What is Valacyclovir
Valacyclovir is an antiviral agent with activity against alpha-herpes viruses.
It is FDA approved for the treatment of: herpes labialis (cold sores) in patients 12 years and older; chickenpox in pediatric patients aged 2 to less than 18 years; herpes zoster (shingles) in immunocompetent adults; and genital herpes (initial episode, recurrent episodes, suppressive therapy, and reduction of transmission) in immunocompetent adults.
Valacyclovir is the L-valyl ester of acyclovir; the result of an effort to develop a prodrug to improve acyclovir oral bioavailability. Improved bioavailability means less frequent dosing for valacyclovir than acyclovir, which is especially beneficial during maintenance therapy.
While valacyclovir is only available as an oral tablet, extemporaneous compounding instructions are available to prepare an oral suspension.
Brand Name
Valtrex
Indications
- acute retinal necrosis (ARN)
- B virus (cercopithecine herpesvirus)
- Bell’s palsy
- cytomegalovirus (CMV)
- cytomegalovirus (CMV) disease prophylaxis
- encephalitis
- Epstein-Barr virus
- herpes genitalis
- herpes genitalis prophylaxis
- herpes labialis
- herpes simplex infection prophylaxis
- herpes simplex virus infection
- herpes simplex virus type 1
- herpes simplex virus type 2
- herpes zoster (shingles) infection
- varicella (chickenpox) infection
- varicella (chickenpox) infection prophylaxis
- varicella-zoster virus
Side Effects
- abdominal pain
- agitation
- alopecia
- anaphylactoid reactions
- anemia
- angioedema
- anuria
- aplastic anemia
- arthralgia
- ataxia
- coma
- confusion
- dehydration
- delirium
- depression
- diarrhea
- dizziness
- dysarthria
- dysmenorrhea
- dyspnea
- elevated hepatic enzymes
- encephalopathy
- erythema multiforme
- fatigue
- fever
- hallucinations
- headache
- hemolytic-uremic syndrome
- hepatitis
- hypertension
- impaired cognition
- mania
- nausea
- neutropenia
- pharyngitis
- photosensitivity
- pruritus
- psychosis
- rash
- renal failure (unspecified)
- rhinorrhea
- seizures
- sinus tachycardia
- sinusitis
- thrombocytopenia
- thrombotic thrombocytopenic purpura (TTP)
- tremor
- urticaria
- vasculitis
- visual impairment
- vomiting
Monitoring Parameters
- serum creatinine/BUN
Contraindications
- acyclovir hypersensitivity
- breast-feeding
- children
- dehydration
- famciclovir hypersensitivity
- ganciclovir hypersensitivity
- geriatric
- infants
- neonates
- penciclovir hypersensitivity
- pregnancy
- renal failure
- renal impairment
- valacyclovir hypersensitivity
- valganciclovir hypersensitivity
Interactions
- Adefovir
- Aldesleukin, IL-2
- Aminoglycosides
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Aprotinin
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Capreomycin
- Cidofovir
- Cimetidine
- Cisplatin
- Colchicine; Probenecid
- Cyclosporine
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Emtricitabine; Tenofovir disoproxil fumarate
- Entecavir
- Foscarnet
- Fosphenytoin
- Gallium Ga 68 Dotatate
- Hyaluronidase, Recombinant; Immune Globulin
- Immune Globulin IV, IVIG, IGIV
- Inotersen
- Iohexol
- Ionic Contrast Media
- Iopamidol
- Iopromide
- Ioversol
- Isosulfan Blue
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lithium
- Mannitol
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Methotrexate
- Mycophenolate
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Oxaliplatin
- Phenytoin
- Polymyxins
- Probenecid
- Tacrolimus
- Talimogene Laherparepvec
- Telbivudine
- Tenofovir Alafenamide
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Vancomycin
- Varicella-Zoster Virus Vaccine, Live
