Valacyclovir

Valacyclovir is used to treat conditions caused by the herpes virus including shingles, chicken pox, cold sores and genital herpes. This medicine prevents the virus from multiplying.

Valacyclovir Overview

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Valacyclovir is a prescription medication used to treat conditions caused by the herpes virus including cold sores, shingles, genital herpes outbreaks, and chicken pox. Valacyclovir belongs to a group of drugs called antivirals which work by preventing the virus from multiplying.

This medication comes in tablet form and is taken one to three times daily, with or without food.

Common side effects of valacyclovir include headaches, nausea, stomach pains, and dizziness.

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Valacyclovir Cautionary Labels

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Uses of Valacyclovir

Valacyclovir is a prescription medicine used in adults:

  • to treat cold sores (also called fever blisters or herpes labialis)
  • to treat shingles (also called herpes zoster)
  • to treat or control genital herpes outbreaks in adults with normal immune systems
  • to control genital herpes outbreaks in adults infected with the human immunodeficiency virus (HIV) with CD4+ cell count greater than 100 cells/mm3
  • with safer sex practices to lower the chances of spreading genital herpes to others. Even with safer sex practices, it is still possible to spread genital herpes.

Valacyclovir is used in children:

  • to treat cold sores (for children aged greater than or equal to 12 years)
  • to treat chickenpox (for children aged 2 to less than 18 years).

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Valacyclovir Brand Names

Valacyclovir may be found in some form under the following brand names:

Valacyclovir Drug Class

Side Effects of Valacyclovir

Serious side effects may occur. See "Drug Precautions" section.

Common side effects of valacyclovir in adults include:

  • headache
  • nausea
  • stomach pain
  • vomiting
  • dizziness

Side effects in HIV-1-infected adults include:

  • headache
  • tiredness
  • rash

Other less common side effects in adults include:

  • painful periods in women
  • joint pain
  • depression
  • low blood cell counts
  • changes in tests that measure how well the liver and kidneys work

The most common side effect seen in children aged less than 18 years was headache.

Talk to your healthcare provider if you develop any side effects that concern you.

These are not all the side effects of valacyclovir. For more information ask your healthcare provider or pharmacist.

Valacyclovir Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Valacyclovir may affect other medicines, and other medicines may affect valacyclovir. However, at this time no clinically significant drug-drug or drug-food interactions with valacyclovir are known. It is a good idea to keep a complete list of all the medicines you take. Show this list to your healthcare provider and pharmacist any time you get a new medicine.

Valacyclovir Precautions

Kidney failure and nervous system problems are not common, but can be serious in some patients taking valacyclovir. 

  • Nervous system problems include aggressive behavior, unsteady movement, shaky movements, confusion, speech problems, hallucinations (seeing or hearing things that are really not there), seizures, and coma. Call your doctor right away if you get a nervous system problem while you are taking valacyclovir.
  • Kidney failure and nervous system problems have happened in patients who already have kidney disease and in elderly patients whose kidneys do not work well due to age. Always tell your healthcare provider if you have kidney problems before taking valacyclovir. 

Do not take valacyclovir if you are allergic to any of its ingredients or to acyclovir.

Valacyclovir Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of valacyclovir there are no specific foods that you must exclude from your diet when receiving valacyclovir.

Inform MD

Before taking valacyclovir, tell your healthcare provider about all your medical conditions, including:

  • if you have had a bone marrow transplant or kidney transplant, or if you have advanced HIV-1 disease or "AIDS". Patients with these conditions may have a higher chance for getting a blood disorder called thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS). TTP/HUS can result in death.
  • if you have kidney problems. Patients with kidney problems may have a higher chance for getting side effects or more kidney problems with valacyclovir. Your healthcare provider may give you a lower dose of valacyclovir.
  • if you are aged 65 years or older. Elderly patients have a higher chance of certain side effects. Also, elderly patients are more likely to have kidney problems. Your healthcare provider may give you a lower dose of valacyclovir.
  • if you are pregnant or breastfeeding
  • about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Valacyclovir may affect other medicines, and other medicines may affect valacyclovir. It is a good idea to keep a complete list of all the medicines you take. Show this list to your healthcare provider and pharmacist any time you get a new medicine.

Valacyclovir and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category B. There are no well-done studies that have been done in humans with valacyclovir. In animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Valacyclovir and Lactation

Tell your doctor if you are breastfeeding. Valacyclovir may pass into your milk and it may harm your baby. Talk with your healthcare provider about the best way to feed your baby if you are taking valacyclovir.

Valacyclovir Usage

Take valacyclovir exactly as prescribed by your healthcare provider. Your dose of valacyclovir and length of treatment will depend on the type of herpes infection that you have and any other medical problems that you have.

  • Do not stop valacyclovir or change your treatment without talking to your healthcare provider.
  • Valacyclovir can be taken with or without food.
  • If you are taking valacyclovir to treat cold sores, chickenpox, shingles, or genital herpes, you should start treatment as soon as possible after your symptoms start. Valacyclovir may not help you if you start treatment too late.
  • If you miss a dose of valacyclovir, take it as soon as you remember and then take your next dose at its regular time. However, if it is almost time for your next dose, do not take the missed dose. Wait and take the next dose at the regular time.
  • Do not take more than the prescribed number of valacyclovir tablets each day. Call your healthcare provider right away if you take too much valacyclovir.

Valacyclovir used daily with the following safer sex practices can lower the chances of passing genital herpes to your partner.

  • Do not have sexual contact with your partner when you have any symptom or outbreak of genital herpes.
  • Use a condom made of latex or polyurethane whenever you have sexual contact.

Valacyclovir can be compounded into a suspension if needed.

Valacyclovir Dosage

Take valacyclovir exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you.

Adult Dosing Recommendations:

Cold Sores (Herpes Labialis): The recommended dosage of valacyclovir for treatment of cold sores is 2 grams twice daily for 1 day taken 12 hours apart. Therapy should be initiated at the earliest symptom of a cold sore (e.g., tingling, itching, or burning).

Genital Herpes: Initial Episode: The recommended dosage of valacyclovir for treatment of initial genital herpes is 1 gram twice daily for 10 days. Therapy was most effective when administered within 48 hours of the onset of signs and symptoms.

Recurrent Episodes: The recommended dosage of valacyclovir for treatment of recurrent genital herpes is 500 mg twice daily for 3 days. Initiate treatment at the first sign or symptom of an episode.

Suppressive Therapy: The recommended dosage of valacyclovir for chronic suppressive therapy of recurrent genital herpes is 1 gram once daily in patients with normal immune function. In patients with a history of 9 or fewer recurrences per year, an alternative dose is 500 mg once daily.

In HIV-1 infected patients with a CD4+ cell count greater than or equal to 100 cells/mm3, the recommended dosage of valacyclovir for chronic suppressive therapy of recurrent genital herpes is 500 mg twice daily.

Reduction of Transmission: The recommended dosage of valacyclovir for reduction of transmission of genital herpes in patients with a history of 9 or fewer recurrences per year is 500 mg once daily for the source partner.

Herpes Zoster: The recommended dosage of valacyclovir for treatment of herpes zoster is 1 gram 3 times daily for 7 days. Therapy should be initiated at the earliest sign or symptom of herpes zoster and is most effective when started within 48 hours of the onset of rash.

Pediatric Dosing Recommendations:

Cold Sores (Herpes Labialis): The recommended dosage of valacyclovir for the treatment of cold sores in pediatric patients aged greater than or equal to 12 years is 2 grams twice daily for 1 day taken 12 hours apart. Therapy should be initiated at the earliest symptom of a cold sore (e.g., tingling, itching, or burning).

Chickenpox: The recommended dosage of valacyclovir for treatment of chickenpox in immunocompetent pediatric patients aged 2 to less than 18 years is 20 mg/kg administered 3 times daily for 5 days. The total dose should not exceed 1 gram 3 times daily. Therapy should be initiated at the earliest sign or symptom.

 

Valacyclovir Overdose

If you take too much valacyclovir, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If valacyclovir is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Other Requirements

  • Store valacyclovir tablets at room temperature, 59° to 77°F (15° to 25°C).
  • If your pharmacist compounded a valacyclovir suspension for you, store your medication between 2° to 8°C (36° to 46°F) in a refrigerator. Discard after 28 days.
  • Keep valacyclovir in a tightly closed container.
  • Do not keep medicine that is out of date or that you no longer need.
  • Keep valacyclovir and all medicines out of the reach of children.