What is the dose of Valtrex (valacyclovir) for herpes simplex?

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Last updated: April 15, 2025View editorial policy

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From the Guidelines

For the treatment of herpes simplex, the recommended dose of valtrex (valacyclovir) is 1 g orally twice a day for 7-10 days. This dosage is based on the guidelines provided by the Centers for Disease Control and Prevention, as outlined in the 1998 guidelines for treatment of sexually transmitted diseases 1.

Key Considerations

  • The dose of valtrex may vary depending on the specific context, such as the severity of the outbreak, the patient's immune status, and the presence of any underlying medical conditions.
  • It is essential to note that valtrex works by converting to acyclovir in the body, which then inhibits viral DNA synthesis, preventing the herpes virus from replicating 1.
  • For best results, treatment should begin at the earliest sign of an outbreak, ideally during the prodromal period when the patient feels tingling or burning before visible sores appear.

Important Details

  • The dosage may need adjustment for patients with kidney impairment.
  • Other treatment options, such as acyclovir and famciclovir, are also available, but valtrex is often preferred due to its convenience and efficacy 1.
  • It is crucial to follow the recommended treatment regimen to ensure optimal outcomes and minimize the risk of complications.

From the FDA Drug Label

The recommended dosage of VALTREX for treatment of cold sores is 2 grams twice daily for 1 day taken 12 hours apart. The dose of valtrex for herpes simplex (cold sores) is 2 grams twice daily for 1 day taken 12 hours apart 2.

  • Initiation of therapy: at the earliest symptom of a cold sore (e.g., tingling, itching, or burning)
  • Duration of therapy: 1 day
  • Frequency of dosing: twice daily, 12 hours apart

From the Research

Dosage of Valtrex for Herpes Simplex

The dosage of Valtrex (valacyclovir) for herpes simplex varies depending on the severity and frequency of outbreaks.

  • For the suppression of genital herpes recurrences in immunocompetent individuals, valacyclovir dosages of ≥ 500 mg daily are recommended 3.
  • In the treatment of facial herpes simplex virus infection, valacyclovir 1000 mg twice daily for 1 day or 500 mg twice daily for 3 days can be used 4.
  • For episodic treatment of recurrent genital herpes, valacyclovir 500 mg twice daily for 3 days can be used 5.
  • For suppressive therapy, valacyclovir 500 mg once daily can be used 5.

Comparison with Other Antivirals

Valacyclovir has been compared with other antivirals such as famciclovir and acyclovir in several studies.

  • Valacyclovir appears to be somewhat better than famciclovir for suppression of genital herpes and associated shedding 6.
  • Valacyclovir is more effective than acyclovir and equally effective as famciclovir at hastening the healing of zoster-associated pain and postherpetic neuralgia 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.

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