Valacyclovir

General

• Type: DNA polymerase Inhibitor
• Dosage Forms: 500 mg, 1000 mg
• Common Trade Names: Valtrex

Adult Dosing

HSV-1

• Acute episode: 2000 mg PO BID x 1 day
• Suppression: 500 mg PO daily

Genital HSV

• 1st episode: 1000 mg PO BID x 7-10 days, start within 48-72 hour of symptoms
• Recurrence: 500 mg PO BID x 3 days, alternative: 1000 mg PO daily x 5 days

Herpes zoster

• 1000 mg PO TID x 7 days

Pediatric Dosing

Genital HSV

• Same as adult dosing for adolescents

Special Populations

• Pregnancy Rating: B
• Lactation: Safe
• Renal Dosing
  • Adult:
  • Pediatric
• Hepatic Dosing
  • Adult: Not defined
  • Pediatric: Not defined

Contraindications

• Allergy to class/drug
• Caution with any renal impairment
• Caution with geriatric patients and reduced GFR

Adverse Reactions

Serious

• Acute renal failure
• Thrombocytopenia
• Aplastic anemia
• Delirium
• Psychosis
• Seizures

Common

• Nausea/vomiting
• Headache
• Abdominal pain
• Depression
• Elevated LFT's
• Fatigue

Pharmacology

• Half-life: < 30 minutes
• Metabolism: GI tract, liver
• Excretion: feces, urine
• Mechanism of Action: DNA polymerase Inhibitor