What is the dosing for Valacyclovir (Valtrex) in the treatment of genital herpes infections?

From the Guidelines

Valacyclovir (Valtrex) dosing for genital herpes infections should be prioritized based on patient adherence, with dosing strategies that are most feasible for patients being recommended. When considering the treatment of genital herpes infections, the dosing of Valacyclovir (Valtrex) varies based on the specific context of treatment, including first clinical episode, episodic therapy, or suppressive therapy 1. The following dosing regimens are recommended:

• For a first-time genital herpes outbreak, the dosage is typically 1 gram (1000 mg) twice daily for 10 days.
• For recurrent episodes, the recommended dosage is 500 mg twice daily for 3 days, starting at the first sign of symptoms.
• For suppressive therapy to prevent outbreaks, the dosage is 1 gram once daily if you have 9 or fewer recurrences per year, or 500 mg once daily if you have fewer than 6 recurrences annually. It's essential to note that HIV-positive patients should take 500 mg twice daily for suppression, and patients with kidney impairment may require dose adjustments 1. Some key points to consider when using Valacyclovir (Valtrex) include:
• The medication works by converting to acyclovir in the body, which inhibits viral DNA synthesis and replication.
• It is most effective when started within 24 hours of symptom onset for episodic treatment.
• The medication can be taken with or without food, and maintaining adequate hydration is recommended while using this medication.
• Common side effects include headache, nausea, and abdominal pain, but the medication is generally well-tolerated 1.

From the FDA Drug Label

2 DOSAGE AND ADMINISTRATION

1. 1 Adult Dosing Recommendations Genital Herpes Initial Episode: The recommended dosage of VALTREX for treatment of initial genital herpes is 1 gram twice daily for 10 days. Recurrent Episodes: The recommended dosage of VALTREX for treatment of recurrent genital herpes is 500 mg twice daily for 3 days Initiate treatment at the first sign or symptom of an episode. Suppressive Therapy: The recommended dosage of VALTREX for chronic suppressive therapy of recurrent genital herpes is 1 gram once daily in patients with normal immune function. In patients with a history of 9 or fewer recurrences per year, an alternative dose is 500 mg once daily In HIV‑1−infected patients with a CD4+ cell count greater than or equal to 100 cells/mm 3, the recommended dosage of VALTREX for chronic suppressive therapy of recurrent genital herpes is 500 mg twice daily Reduction of Transmission: The recommended dosage of VALTREX for reduction of transmission of genital herpes in patients with a history of 9 or fewer recurrences per year is 500 mg once daily for the source partner.

The dosing for Valtrex (Valacyclovir) in Genital Herpes Infections is as follows:

• Initial Episode: 1 gram twice daily for 10 days
• Recurrent Episodes: 500 mg twice daily for 3 days
• Suppressive Therapy:
  • 1 gram once daily in patients with normal immune function
  • 500 mg once daily in patients with a history of 9 or fewer recurrences per year
  • 500 mg twice daily in HIV-1 infected patients with a CD4+ cell count greater than or equal to 100 cells/mm^3
• Reduction of Transmission: 500 mg once daily for the source partner in patients with a history of 9 or fewer recurrences per year 2

From the Research

Valtrex (Valacyclovir) Dosing for Genital Herpes Infections

• The dosing regimen for Valtrex (Valacyclovir) in the treatment of genital herpes infections is as follows:
  • Episodic treatment: Valtrex is approved for a 3-day regimen of episodic treatment of recurrent genital herpes 3, 4
  • Suppressive therapy: Valtrex is approved for once-daily dosing for suppressive therapy of genital herpes 3, 4
• The efficacy of Valtrex in the treatment of genital herpes infections has been demonstrated in several clinical trials, with similar efficacy to acyclovir in episodic and suppressive treatment 3, 5
• The safety profile of Valtrex is acceptable in patients with herpes simplex and herpes zoster, making it an attractive option for treatment 3, 4
• Factors influencing the choice of therapy, such as cost, ease of dosing, and acyclovir resistance, should be considered when selecting a treatment regimen 5
• Clinical strategies for the comprehensive management of genital herpes simplex virus infections, including the use of antivirals for symptom relief and prevention of transmission, have been recommended 5, 6, 7