Drug Name
Generic Name : valacyclovir hydrochloride
Brand Name: Valtrex
Classification: Antiviral
Pregnancy Category B
Dosage & Route
Available forms :Tablets—500 mg, 1 g
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
- Safety and efficacy not established.
Therapeutic actions
- Antiviral activity; inhibits viral DNA replication and deactivates viral DNA polymerase.
Indications
- 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
- Contraindicated with allergy to valacyclovir or acyclovir.
- Use cautiously with pregnancy, renal impairment, thrombotic thrombocytopenic purpura, lactation.
Nursing considerations
CLINICAL ALERT! Name confusion has been reported with Valtrex (valacyclovir) and Valcyte (valganciclovir); use caution.
Assessment
- History: Allergy to valacyclovir, acyclovir; renal disease; lactation; thrombotic thrombocytopenic purpura, pregnancy
- Physical: Orientation; urinary output; abdominal examination, normal output; BUN, creatinine clearance
Interventions
- 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.
Teaching points
- 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.