Valacyclovir, delivered to your door

Valacyclovir is used for treating cold sores and genital herpes. Valacyclovir starts to work immediately in the body after you take it. It can help shorten the duration of an outbreak and reduce the risk of transmitting the virus to others.

Valacyclovir acts through multiple mechanisms to prevent the replication of herpes DNA, preventing the virus from making copies of itself, which is how the virus causes outbreaks. Valacyclovir is active against HSV-1, HSV-2, VZV (the virus that causes chickenpox and shingles), and to a lesser extent, other herpes viruses, like CMV. When viral DNA is prevented from replicating, the virus cannot multiply and infect uninfected cells. This is how valacyclovir works:

• Stops or shortens outbreaks of genital herpes and oral herpes

• Prevents outbreaks of genital and oral herpes

• Decreases the risk of infecting an uninfected partner

Once in the body, valacyclovir starts to work almost immediately. Since it specifically attacks the DNA replication process, it will only attack herpes viruses that are multiplying. While it starts to work on an active infection very quickly, it will not fight the inactive virus hiding in the nervous system.

While it goes to work within hours of taking the medication, the symptoms and sores of an outbreak may take days to heal, and the virus can stay active throughout the healing process.

Abort (stop) an outbreak at the earliest sign or symptom (prodrome)

It’s important to take the medicine at the first sign or symptom because there is no evidence that the medication works once lesions are visible. Most people will be able to tell when an outbreak is coming on. They may experience burning, itching, tingling, or other sensations that alert them to an imminent outbreak.

Treatment with suppressive therapy

Valacyclovir is not approved for suppressive therapy of oral herpes (cold sores), but healthcare professionals have the discretion to prescribe it for this use if they believe that it is an appropriate course of treatment for a particular patient. This is considered an off-label treatment. It is up to the provider's medical judgment to decide if off-label treatment is appropriate for a patient based on the patient’s unique medical history, symptoms, and preferences.

Treatment of initial genital outbreak

To treat an initial episode of genital herpes, the FDA recommends taking valacyclovir 1 gram (1000 mg) twice a day for 10 days starting at the first sign or symptom of lesions, preferably within 48 hours of onset. The CDC recommends this same dose for 7 to 10 days; “treatment may be extended if healing is not complete after 10 days.” For HIV-infected patients, they recommend 1 gram (1000 mg) every 12 hours for 5 to 14 days.

Treatment of recurrent genital herpes, including HIV-infected patients

The FDA recommends using 500 mg of valacyclovir twice daily for 3 days starting at the first sign or symptom of lesions—preferably within 24 hours of onset. The CDC also recommends valacyclovir 500 mg twice daily for 3 days, but adds an alternative regimen of valacyclovir 1 g (1000 mg) one time a day for 5 days. Valacyclovir 1 g taken every 12 hours for 5 to 14 days is recommended by the HIV guidelines.

Treatment with suppressive therapy

People with fewer than 10 outbreaks per year should take valacyclovir 500 mg once daily. Valacyclovir 1,000 mg once daily is recommended for people with 10 or more outbreaks per year.

To prevent transmission to a partner

The infected partner should take valacyclovir 500 mg once a day to decrease the risk of transmission to the uninfected partner. The data are strong but refer to patients with 9 or fewer outbreaks each year.

Common side effects include headache, nausea, and stomach pain. More serious side effects can occur and are more likely if you have a weakened immune system or are elderly.

For more comprehensive information on side effects that can occur with valacyclovir, see full Important safety information here. [https://ro.co/safety-info/valacyclovir/]

Valacyclovir comes in two doses, 500 mg and 1000 mg tablets. Although there are only two doses, there are several ways to use the medicine for different indications. Remember that these doses may need to be changed for people with specific conditions, such as kidney problems. If you’re prescribed valacyclovir, take it according to your prescriber’s instructions.