From the Guidelines
The recommended dose of Valtrex (valacyclovir) for treating herpes is 1 gram (1000 mg) taken twice daily for 10 days for initial genital herpes outbreaks, 500 mg twice daily for 3 days for recurrent genital herpes episodes, 1 gram three times daily for 7 days for herpes zoster (shingles), and 2 grams taken twice, 12 hours apart, for cold sores (herpes labialis). For initial genital herpes outbreaks, the dose is based on the study by 1, which discusses the most practical treatment regimens for first clinical episode of genital herpes. The dose for recurrent genital herpes episodes is also supported by 1, which prioritizes dosing strategies that are most feasible for patient adherence. For herpes zoster (shingles), the dose is based on the study by 1, which recommends valacyclovir 1 g orally twice a day for 7-10 days. For cold sores (herpes labialis), the dose is often prescribed as a single-day treatment of 2 grams taken twice, 12 hours apart. Suppressive therapy for patients with frequent recurrences typically involves 500-1000 mg once daily, as discussed in 1. These doses may need adjustment for patients with kidney impairment, and the medication should be taken with plenty of water to protect kidney function. Common side effects include headache, nausea, and abdominal pain. It's most effective when started within 24-48 hours of symptom onset. The medication works by converting to acyclovir in the body, which inhibits viral DNA replication. Some key points to consider when prescribing Valtrex include:
- The importance of starting treatment within 24-48 hours of symptom onset
- The need for adequate hydration to protect kidney function
- The potential for adjustment of doses in patients with kidney impairment
- The common side effects of headache, nausea, and abdominal pain. Overall, Valtrex is an effective treatment for herpes, and the recommended doses are based on the most recent and highest quality studies, including 1, 1, and 1.
From the FDA Drug Label
The recommended dosage of VALTREX for treatment of initial genital herpes is 1 gram twice daily for 10 days. The recommended dosage of VALTREX for treatment of recurrent genital herpes is 500 mg twice daily for 3 days The recommended dosage of VALTREX for chronic suppressive therapy of recurrent genital herpes is 1 gram once daily in patients with normal immune function. 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 recommended dosage of VALTREX for treatment of cold sores is 2 grams twice daily for 1 day taken 12 hours apart. The recommended dosage of VALTREX for treatment of herpes zoster is 1 gram 3 times daily for 7 days
The recommended dose of Valtrex (valacyclovir) for treating herpes depends on the type of herpes and the patient's condition.
- For genital herpes:
- Initial episode: 1 gram twice daily for 10 days
- Recurrent episodes: 500 mg twice daily for 3 days
- Suppressive therapy: 1 gram once daily
- For cold sores: 2 grams twice daily for 1 day
- For herpes zoster: 1 gram 3 times daily for 7 days 2
From the Research
Valtrex Dose for Herpes
The recommended dose of Valtrex (valacyclovir) for treating herpes varies depending on the type of herpes and the patient's condition.
- For the treatment of genital herpes, valacyclovir has been shown to be effective in episodic treatment and daily suppressive therapy 3, 4.
- The standard dose for episodic treatment of genital herpes is 500 mg twice daily for 3 days 4.
- For daily suppressive therapy, the recommended dose is 500 mg to 1000 mg once daily 3, 5.
- Valacyclovir is also effective in reducing the transmission of herpes simplex virus infection 3.
- For the treatment of herpes labialis, valacyclovir is indicated, but the dose is not specified in the provided studies.
- For the treatment of herpes zoster, valacyclovir is more effective than acyclovir or placebo in shortening the length and severity of herpes zoster-associated pain and postherpetic neuralgia 3.
Key Considerations
- The dose and duration of valacyclovir treatment may vary depending on the patient's condition and the severity of the infection.
- Valacyclovir has been shown to be well-tolerated and effective in immunocompetent and immunocompromised patients, but high-dose prophylactic therapy may increase the risk of thrombotic microangiopathy (TMA)-like syndrome in immunocompromised patients 5.
- The choice of therapy should be based on factors such as cost, ease of dosing, and acyclovir resistance 6.