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Valacyclovir: Uses,Dosage,Side Effects

Generic Name
Valacyclovir
Therapeutic Class: Anti Viral / Herpes simplex & Varicella-zoster virus infections

Indications:
Adult Patients:
  • Cold Sores (Herpes Labialis)
  • Genital Herpes
  • Treatment in immunocompetent patients (initial or recurrent episode)
  • Suppression in immunocompetent or HIV-infected patients
  • Reduction of transmission
  • Herpes Zoster
Pediatric Patients:
  • Cold Sores (Herpes Labialis)
  • Chickenpox
Presentation:
Valacyclovir 500 Tablet: Each tablet contains Valacyclovir Hydrochloride INN equivalent to Valacyclovir 500 mg.
Valacyclovir 1 gm Tablet: Each tablet contains Valacyclovir Hydrochloride INN equivalent to Valacyclovir 1 gm.

Description:
Valacyclovir Hydrochloride is a nucleoside analog DNA polymerase inhibitor. It is rapidly converted to acyclovir which has demonstrated antiviral activity against HSV types 1 (HSV-1) and 2 (HSV-2) and VZV. The viral enzyme converts acyclovir to Acyclovir triphosphate which inhibits viral DNA synthesis.

Dosage & Administration:
Adult Dosage:

Cold Sores: 2 grams every 12 hours for 1 day

Genital Herpes :
  • Initial episode: 1 gram twice daily for 10 days
  • Recurrent episodes: 500 mg twice daily for 3 days
  • Suppressive therapy
  • Immunocompetent patients: 1 gram once daily
  • Alternate dose in patients with < 9 recurrences/y : 500 mg once daily
  • HIV-infected patients: 500 mg twice daily
  • Reduction of transmission: 500 mg once daily
  • Herpes Zoster: 1 gram 3 times daily for 7 days
Pediatric Dosage:
  • Cold Sores (> 12 years of age): 2 grams every 12 hours for 1 day
  • Chickenpox (2 to < 18 years of age) : 20 mg/kg 3 times daily for 5 days; not to exceed 1 gram 3 times daily
Side Effects:
The most common adverse reactions reported in at least one indication by >10% of adult patients treated with valacyclovir hydrochloride and more commonly than in patients treated with placebo are headache, nausea, and abdominal pain.
The only adverse reaction occurring in >10% of pediatric patients <18 years of age was a headache.

Precautions:
Dosage reduction is recommended when administering valacyclovir to patients with renal impairment. Similar caution should be exercised when administering valacyclovir to geriatric patients (over 65 years), and patients receiving potentially nephrotoxic agents. The safety and efficacy of valacyclovir have not been established in immunocompromised patients other than for the suppression of genital herpes in HIV-infected patients.

Use in Pregnancy & Lactation:
Pregnancy Category B. Valacyclovir should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Caution should be exercised when Valacyclovir is administered to a lactating woman.

Drug Interaction:
No clinically significant drug-drug or drug-food interactions with valacyclovir are known.

Overdose:
Caution should be exercised to prevent inadvertent overdose.

Storage:
Store in a cool & dry place, away from children.

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