What is the recommended dose of valacyclovir (Valtrex) for herpes zoster (shingles)?

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Last updated: March 26, 2025 • View editorial policy

From the Guidelines

The recommended dose of valacyclovir (Valtrex) for herpes zoster (shingles) is 1 g orally three times a day, however the provided evidence suggests 1 g orally twice a day for 7-10 days. When considering the treatment of herpes zoster, it is crucial to prioritize the most recent and highest quality evidence available. However, based on the provided evidence from 1, the dose of valacyclovir for herpes zoster is recommended as 1 g orally twice a day for 7-10 days. Some key points to consider when treating herpes zoster with valacyclovir include:

  • Starting treatment at the earliest sign of shingles, ideally within 72 hours of rash onset, to improve outcomes and reduce the risk of complications
  • Potential dose adjustments for patients with kidney impairment
  • Common side effects such as headache, nausea, and dizziness
  • The importance of completing the full course of medication even if symptoms improve before the treatment ends
  • Staying well-hydrated while taking this medication It is essential to note that the provided evidence from 1 is from 1998, and more recent guidelines may have updated recommendations. However, based on the available evidence, the recommended dose of valacyclovir for herpes zoster is 1 g orally twice a day for 7-10 days.

From the FDA Drug Label

The recommended dosage of VALTREX for treatment of herpes zoster is 1 gram 3 times daily for 7 days Therapy should be initiated at the earliest sign or symptom of herpes zoster and is most effective when started within 48 hours of the onset of rash.

The recommended dose of valacyclovir (Valtrex) for herpes zoster (shingles) is 1 gram 3 times daily for 7 days. Therapy should be initiated at the earliest sign or symptom of herpes zoster and is most effective when started within 48 hours of the onset of rash 2.

From the Research

  • The recommended dose of valacyclovir (Valtrex) for herpes zoster (shingles) is 1000 mg three times daily for 7 days 3, 4, 5.
  • This dose has been shown to be effective in accelerating the resolution of herpes zoster-associated pain and reducing the duration of postherpetic neuralgia 3, 4, 5.
  • Alternatively, a dose of 1.5 g twice daily for 7 days has also been found to be safe and effective in treating uncomplicated herpes zoster in immunocompetent patients 18 years of age or older 6.

Comparison with Other Antiviral Agents

  • Valacyclovir has been compared with acyclovir and famciclovir in several studies, and has been found to be at least as effective as these agents in treating herpes zoster 3, 7, 4, 5.
  • Valacyclovir has also been shown to offer simpler dosing and a more favorable safety profile compared to acyclovir 3, 4, 5.

Duration of Treatment

  • The duration of treatment with valacyclovir for herpes zoster is typically 7 days 3, 4, 6, 5.
  • However, some studies have investigated the use of valacyclovir for 14 days, and have found that this duration of treatment does not offer significant advantages over a 7-day course 3, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.