Valacyclovir

C difficile risk
None
Oral Bioavailability
Excellent

Dosing

  • 500-1000mg BID/TID depending on indication

  • HSV First Episode (genital): 1g PO BID x 7-10 days

  • HSV Recurrent Episodes (genital): 500 mg PO BID x 3 days OR 1 g PO daily x 3 days

  • HSV Episodic/Recurrent (oral): 2g PO BID x 1 day

Treatment of Initial Episode:Recurrent Episode:1 g twice PO daily for 7 to 10 days; extend duration if lesion has not healed completely after 10 days500 mg PO twice daily for 3 days OR 1 g PO once daily for 5 days

500 mg PO twice daily, beginning at 36 weeks' gestation and continued until delivery

<10 eGFR10 - 30 eGFR30+ eGFR500 mg po daily500 - 1000 mg po daily to BIDNo dose adjustment required.

General Information

Treatment and prevention of infections caused by HSV (genital, orolabial), VZV

Pregnancy: Compatible.

Breastfeeding: Compatible.

CBC, Scr, liver enzymes

Headache
GI intolerance
Increased liver enzymes
Thrombocytopenia, leukopenia
Rash

May increase the serum concentration of clozapine, tenofovir.
May diminish the therapeutic effect of Varicella Virus Vaccine. Management: When possible, avoid use of acyclovir or valacyclovir within the 24 hours prior to administration of the varicella vaccine, and avoid use of these antiviral agents for 14 days after vaccination.

Pro-drug of acyclovir. Valacyclovir is rapidly and nearly completely converted to acyclovir by intestinal and hepatic metabolism.

Antimicrobial class: Antiviral.