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 consistent therapeutic delivery, making it a frontline choice for both episodic treatment and chronic suppression. This nucleoside analogue DNA polymerase inhibitor works by interrupting viral replication, thereby reducing symptom duration, lesion healing time, and transmission risk. Trusted by healthcare professionals globally, Valtrex represents a clinically validated approach to herpes management with a well-characterized safety profile.
Features
- Active ingredient: Valacyclovir hydrochloride
- Available in 500 mg and 1000 mg film-coated tablets
- High oral bioavailability (54.5%), significantly greater than acyclovir
- Rapid conversion to active metabolite acyclovir
- Convenient once- or twice-daily dosing regimens
- FDA-approved for HSV-1, HSV-2, and herpes zoster infections
- Demonstrated efficacy in immunocompetent and immunocompromised patients
Benefits
- Reduces healing time for initial and recurrent herpes outbreaks
- Decreases the frequency of recurrent episodes with suppressive therapy
- Lowers risk of viral transmission to partners when used daily
- Minimizes pain and discomfort associated with active lesions
- Provides flexible dosing options for episodic or chronic management
- Supported by extensive clinical trial data and post-marketing surveillance
Common use
Valtrex is primarily indicated for the treatment of herpes zoster (shingles) in immunocompetent adults, the treatment of initial and recurrent episodes of genital herpes in immunocompetent and HIV-infected adults, and for chronic suppressive therapy of recurrent genital herpes. It is also approved for the treatment of herpes labialis (cold sores) in immunocompetent adults and children aged 12 years and older. Off-label uses may include prevention of cytomegalovirus (CMV) infection in transplant recipients and management of Epstein-Barr virus infections in specific clinical scenarios, though these applications require careful medical supervision.
Dosage and direction
Herpes Zoster: 1000 mg three times daily for 7 days, initiated within 72 hours of rash appearance.
Genital Herpes (Initial Episode): 1000 mg twice daily for 10 days.
Recurrent Genital Herpes: 500 mg twice daily for 3 days, starting at first sign of symptoms.
Chronic Suppressive Therapy: 1000 mg once daily (or 500 mg once daily in patients with ≤9 recurrences per year).
Herpes Labialis: 2000 mg twice daily for 1 day, with doses approximately 12 hours apart.
Dosage adjustment required for patients with renal impairment: CrCl 30-49 mL/min: 1000 mg every 12 hours; CrCl 10-29 mL/min: 1000 mg every 24 hours; CrCl <10 mL/min: 500 mg every 24 hours. Tablets should be taken with water, with or without food.
Precautions
Patients should maintain adequate hydration during therapy to prevent crystalluria and nephrotoxicity. Use with caution in elderly patients due to increased likelihood of decreased renal function. Monitor renal function in patients with pre-existing renal impairment or those receiving concomitant nephrotoxic drugs. Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) has been reported in immunocompromised patients receiving higher than recommended doses. Not a cure for herpes infections; does not prevent transmission through sexual contact, though risk is reduced with suppressive therapy.
Contraindications
Hypersensitivity to valacyclovir, acyclovir, or any component of the formulation. Contraindicated in patients with demonstrated clinically significant hypersensitivity reactions to previous valacyclovir administration. Not recommended for use in patients with advanced HIV disease or bone marrow or renal transplants without careful consideration of risk-benefit ratio.
Possible side effect
Common adverse reactions (≥5%) include headache (17%), nausea (8%), abdominal pain (3%), vomiting (3%), and dizziness (4%). Less frequent side effects include diarrhea, rash, arthralgia, and fatigue. Serious adverse reactions may include nephrotoxicity, neurological effects (agitation, hallucinations, confusion, coma), thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome. Laboratory abnormalities may include elevated liver enzymes, neutropenia, and thrombocytopenia.
Drug interaction
Probenecid and cimetidine may reduce renal clearance of acyclovir, increasing plasma concentrations. Concurrent use with other nephrotoxic drugs (aminoglycosides, cyclosporine, NSAIDs) may increase risk of renal dysfunction. No clinically significant interactions observed with antacids, digoxin, thiazide diuretics, or oral contraceptives in clinical studies, though monitoring is advised with combination therapy.
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 dose. Maintain regular dosing schedule to ensure consistent antiviral coverage. For once-daily suppressive therapy, taking the missed dose as soon as possible is particularly important to maintain therapeutic levels.
Overdose
Overdose may lead to renal impairment (elevated BUN and creatinine), neurological symptoms (agitation, coma, hallucinations, seizures), and nausea. Management includes supportive care and adequate hydration to prevent precipitation of acyclovir in renal tubules. Hemodialysis significantly enhances acyclovir elimination (approximately 60% reduction in plasma concentrations during 4-hour dialysis session). In case of suspected overdose, contact poison control center immediately.
Storage
Store at 20-25°C (68-77°F); excursions permitted to 15-30°C (59-86°F). Keep in original container with tightly closed lid to protect from moisture. Do not remove desiccant from bottle. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Do not transfer to alternative containers that may not provide adequate moisture protection.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Valtrex is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to therapy may vary based on medical history, renal function, and immunological status. Always follow your healthcare provider’s instructions regarding dosage, duration, and monitoring requirements. Report any unusual symptoms or side effects to your physician promptly.
Reviews
Clinical studies demonstrate Valtrex reduces median healing time for initial genital herpes episodes from 11.5 to 9.1 days and for recurrent episodes from 6.0 to 4.8 days. Suppressive therapy shows 70-80% reduction in recurrence frequency among patients with frequent outbreaks. Patient-reported outcomes indicate significant improvement in quality of life measures, particularly reduction in pain severity and emotional distress associated with recurrent outbreaks. Long-term safety data support continued efficacy with maintained suppression over 6 years of continuous use in clinical trials.