Monday, September 19, 2022

Valacyclovir Dosage For Genital Herpes

Can You Take Famciclovir Daily

Valacyclovir Tablets for herpes infections

Yes, famciclovir can be taken daily for herpes suppression, to lower the risk of genital herpes or shingles outbreaks.

You may be prescribed 250 mg of the medicine to be taken twice a day for 12 months.

Suppression therapy is also advised during pregnancy to avoid viral shedding and transmission of HSV infection to the baby.

Studies have shown that famciclovir is safe when administered over a period of 1 year. Speak to your doctor if you plan to take famciclovir for longer than 52 weeks.

Important: How To Use This Information

This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Patients With Renal Impairment

Dosage recommendations for adult patients with reduced renal function are provided in Table 1. Data are not available for the use of VALTREX in pediatric patients with a creatinine clearance less than 50 mL/min/1.73 m2.

Table 1. VALTREX Dosage Recommendations for Adults with Renal Impairment

Indications

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Us Food And Drug Administration

Herpes Simplex Infections

VACV is indicated for the treatment of both genital and orofacial HSV infections. For first-episode genital HSV, VACV 1000 mg twice daily for 10 days is recommended.1 Head-to-head comparison of VACV 1000 mg twice daily and ACV 200 mg 5 times daily found no difference between the two in terms of safety and efficacy in the initial, episodic, and suppressive treatment of genital herpes.20,21 The twice-daily regimen of VACV is also more convenient for patients, which leads to potentially greater patient compliance. For episodic treatment of recurrent genital HSV, VACV is dosed at 500 mg twice daily for 3 to 5 days.21 Continuous therapy with 500 mg daily for suppression of recurrent genital HSV is approved for people with nine or fewer episodes yearly as with ACV there needs to be flexibility in aforementioned guidelines. Alternatively, patients with 10 or more episodes yearly may require 1000 mg daily or 500 mg twice daily. Daily use of VACV also reduces HSV transmission by reducing asymptomatic HSV shedding. In a study, high-dose ACV was associated with less frequent shedding compared with standard-dose VACV , but the number of episodes per person-year did not differ significantly.22 In another study, it was discovered that patients with newly diagnosed HSV-2 infection had a 78% reduction in viral shedding with VACV 1000 mg daily compared with placebo.23

Herpes Zoster

Diane Hanfelt-Goade, in, 2010

What Conditions Do Acyclovir And Valacyclovir Treat

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Acyclovir and valacyclovir are both used for the following indications:

  • Treatment of chickenpox

Additionally, the acyclovir injection can be used to treat:

  • Herpes of the brain in children and adults
  • Herpes infection in newborn babies

Acyclovir and valacyclovir do not cure cold sores, herpes, or shingles. However, they relieve the symptoms of the outbreaks and help the lesions heal faster.

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Clinical Trials Experience In Adult Patients

Table 2. Incidence of Laboratory Abnormalities in Herpes Zoster and Genital Herpes Study Populations

a Data were not collected prospectively. LLN = Lower limit of normal. ULN = Upper limit of normal.
Laboratory Abnormality

Hematologic: Thrombocytopenia, aplastic anemia, leukocytoclastic vasculitis, TTP/HUS .Skin: Erythema multiforme, rashes including photosensitivity, alopecia.

Interactions With Other Medicines And Other Forms Of Interactions

The combination of valaciclovir with nephrotoxic medicinal products should be made with caution, especially in subjects with impaired renal function, and warrants regular monitoring of renal function. This applies to concomitant administration with aminoglycosides, organoplatinum compounds, iodinated contrast media, methotrexate, pentamidine, foscarnet, ciclosporin, and tacrolimus.Aciclovir is eliminated primarily unchanged in the urine via active renal tubular secretion. Any drugs administered concurrently that compete with this mechanism may increase aciclovir plasma concentrations following valaciclovir administration.Following 1 g valaciclovir, cimetidine and probenecid increase the AUC of aciclovir by this mechanism, and reduce aciclovir renal clearance. However, no dosage adjustment is necessary at this dose because of the wide therapeutic index of aciclovir.In patients receiving high dose valaciclovir for CMV prophylaxis, caution is required during concurrent administration with drugs which compete with aciclovir for elimination, because of the potential for increased plasma levels of one or both drugs or their metabolites. Increases in plasma AUCs of aciclovir and of the inactive metabolite of mycophenolate mofetil, an immunosuppressant agent used in transplant patients, have been shown when the drugs are coadministered.Care is also required if administering high dose valaciclovir with drugs which affect other aspects of renal physiology .

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Which Is Better Acyclovir Or Valacyclovir

The choice between acyclovir and valacyclovir depends on a few factors, including side effects and how often you take the medication. Acyclovir and valacyclovir are equally effective. However, you are more likely to follow your medication regimen if you only need to take medicine once or twice a day versus five times per day.

On the other hand, acyclovir is available as an oral suspension and tablets that dissolve under the tongue. These formulations are easier to use with children or people who have trouble swallowing pills.

Acyclovir is also available as a cream and an ointment. These topical formulations may be applied directly to cold sores or herpes lesions.

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Extemporaneous Preparation Of Oral Suspension

Natural formula for genital herpes: frequency results-video abstract_SUB ID_112852

Ingredients and Preparation per USPNF

VALTREX tablets 500 mg, cherry flavor, and Suspension Structured Vehicle USP-NF . Valacyclovir oral suspension should be prepared in lots of 100 mL.

Instructions for Preparing Suspension at Time of Dispensing

Transfer the suspension to an amber glass medicine bottle with a child-resistant closure.
The prepared suspension should be labeled with the following information Shake well before using. Store suspension between 2°C to 8°C in a refrigerator. Discard after 28 days.

*The amount of cherry flavor added is as instructed by the suppliers of the cherry flavor.

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What Should I Discuss With My Healthcare Provider Before Taking Valacyclovir

You should not use this medicine if you are allergic to valacyclovir or acyclovir .

Tell your doctor if you have ever had:

  • a kidney transplant or bone marrow transplant.

Tell your doctor if you are pregnant or plan to become pregnant. Herpes can be passed to your baby during childbirth if you have a genital lesion when your baby is born. If you have genital herpes, it is very important to prevent herpes lesions during pregnancy. Take your medicine as directed to best control your infection.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Do not give this medicine to a child without medical advice.

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.

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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.

Carcinogenesis Mutagenesis Impairment Of Fertility

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The data presented below include references to the steady-state acyclovir AUC observed in humans treated with 1 gram valacyclovir hydrochloride given orally 3 times a day to treat herpes zoster. Plasma drug concentrations in animal studies are expressed as multiples of human exposure to acyclovir .Valacyclovir was noncarcinogenic in lifetime carcinogenicity bioassays at single daily doses of valacyclovir giving plasma acyclovir concentrations equivalent to human levels in the mouse bioassay and 1.4 to 2.3 times human levels in the rat bioassay. There was no significant difference in the incidence of tumors between treated and control animals, nor did valacyclovir shorten the latency of tumors.Valacyclovir was tested in 5 genetic toxicity assays. An Ames assay was negative in the absence or presence of metabolic activation. Also negative were an in vitro cytogenetic study with human lymphocytes and a rat cytogenetic study.In the mouse lymphoma assay, valacyclovir was not mutagenic in the absence of metabolic activation. In the presence of metabolic activation , valacyclovir was mutagenic.Valacyclovir was mutagenic in a mouse micronucleus assay.Valacyclovir did not impair fertility or reproduction in rats at 6 times human plasma levels.

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Central Nervous System Effects

Central nervous system adverse reactions, including agitation, hallucinations, confusion, delirium, seizures, and encephalopathy, have been reported both adult and pediatric patients with or without reduced renal function and in patients with underlying renal disease who received higher than recommended doses of valacyclovir hydrochloride for their level of renal function. Elderly patients are more likely to have central nervous system adverse reactions. Valacyclovir hydrochloride should be discontinued if central nervous system adverse reactions occur . Central nervous system adverse reactions, including agitation, hallucinations, confusion, delirium, seizures, and encephalopathy, have been reported in both adult and pediatric patients with or without reduced renal function and in patients with underlying renal disease who received higher than recommended doses of valacyclovir hydrochloride for their level of renal function. Elderly patients are more likely to have central nervous system adverse reactions. Valacyclovir hydrochloride should be discontinued if central nervous system adverse reactions occur .

Common Side Effects Of Valtrex

Taking Valtrex may cause side effects, such as:

Its unknown whether Valtrex causes other adverse effects like hair loss, weight gain, dry mouth, or any other symptoms not listed by the United States Food and Drug Administration . This is not a complete list of side effects. Other side effects may occur. Consult your healthcare provider if you have questions about side effects of Valtrex.

A frequently asked question about Valtrex is whether it will make you urinate more often. It wont necessarily make you pee more, but you should drink plenty of water while taking Valtrex to help the kidneys process it as best they can. Therefore, this extra hydration can result in frequent urination.

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If You Forget To Take Them

For prevention of CMV infection and disease, the treatment of shingles or the treatment of herpes simplex If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Otherwise, take it as soon as you remember, then go back to taking it as you would normally.

For the treatment of cold soresTake the second dose as soon as possible once 12 hours have passed.

Do not take a double dose to make up for the dose that you missed.

If you miss more than one dose, or you are not sure what to do ask your doctor or pharmacist.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

What Valtrex Tablets Look Like

Acyclovir – Mechanism of Action, Indications, and Side Effects

Valtrex 500 mg tabletsWhite, film coated tablet, white to off-white core, biconvex, elongated, unscored engraved with “500” on one side and plain on the other. AUST R 73917. AUST R 73918.

Available in a pack size of 10, 30, 42 and 100 tablets.

Valtrex 1000 mg tabletsWhite, film coated tablet, white to off-white core, biconvex, elongated, unscored engraved with “1000” on one side and plain on the other. AUST R 73920.

Available in a pack size of 4 tablets.

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How Should This Medicine Be Used

Valacyclovir comes as a tablet to take by mouth. It is usually taken every 8 hours for 7 days to treat shingles. To treat genital herpes it is usually taken twice a day for 5 days. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take valacyclovir exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Use this medication as soon as possible after symptoms appear.

Continue to take valacyclovir even if you feel well. Do not stop taking valacyclovir without talking to your doctor.

How Supplied/storage And Handling

Valacyclovir Tablets USP, 500 mg are blue, film-coated, capsule shaped tablets with F 82 on one side and plain on the otherside. Bottles of 30 NDC 65862-448-30 Bottles of 90 NDC 65862-448-90 Bottles of 100 NDC 65862-448-01 Bottles of 500 NDC 65862-448-05 Bottles of 3,500 NDC 65862-448-35 10 x 10 Unit-dose Tablets NDC 65862-448-10 Valacyclovir Tablets USP, 1 gram are

blue, film-coated, capsule shaped tablets with a partial scorebar on both sides containing F on one side and 8 and 3 on the otherside. Bottles of 30 NDC 65862-449-30 Bottles of 90 NDC 65862-449-90 Bottles of 100 NDC 65862-449-01 Bottles of 500 NDC 65862-449-05 Bottles of 1,500 NDC 65862-449-15 Store at 20o to 25oC . Dispense in a well-closed container as defined in the USP.

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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 Herpes And Other Conditions

Valacyclovir For Genital Herpes

Let’s be real, cold sores are uncomfortable and embarrassing. And while they’re not usually painful, they can be, and they’re unsightly. And they’re contagious, which means you can spread them to others, which you want to avoid. So what can you do?

Cold sores are caused by the herpes simplex virus . This virus is present in millions of people’s bodies and is usually harmless. But it can be triggered to outbreak by a variety of factors, including stress, illness, sun exposure, fever, and menstrual cycle. While the virus is active, it reproduces in the skin, tingling, and itching before it erupts in a painful and unsightly blister.

When cold sores erupt, they’re often painful and can last up to 10 days, although a majority of outbreaks last 5-7 days. While they’re painful, they’re also contagious. They can be spread when the sores are active, and even after they’re healed because the virus is present in the body’s mucus membranes .

The good news is that it’s possible to control your outbreaks with the right treatment.

While there’s no cure for herpes, there are a number of antiviral medications available that can help you manage your outbreaks and keep your outbreaks from developing into full-blown cold sores.

The most common medication prescribed for HSV-1 is Valacyclovir, or Valtrex.

What is Valacyclovir?

Because Valacyclovir works to slow the replication of the HSV-1 virus, it can help to reduce the symptoms of a cold sore outbreak.

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When Treatments For Genital Herpes Are Given

  • Initial treatment. If you have symptoms such as sores when youre first diagnosed with genital herpes, your doctor will usually give you a brief course of antiviral therapy to relieve them or prevent them from getting worse. Your doctor may keep you on the drugs longer if the sores dont heal in that time.

After the first treatment, work with your doctor to come up with the best way to take antiviral therapies. There are two options:

  • Intermittent treatment. Your doctor may prescribe an antiviral drug for you to keep on hand in case you have another flare-up this is called intermittent therapy. You can take the pills for two to five days as soon as you notice sores or when you feel an outbreak coming on. Sores will heal and disappear on their own, but taking the drugs can make the symptoms less severe and make them go away faster.
  • Suppressive treatment. If you have outbreaks often, you may want to consider taking an antiviral drug every day. Doctors call this suppressive therapy. For someone who has more than six outbreaks a year, suppressive therapy can reduce the number of outbreaks by 70% to 80%. Many people who take the antiviral drugs daily have no outbreaks at all.

There is no set number of outbreaks per year that doctors use to decide when someone should start suppressive therapy. Rather, more important factors are how often the outbreaks happen and if they are severe enough to interfere with your life.

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