Using Valacyclovir To Treat A Primary Outbreak Of Genital Herpes
Valacyclovir can be extremely helpful for treating an initial herpes outbreak. Used early, it acts to suppress the virus and prevent it from multiplying, providing relief from the physical symptoms of a herpes outbreak and helping you recover faster.
Because primary herpes outbreaks tend to be the most intense experience infected people will have with the virus, treatment involves a relatively high dose of valacyclovir.
The standard dose of valacyclovir for an initial outbreak of genital herpes is 1,000 mg twice a day. This is typically continued over a 10-day period to continually suppress the virus and help the lesions caused by the viral infection to close and heal.
If you believe you may experiencing the first signs of a genital herpes outbreak, its important to see your doctor as soon as possible about treatment options. Valacyclovir is most effective if its taken as early as possible during an outbreak.
Your doctor may also recommend the use of pain relief medication to manage the other physical symptoms of a primary herpes outbreak.
Warnings For People With Certain Health Conditions
For people with kidney problems: Your kidneys clear this drug from your body. If you have kidney problems or a history of kidney disease, you may not be able to clear it from your body. This may increase the levels of the drug in your body and cause more side effects. This drug can also make your kidney function worse. To help prevent these problems, your doctor may prescribe a lower dosage of this drug for you.
For people with advanced HIV or a history of transplant: If you have advanced HIV or a history of bone marrow or kidney transplant, you may be at a higher risk of certain blood disorders. These conditions are called thrombocytopenic purpura and hemolytic uremic syndrome . They can result in severely low red blood cells and platelets in your body. TTP or HUS can cause death.
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Valacyclovir Dosage For Cold Sores
Oral herpes is the most common form of the herpes virus, affecting approximately two thirds of all people aged 14 to 49.
Valacyclovir is highly effective at treating oral herpes. Taken early in the formation of a cold sore, repeated use of valacyclovir over the course of one day can reduce the amount of time required for a cold sore to heal.
The typical dose of valacyclovir used to treat cold sores is 2,000 mg, with a secondary dose of 2,000 mg within 12 hours. This repeated, high dose of valacyclovir quickly ends viral replication and allows cold sores to heal one to two days faster than normal.
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How To Use Valtrex
Read the Patient Information Leaflet if available from your pharmacist before you start taking valacyclovir and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take valacyclovir by mouth, with or without food, as directed by your doctor. Drink plenty of fluids while taking this medication to lower the chance of side effects.
The dosage and length of treatment are based on your type of infection, medical condition, and response to treatment. For treating chickenpox in children, the dosage is also based on weight.
This medication works best when started at the first sign of an outbreak, as directed by your doctor. It may not work as well if you delay treatment. For shingles or chickenpox, start taking valacyclovir at the first symptom or as soon as possible after the rash appears. For cold sores or genital herpes, start taking this medication at the first sign or as soon as you feel tingling, itching, or burning.
Valacyclovir works best when the amount of medicine in your body is kept at a constant level. Take this drug at evenly spaced intervals. To help you remember, take it at the same time each day.
Continue to take this medication until the full prescribed amount is finished. Do not change your dose, skip any doses, or stop this medication early without your doctors approval.
Tell your doctor if your condition persists or worsens.
What Other Drugs Will Affect Valtrex
Valtrex can harm your kidneys. This risk may increase when you also use certain other medicines, including: antivirals, chemotherapy, certain antibiotics, medicine for bowel disorders, medicine for high blood pressure, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines . Ask your pharmacist if you are concerned you are taking other medications that may harm your kidneys.
Other drugs may interact with valacyclovir, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
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History Of Present Illness:
A 36-year-old female presented to the Emergency Treatment Center of the University of Iowa Hospitals and Clinics with one day of right eye pain, photophobia and decreased vision. There was no history of trauma. The ETC physician performed fluorescein staining and made a diagnosis of a corneal abrasion. The patient was treated with topical trimethoprim-polymyxin four times daily and oral acetaminophen-hydrocodone 10/500 as needed for pain relief. She was instructed to follow-up with her eye care provider the next day if symptoms did not improve or resolve.
The following day, her symptoms did not resolve and was therefore referred to the UIHC Cornea service for further evaluation.
Treating Cold Sores With Valtrex
Cold sores typically start to heal on their own within about four to six days. Although, the first cold sore you get will likely last longer.
Most people dont require treatment for their cold sores, but, in some cases, a doctor may prescribe an antiviral medication such as Valtrex. This may be because you get cold sores often or if youre at high risk of serious complications, such as from a weakened immune system.
To treat a cold sore, you take Valtrex on the day you notice a cold sore forming. Valtrex works by preventing the herpes virus from growing and spreading.
Your doctor may also prescribe Valtrex to help prevent future cold sores, which is an off-label use. In that case, you and your doctor would work together to create the best treatment plan for you.
Valtrex is an oral caplet. It comes in 500-milligram and 1-gram strengths. Its available as a brand-name product as well as a generic medication . The generic product is an oral tablet which comes in the same strengths.
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Usual Adult Dose For Herpes Simplex
Treatment of First Episode of Genital Herpes:200 mg orally every 4 hours 5 times a day for 10 days 400 mg orally 3 times a day for 5 to 10 days Severe Disease or Complications Requiring Hospitalization:5 mg/kg IV every 8 hours for 5 days 5 to 10 mg/kg IV every 8 hours for 2 to 7 days or until clinical improvement is observed, followed by oral antiviral therapy to complete at least 10 days of total therapy Episodic Therapy: Effective treatment requires therapy initiation within 1 day of lesion onset or during the prodrome preceding an episode/recurrence200 mg orally every 4 hours 5 times a day for 5 days 400 mg orally 3 times a day for 5 days OR 800 mg orally 2 times a day for 5 days OR 800 mg orally 3 times a day for 2 days
How Supplied/storage And Handling
Valtrex tablets containing 556.2 mg of valacyclovir hydrochloride equivalent to 500 mg valacyclovir.
Bottle of 30 .
Bottle of 90 .
Valtrex tablets containing 1.112 grams of valacyclovir hydrochloride equivalent to 1 gram of valacyclovir.
Bottle of 30 .
Bottle of 90 .
Storage:
Store at 15°C to 25°C . Dispense in a well-closed container as defined in the USP.
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What Is In This Leaflet
This leaflet answers some common questions about Valtrex tablets. It does not contain all of the available information.
It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking Valtrex tablets against the benefits this medicine is expected to have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
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What Are The Side Effects Of Valtrex
This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.
Valtrex can cause several side effects, most of which are not dangerous. However, some serious side effects can occur.
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Suppressive Therapy For Recurrent Hsv
Suppressive therapy reduces frequency of genital herpes recurrences by 70%80% among patients who have frequent recurrences . Persons receiving such therapy often report having experienced no symptomatic outbreaks. Suppressive therapy also is effective for patients with less frequent recurrences. Long-term safety and efficacy have been documented among patients receiving daily acyclovir, valacyclovir, and famciclovir . Quality of life is improved for many patients with frequent recurrences who receive suppressive therapy rather than episodic treatment . Providers should discuss with patients on an annual basis whether they want to continue suppressive therapy because frequency of genital HSV-2 recurrence diminishes over time for many persons. However, neither treatment discontinuation nor laboratory monitoring is necessary because adverse events and development of HSV antiviral resistance related to long-term antiviral use are uncommon.
Valacyclovir 500 mg orally 2 times/day for 3 daysOR
Valacyclovir 1 gm orally once daily for 5 days
*Acyclovir 400 mg orally 3 times/day is also effective, but are not recommended because of frequency of dosing.
Treatment Of Primary Infection
Antiviral therapy is recommended for an initial genital herpes outbreak, especially if the patient has systemic symptoms or is immunocompromised.2 Oral acyclovir is effective in reducing symptoms1. Intravenous administration may be required in immunocompromised patients and those with severe disseminated infection.1 Topical acyclovir reduces the duration of viral shedding and the length of time before all lesions become crusted, but this treatment is much less effective than oral or intravenous acyclovir.1
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How To Take Valtrex Tablets
Take Valtrex tablets exactly as your doctor has prescribed. Your doctor or pharmacist will tell you:
- how many tablets to take at each dose
- how many doses to take each day
- when to take your doses each day.
The label on the pack will give the same information. If there is something you do not understand, ask your doctor or pharmacist.
Prevention And/or Blocking Of Cold Sores
Increases in the proportion of subjects in whom cold sore lesion development was prevented and/or blocked were observed with both treatment regimens when compared to placebo .4). In study 1, a greater proportion of subjects experienced prevention and/or blockage of cold sore lesions than those in the placebo group, but the treatment differences were not statistically significant at the two-sided 5% level. In study 2, a greater proportion of subjects in both treatment groups experienced prevention and/or blockage of cold sore lesions than those in the placebo group . However, after adjustment for multiple comparisons, neither treatment difference was statistically significant at the 5% level. Figure Figure22 shows the difference in proportion of subjects in whom cold sore lesion development was prevented and/or blocked for the 1- and 2-day valacyclovir treatment regimens in each study.
Plot of the difference in proportion of subjects in whom cold sore lesion development was prevented and/or blocked with 1-day treatment and 2-day treatment from placebo within each study. 95% CI, 95% confidence interval.
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How To Take Valtrex
Valtrex is a tablet that should be swallowed. You can take Valtrex with or without food. It is important to stay hydrated when using Valtrex.
If you are taking Valtrex for cold sores, chicken pox, shingles, or genital herpes, start treatment as soon as possible after your symptoms start. Initial signs of infection may include tingling, itching, or burning, or when the sore appears.
When You Must Not Take Them
- Do not take Valtrex tablets if you have ever had an allergic reaction to valaciclovir, aciclovir or any of the ingredients listed at the end of this leaflet.
- Symptoms of an allergic reaction may be mild or severe. They usually include some or all of the following: wheezing, swelling of the lips/mouth, difficulty in breathing, hay fever, lumpy rash or fainting.
- Do not take Valtrex tablets if you are pregnant, trying to become pregnant or breast-feeding, unless your doctor says you should.
- Your doctor will discuss the risks and benefits of using Valtrex tablets when pregnant and during breast-feeding.
- Do not take Valtrex tablets after the expiry date printed on the pack.
- If you take it after the expiry date has passed, it may not work as well.
- Do not take Valtrex tablets if the packaging is torn or shows signs of tampering.
- If you are not sure whether you should be taking Valtrex, talk to your doctor.
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Dosage For Genital Herpes
Adult dosage
- First episode: 1 g, taken twice per day for 10 days. This drug works best if its started within 48 hours of when the first symptom appears.
- Repeating episodes: 500 mg, taken twice per day for 3 days. Treatment should be started when the first symptom appears.
- For preventing flare-ups in people with a normal immune system: 500 mg to 1 g, taken once per day.
- For preventing flare-ups in people with HIV: 500 mg, taken twice per day.
- For reducing the risk of transmission to a sexual partner: 500 mg, taken once per day.
Child dosage
This drug has not been studied for the treatment of genital herpes in children younger than 18 years.
Senior dosage
The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.
Your doctor may start you on a lowered dosage or a different treatment schedule. This can help keep levels of this drug from building up too much in your body.
Dosage Forms And Strengths
Tablets:
- 500-mg: Each blue, filmcoated, capsuleshaped tablet printed with Valtrex 500 mg contains 556.2 mg of valacyclovir hydrochloride equivalent to 500 mg of the free base.
- 1-gram: Each blue, filmcoated, capsuleshaped tablet, with a partial scorebar on both sides, printed with Valtrex 1 gram contains 1.112 grams of valacyclovir hydrochloride equivalent to 1 gram of the free base.
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Valacyclovir Dosage For Cold Sores And Genital Herpes
Medically reviewed by Kristin Hall, FNP
Valacyclovir , is one of the most common medications used to treat the herpes simplex virus. Used regularly by millions of people worldwide, its a safe, highly effective drug that can control from herpes outbreaks and reduce the risk of spreading the virus.
Like other drugs used to treat herpes, valacyclovir is an antiviral medication. It works through a complex mechanism that stops the herpes virus from replicating further within the body, making it useful for a variety of herpes-related conditions.
Valacyclovir is used to treat HSV-1 and HSV-2, as well as the varicella zoster virus . Because of its antiviral properties, its also used to prevent cytomegalovirus and to limit the effects of viruses in people with weakened immune systems, such as cancer patients.
Below, weve listed common valacyclovir dosages for a variety of conditions, such as outbreaks of oral or genital herpes. The dosage information provided below is for adults — for children, you should consult your doctor, who will provide dosing recommendations based on your childs age, weight and health.
Note: If you have been prescribed valacyclovir by your doctor to treat any condition, follow the dose and frequency they recommend. The information below is provided as a reference only — you should always follow your doctors advice when using any prescription medication.
What Medications Are Similar
There are several antiviral medications that are similar to Valtrex but do not have identical approved indications. These include:
- Sitavig and Zovirax : This medication is available as a tablet or a liquid to be swallowed. It is also available in an injectable form to be used for severe HSV infections, including HSV encephalitis . It is also available as a cream for the treatment of cold sores.
- Famvir : This is available as a tablet for the treatment of cold sores, genital herpes, and shingles.
Many other antiviral medications are used for treating different infections. For example, Epivir and Viread are used to treat HIV. Baraclude is used to treat hepatitis B.
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What Is Valtrex Used For
The Food and Drug Administration approved Valtrex for the following indications:
- Genital herpes, usually caused by herpes simplex virus 2
- Prevention of transmission of HSV
- Suppression of HSV
- Suppression of HSV for people who are immunosuppressed due to human immunodeficiency virus
- Shingles, which is caused by reactivation of varicella zoster and produces a painful rash
The dosing of Valtrex differs for children and adults and is based on weight for the treatment of chicken pox. Valtrex is used short term for the treatment of chicken pox, shingles, and cold sores.
It can also be used for the short-term treatment of genital herpes or long term to suppress the virus and prevent transmission to a partner. However, it is important to remember that Valtrex will not cure your herpes infection completely.
Verywell / Dennis Madamba