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Brand name: valtrex

Generic name: valacyclovir
valacyclovir hydrochloride
(val ah sye' kloe ver)
Valtrex Valacyclovir
Pregnancy Category B
Drug class
Antiviral
Therapeutic actions
Antiviral activity; inhibits viral DNA replication and deactivates viral DNA polymerase.
Indications Valtrex Valacyclovir
· Treatment of herpes zoster (shingles)
· Episodic treatment of first-episode or recurrent genital herpes in immunocompetent patients
· Suppression of recurrent episodes of genital herpes in HIV patients
· Reduction of risk of heterosexual transmission of genital herpes to healthy partners when combined with safe sex practices
· Treatment of cold sores (herpes labialis) in healthy adults and adolescents
Contraindications and cautions Valtrex Valacyclovir
· Contraindicated with allergy to valacyclovir or acyclovir.
· Use cautiously with pregnancy, renal impairment, thrombotic thrombocytopenic purpura, lactation.
Available forms Valtrex Valacyclovir
Tablets—500 mg, 1 g
Dosages Valtrex Valacyclovir
ADULTS
· Herpes zoster: 1 g tid PO for 7 days; most effective if started within 48 hr of onset of symptoms (rash).
· Genital herpes: 1 g PO bid for 7–10 days.
· Episodic treatment of recurrent genital herpes: 500 mg PO bid for 3 days.
· Suppression of recurrent episodes of genital herpes: 1 g PO daily; patients with history of less than nine episodes in 1 yr may respond to 500 mg PO daily.
· Reduction of risk of transmission: 500 mg/day PO daily for the source partner.
· Cold sores: 2 g PO bid for 1 day.
PEDIATRIC PATIENTS Valtrex Valacyclovir
Safety and efficacy not established.
PATIENTS WITH RENAL IMPAIRMENT
| Indication | CrCl 30–49 |
CrCl 10–29 |
CrCl < 10 |
| Herpes zoster | 1 g q 12 hr | 1 g q 24 hr | 500 mg q 24 hr |
| Genital herpes –initial treatment –recurrent episodes –suppressive therapy –suppressive therapy for 9 or fewer episodes |
1 g q 12 hr 500 mg q 12 hr 1 g q 24 hr 500 mg q 24 hr |
1 g q 24 hr 500 mg q 24 hr 500 mg q 24 hr 500 mg q 48 hr |
500 mg q 24 hr 500 mg q 24 hr 500 mg q 24 hr 500 mg q 48 hr |
Pharmacokinetics
| Route | Onset | Peak |
| Oral | Rapid | 3 hr |
Metabolism: Not metabolized; T1/2: 2.5–3.3 hr
Distribution: Crosses placenta: enters breast milk
Excretion: Feces, urine
Adverse effects Valtrex Valacyclovir
· CNS: Headache, dizziness
· GI: Nausea, vomiting, diarrhea, anorexia
· GU: Acute renal failure
Interactions Valtrex Valacyclovir
Drug-drug
· Decreased rate of effectiveness with probenecid, cimetidine
Nursing considerations Valtrex Valacyclovir
CLINICAL ALERT!
Name confusion has been reported with Valtrex (valacyclovir) and Valcyte (valganciclovir); use caution.
Assessment Valtrex Valacyclovir
· History: Allergy to valacyclovir, acyclovir; renal disease; lactation; thrombotic thrombocytopenic purpura, pregnancy
· Physical: Orientation; urinary output; abdominal examination, normal output; BUN, creatinine clearance
Interventions Valtrex Valacyclovir
· Begin treatment within 72 hr of onset of symptoms of shingles.
· Administer without regard to meals; administer with meals to decrease GI upset if needed.
· Provide appropriate analgesics for headache, discomfort of shingles.
· Advise continued use of safe sex practices.
Valtrex Valacyclovir
· Take this drug without regard to meals; if GI upset is a problem, take with meals.
· Take the full course of therapy as prescribed.
· Avoid contact with lesions and avoid intercourse when lesions or symptoms are present to avoid infecting others.
· Start therapy at first sign of an episode when treating recurrent herpes.
· You may experience these side effects: Nausea, vomiting, loss of appetite, diarrhea; headache, dizziness.
· Report severe diarrhea, nausea; headache; worsening of the shingles.

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