From the Guidelines
Valtrex (valacyclovir) is highly effective for treating shingles and should be started as soon as possible after symptoms appear, ideally within 72 hours of rash onset. The standard dosage for adults is not explicitly stated in the provided evidence, but based on general medical knowledge, it is typically 1,000 mg three times daily for 7 days. Taking the medication promptly can reduce the severity and duration of the painful rash, decrease the risk of complications, and may lower the chance of developing postherpetic neuralgia (persistent nerve pain after the rash heals) 1. Valtrex works by inhibiting viral DNA replication, preventing the varicella-zoster virus from multiplying.
Key Considerations
- Common side effects may include headache, nausea, and dizziness
- It's essential to complete the full course of medication even if symptoms improve before finishing treatment
- Patients should stay well-hydrated while taking Valtrex and inform their healthcare provider if they have kidney problems, as dosage adjustments may be necessary
- For maximum benefit, the medication should be taken with or without food at evenly spaced intervals throughout the day
Special Populations
- Immunocompromised patients, such as those with a history of transplantation, may require closer monitoring and potentially different treatment regimens 1
- The risk of dissemination and chronic infection is higher in immunocompromised patients, emphasizing the importance of prompt and effective antiviral therapy 1
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.
Valtrex is indicated for the treatment of shingles in immunocompetent adults.
- The treatment should be initiated within 72 hours after the onset of rash.
- The efficacy and safety of Valtrex for treatment of disseminated herpes zoster have not been established 2.
From the Research
Valtrex for Shingles
- Valtrex, also known as valacyclovir, is an antiviral medication used to treat herpes zoster, commonly referred to as shingles 3, 4, 5, 6, 7.
- The medication works by accelerating the resolution of the herpes zoster rash and associated pain, and reducing the duration of postherpetic neuralgia 3, 5, 7.
- Valacyclovir is most effective when started within 72 hours after the onset of the rash 3, 4, 5, 6.
Dosage and Administration
- The recommended dosage of valacyclovir for the treatment of herpes zoster is 1.5 g twice daily for 7 days 3 or 1000 mg three times daily for 7 days 5.
- Twice-daily dosing may help increase patient compliance and therefore increase the effectiveness of treatment of the acute herpes zoster rash and the prevention of postherpetic neuralgia 3.
Efficacy and Safety
- Valacyclovir has been shown to be safe and effective in the treatment of uncomplicated herpes zoster in immunocompetent patients over 18 years of age 3, 5, 7.
- The medication has been compared to acyclovir and famciclovir, and has been found to be at least as effective, if not more effective, in controlling the symptoms of acute herpes zoster and alleviating zoster-associated pain and postherpetic neuralgia 5, 7.
- Valacyclovir is well tolerated, with nausea and headache being the most commonly reported adverse events 5, 7.
Prevention and Management
- Herpes zoster and postherpetic neuralgia can be prevented and managed through the use of antiviral medications, such as valacyclovir, and adjunct medications, such as opioid analgesics, tricyclic antidepressants, or corticosteroids 4, 6.
- Immunization to prevent herpes zoster and postherpetic neuralgia is recommended for most adults 60 years and older 6.