g PO q12h x 1 day | Normal host | Adult |
| Herpes labialis | 500mg PO BID x 5-10 days | Immunocompromised | Adult |