II. Indications

  1. Herpes Zoster (Shingles)
  2. Genital Herpes (initial, recurrent or prophylaxis)
  3. Herpes Labialis (Oral Herpes)

III. Dosing

  1. Herpes Labialis (Cold Sores)
    1. Adult: 2 grams PO q12 hours for 1 day
  2. Herpes Zoster (Shingles)
    1. Adult: 1 gram tid for 7 days
  3. Genital Herpes
    1. Initial: 1 gram PO bid for 10 days
    2. Recurrent: 500 mg PO bid for 3 days
    3. Prophylaxis (for up to 1 year)
      1. Immunocompetent (<9 episodes/year): 500 mg PO qd
      2. Immunocompetent (9 or more per year): 1000 mg PO qd
      3. HIV with CD4>100: 500 mg PO bid

IV. Adverse Effects

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Cost: Medications

valacyclovir (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
VALACYCLOVIR HCL 1 GRAM TABLET Generic $0.63 each
VALACYCLOVIR HCL 500 MG TABLET Generic $0.37 each
valtrex (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
VALTREX 1 GM CAPLET Generic $0.63 each
VALTREX 500 MG CAPLET Generic $0.37 each

Ontology: valacyclovir (C0249458)

Definition (NCI_NCI-GLOSS) A substance that is being studied in the prevention of fungal, bacterial, and viral infections in patients undergoing donor stem cell transplantation with cells that are infected with cytomegalovirus. It belongs to the family of drugs called antivirals.
Definition (NCI) The hydrochloride salt of the L-valyl ester of the antiviral drug acyclovir. Orally administered, valacyclovir is rapidly converted to acyclovir which inhibits viral DNA replication after further conversion to the nucleotide analog acyclovir triphosphate by viral thymidine kinase, cellular guanyl cyclase, and a number of other cellular enzymes. Acyclovir triphosphate competitively inhibits viral DNA polymerase; incorporates into and terminates the growing viral DNA chain; and inactivates viral DNA polymerase. The greater antiviral activity of acyclovir against herpes simplex virus (HSV) compared with varicella-zoster virus (VZV) is due to its more efficient phosphorylation by HSV thymidine kinase.
Definition (CSP) used in the management of herpes simplex virus and varicella zoster virus infections and the prophylaxis of human cytomegalovirus infections.
Definition (PDQ) A synthetic valyl ester derivative of acyclovir, the antiviral valacyclovir is an acyclovir prodrug that, after metabolization, inhibits viral DNA replication through interference with thymidine kinase. It is used in the management of herpes simplex and varicella zoster infections, as well as prophylactically for human cytomegalovirus infections. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=257236&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=257236&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C28235" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C084555
SnomedCT 324820003, 96098007
LNC LP171646-5
English valaciclovir, valacyclovir, Valacyclovir product (product), Valaciclovir product (product), Valacyclovir, Valaciclovir, valacyclovir [Chemical/Ingredient], valACYclovir, L-Valine ester with 9-((2-hydroxyethoxy)methyl)guanine, VALACYCLOVIR, Valaciclovir product, Valacyclovir (substance), Valacyclovir product, Valaciclovir product (substance)
Spanish valaciclovir (producto), producto con valaciclovir (producto), producto con valaciclovir, valaciclovir (sustancia), valaciclovir

Ontology: Valtrex (C0592245)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C084555
English Valtrex, valtrex