Valtrex: Effective Antiviral Treatment for Herpes Outbreaks
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| Product dosage: 500mg | |||
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Synonyms | |||
Valtrex (valacyclovir hydrochloride) is a prescription antiviral medication specifically formulated to manage herpes virus infections. As a prodrug of acyclovir, it offers enhanced bioavailability and more convenient dosing compared to earlier antiviral treatments. This medication works by inhibiting viral DNA replication, effectively reducing the severity and duration of outbreaks while decreasing transmission risk. Clinical evidence supports its use for episodic treatment and chronic suppression across multiple herpesvirus indications.
Features
- Active ingredient: Valacyclovir hydrochloride (prodrug converted to acyclovir)
- Standard tablet formulation: 500 mg and 1000 mg strengths
- High oral bioavailability (54%) compared to acyclovir (10-20%)
- Rapid conversion to active compound acyclovir following administration
- FDA-approved for herpes zoster, genital herpes, and cold sores
- Demonstrated efficacy in reducing viral shedding
- Convenient twice or once-daily dosing regimens
- Available as film-coated tablets for easier swallowing
Benefits
- Significantly reduces healing time for active herpes outbreaks
- Decreases the frequency of recurrent genital herpes episodes
- Lowers risk of transmission to sexual partners when used daily
- Provides symptomatic relief from pain and discomfort
- Minimizes the development of new lesions during treatment
- Supports improved quality of life through outbreak management
Common use
Valtrex is primarily indicated for the treatment of herpes zoster (shingles) in immunocompetent adults, the treatment and suppression of recurrent genital herpes in immunocompetent and HIV-infected adults, and the treatment of herpes labialis (cold sores) in immunocompetent adults and adolescents. Off-label uses include suppression of recurrent herpes labialis, treatment of Epstein-Barr virus infections in immunocompromised patients, and cytomegalovirus prophylaxis in transplant recipients. The medication is particularly valuable for patients experiencing frequent recurrences or those wishing to reduce transmission risk to partners.
Dosage and direction
For herpes zoster: 1000 mg three times daily for 7 days, initiated within 48 hours of rash appearance. For genital herpes treatment: 1000 mg twice daily for 10 days for initial episodes or 500 mg twice daily for 3 days for recurrent episodes. For suppression: 1000 mg once daily or 500 mg once daily in patients with fewer than 10 recurrences per year. For cold sores: 2000 mg twice daily for 1 day, with doses approximately 12 hours apart. All doses should be taken with adequate water to ensure proper renal clearance. Dosage adjustments are required for patients with renal impairment based on creatinine clearance.
Precautions
Patients should maintain adequate hydration during therapy to prevent crystalluria and nephrotoxicity. Renal function should be assessed before initiation and during treatment, particularly in elderly patients or those with pre-existing renal impairment. Use with caution in patients receiving nephrotoxic drugs concurrently. Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome has been reported in immunocompromised patients receiving higher doses. Patients should avoid sexual contact during outbreaks even while taking medication to prevent transmission. Sun protection is recommended as sunlight can trigger herpes outbreaks.
Contraindications
Valtrex is contraindicated in patients with known hypersensitivity to valacyclovir, acyclovir, or any component of the formulation. Should not be administered to patients with demonstrated clinically significant hypersensitivity reactions to previous antiviral medications. Contraindicated in patients with severe renal impairment (creatinine clearance <15 mL/min) without appropriate dosage adjustment. Not recommended for use in patients with advanced HIV disease or bone marrow transplant recipients without close monitoring due to increased risk of thrombotic microangiopathy.
Possible side effects
Common adverse reactions (>1%) include headache (13-38%), nausea (5-15%), vomiting (less than 5%), diarrhea (less than 5%), dizziness (2-4%), and abdominal pain (1-3%). Less frequent side effects include fatigue, rash, arthralgia, and photosensitivity reactions. Serious adverse effects include neurological symptoms (agitation, hallucinations, confusion, seizures), particularly in elderly patients and those with renal impairment. Hematological abnormalities including thrombocytopenia, leukopenia, and anemia have been reported. Renal impairment ranging from elevated creatinine to acute renal failure may occur, especially with dehydration or pre-existing renal disease.
Drug interaction
Probenecid and cimetidine reduce the renal clearance of acyclovir, potentially increasing blood levels and toxicity risk. Concurrent use with other nephrotoxic drugs (aminoglycosides, cyclosporine, NSAIDs) may increase the risk of renal dysfunction. No clinically significant interactions have been observed with antacids, cimetidine, or warfarin. Caution is advised when administering with drugs that compete for renal tubular secretion. Monitoring is recommended when used concomitantly with medications that affect renal function.
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Resume the regular dosing schedule. For twice-daily regimens, if remembered within 6 hours of the missed dose, take immediately. For once-daily regimens, if remembered within 12 hours, take immediately. Consistent dosing is important for maintaining therapeutic levels, particularly during outbreak treatment.
Overdose
Overdose may lead to renal impairment with elevated BUN and serum creatinine, potentially progressing to acute renal failure. Neurological symptoms including agitation, hallucinations, confusion, and seizures have been reported. Management includes supportive care and adequate hydration to promote drug elimination. Hemodialysis significantly enhances acyclovir removal (approximately 60% reduction in plasma concentrations during a 4-hour dialysis session). Patients should be monitored for at least 48 hours post-overdose, with particular attention to renal and neurological status.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) with excursions permitted between 15-30°C (59-86°F). Keep in original container with lid tightly closed to protect from moisture and light. Do not store in bathroom or other humid areas. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Tablets should be protected from excessive heat and moisture to maintain stability and efficacy.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting any new medication. Individual response to treatment may vary based on medical history, concomitant conditions, and other factors. Proper diagnosis by a healthcare provider is essential before initiating therapy. Not all possible uses, precautions, side effects, or interactions are listed here. Report any adverse reactions to your healthcare provider promptly.
Reviews
Clinical studies demonstrate Valtrex reduces median time to healing by 1-2 days compared to placebo in herpes zoster patients. In genital herpes suppression trials, 69-81% of patients remained recurrence-free during 6-12 months of therapy versus 9-45% with placebo. Patient-reported outcomes indicate significant improvement in quality of life measures, particularly reduction in pain and emotional distress associated with outbreaks. Healthcare providers consistently rate Valtrex as effective and well-tolerated for appropriate patient populations when used according to prescribing guidelines.