II. Indications
- Herpes Zoster (Shingles)
- Genital Herpes (initial, recurrent or prophylaxis)
- Herpes Labialis (Oral Herpes)
III. Mechanism
- See Acyclovir
IV. Dosing
-
Herpes Labialis (Cold Sores)
- Adults (and age >12 years): 2 grams orally every 12 hours for 1 day (2 doses)
-
Herpes Zoster (Shingles)
- Adult: 1 gram orally three times daily for 7 days
-
Genital Herpes
- Initial: 1 gram orally twice daily for 10 days
- Recurrent
- Take 500 mg orally twice daily for 3 days (FDA approved) OR
- Take 1000 mg orally daily for 5 days (off label)
- Prophylaxis (for up to 1 year)
- Immunocompetent (<9 episodes/year): 500 mg orally daily
- Immunocompetent (9 or more per year): 1000 mg orally daily
- HIV with CD4>100: 500 mg orally twice daily
-
Chicken Pox (immunocompetent)
- Age 2 to 12 years: 20 mg/kg/dose (max 1000 mg) orally three times daily for 5 days
-
Renal Dosing
- Reduce dose if eGFR <50 ml/min
V. Adverse Effects
- Nausea or Vomiting
- Headache
- Dizziness
-
Thrombotic Thrombocytopenic Purpura (rare)
- Has been associated with very high doses (8 g/day)
VI. Safety
- Pregnancy Category B
- Considered safe in Lactation
VII. Resources
VIII. References
Images: Related links to external sites (from Bing)
Related Studies
| valacyclovir (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| VALACYCLOVIR HCL 1 GRAM TABLET | Generic | $0.51 each |
| VALACYCLOVIR HCL 500 MG TABLET | Generic | $0.28 each |
| valtrex (on 9/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| VALTREX 1 GM CAPLET | Generic | $0.51 each |
| VALTREX 500 MG CAPLET | Generic | $0.28 each |