Valaciclovir tablets are indicated for the treatment of herpes zoster (shingles) and ophthalmic zoster in immunocompetent adults.
ORAL Herpes zoster (shingles): Adult: 1 g tid for 7 days; commence w/in 72 hr of rash. Genital herpes: Adult: Initial episode: 1 g bid for up to 10 days, begin course w/in 72 hr of symptom onset. Prophylaxis of herpes simplex infections: Adult: Immunocompetent patients: 500 mg daily in 1-2 divided doses. Immunocompromised patients: 500 mg bid. Herpes simplex infections of skin & mucous membranes: Adult: Initial episode: 500 mg bid for up to 10 days, start treatment as early as possible. For recurrent episodes. 500 mg bid for 5 days, begin during prodromal period or as soon as symptoms appear. Recurrent genital herpes: Adult: 500 mg bid for 3 days w/in 24 hr of 1st sign or symptom. Suppression of recurrent episodes of genital herpes: Adult: Immunocompetent patients: 1 g once daily or 500 mg once daily for patients w/ 9 recurrences/year; HIV infected patients w/ CD4 cells count 100 cells/ mm3: 500 mg bid up to 6 mth. Reduction of transmission of genital herpes: Adult: In combination w/ safer sex practices & abstinence when lesions are present. 500 mg once daily for infected partner w/ history of 9 recurrences/yr. Prophylaxis of cytomegaloviral infections in immunocompromised patients: Adult: 2 g 4 times daily for 90 days, started w/in 72 hr after transplant. Child: >12 yr: 2g 4 times daily for 90 days, started w/in 72 hr after transplant. Herpes labialis: Adult: 2 g 12 hrly for 1 day, admin at earliest symptom of cold sore (e.g. tingling, itching or burning).
Hypersensitvity to valaciclovir, aciclovir. Dehydration; renal or hepatic impairment, pregnancy, lactation. Maintain adequate hydration. Monitor renal function daily esp during 1st 10 days post transplant.
Headache, nausea, vomiting, diarrhoea, rash, photosensitivity, LFT abnormalities, psychiatric reactions (e.g. confusion, hallucinations & thinking disorders) esp at high doses. Hepatitis; renal failure; blood dyscrasias; thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.
Benefit should outweigh risk for pregnancy. Based on its rapid conversion to acyclovir (acyclovir), this drug appears to be compatible with breastfeeding.
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