From the Guidelines
Valacyclovir is necessary for treating herpes zoster (shingles), particularly in patients with moderate to severe symptoms, those at high risk of complications, and those who are immunocompromised 1.
Key Points
- The typical dose is 1000 mg three times daily for 7 days, with treatment ideally starting within 72 hours of rash onset 1.
- This antiviral medication can help reduce the severity and duration of symptoms, as well as decrease the risk of postherpetic neuralgia, a common complication of shingles.
- In patients with renal impairment, dose adjustment may be necessary.
- Antiviral therapy is recommended for all immunocompromised patients with herpes zoster 1.
- Treatment should be prescribed within 72 h of rash onset and should continue for a minimum of 7–10 days 1.
- For complicated cases, including multi-dermatomal, ophthalmic, visceral, or disseminated herpes zoster, intravenous acyclovir is recommended 1.
- It is essential to consult a healthcare provider for proper evaluation and guidance on treatment.
From the FDA Drug Label
VALTREX is indicated for the treatment of herpes zoster (shingles) in immunocompetent adults. The efficacy of VALTREX when initiated more than 72 hours after the onset of rash and the efficacy and safety of VALTREX for treatment of disseminated herpes zoster have not been established.
Valacyclovir (Valtrex) is necessary for treating herpes zoster (shingles) in immunocompetent adults, as it is indicated for this use. However, the efficacy of valacyclovir when initiated more than 72 hours after the onset of rash has not been established, so treatment should be initiated as soon as possible after a diagnosis of herpes zoster 2.
From the Research
Efficacy of Valacyclovir in Treating Herpes Zoster
- Valacyclovir has been shown to be effective in treating herpes zoster, with studies demonstrating its ability to accelerate the resolution of the herpes zoster rash and associated pain, and reduce the duration of postherpetic neuralgia 3, 4, 5.
- The drug has been found to be at least as effective as acyclovir in controlling the symptoms of acute herpes zoster, and has been shown to alleviate zoster-associated pain and postherpetic neuralgia significantly faster than acyclovir 4.
- Valacyclovir has also been found to be well tolerated, with nausea and headache being the most commonly reported adverse events 4, 6.
Dosage and Administration
- The recommended dosage of valacyclovir for the treatment of herpes zoster is 1 g three times daily for 7 days 6.
- A study comparing two dosages of valacyclovir (1 g three times daily and 2 g three times daily) found that both dosages were safe and effective for the treatment of herpes zoster in immunocompromised patients 6.
- Twice-daily dosing of valacyclovir has also been shown to be effective and may help increase patient compliance 3.
Comparison with Other Antiviral Drugs
- Valacyclovir has been found to be at least equivalent to, and better in certain parameters than, acyclovir and famciclovir in the treatment of herpes zoster 4, 5.
- A study comparing valacyclovir with famciclovir found that both drugs were effective in speeding the resolution of acute herpes zoster rash and shortening the duration of postherpetic neuralgia 4.