From the Guidelines
A 30-day supply of valacyclovir 500 mg is typically prescribed to treat or suppress herpes virus infections, particularly for daily suppressive therapy to reduce the frequency of herpes recurrences, as supported by the most recent guidelines 1. The medication is commonly used for treating initial or recurrent outbreaks of genital herpes, cold sores (herpes labialis), or as daily suppressive therapy.
- For initial genital herpes episodes, the typical dosage is 1 gram twice daily for 10 days.
- For recurrent episodes, 500 mg twice daily for 3 days is common.
- For suppressive therapy, 500 mg to 1 gram once daily is often prescribed, which explains the 30-day supply. Valacyclovir is also used for herpes zoster (shingles) treatment, though typically at higher doses. The medication works by converting to acyclovir in the body, which inhibits viral DNA replication, as described in earlier studies 1. Patients should take the full course as prescribed, even if symptoms improve, and should stay hydrated while using this medication. Common side effects may include headache, nausea, or abdominal pain, as noted in various guidelines 1. Valacyclovir is not a cure for herpes infections but helps manage symptoms and reduce viral shedding, with the added benefit of reducing transmission risk in certain cases 1.
From the FDA Drug Label
The recommended dosage of VALTREX for the treatment of cold sores in pediatric patients aged greater than or equal to 12 years is 2 grams twice daily for 1 day taken 12 hours apart. For recurrent episodes of genital herpes, the recommended dosage is 500 mg twice daily for 5 days in immunocompetent adults, and for suppressive therapy, the recommended dosage is 500 mg once daily for immunocompetent patients with less than or equal to 9 recurrences/year, or 500 mg twice daily in HIV-1-infected patients.
A 30-day supply of valacyclovir 500 mg is used for suppressive therapy of genital herpes in immunocompetent patients with less than or equal to 9 recurrences/year, or for reduction of transmission of genital herpes in immunocompetent adults, at a dosage of 500 mg once daily 2.
From the Research
Uses of Valacyclovir 500 mg
- Valacyclovir 500 mg is used to treat infections caused by herpes simplex virus (HSV) and varicella zoster virus, and for prophylaxis against cytomegalovirus (CMV) 3
- A 30-day supply of valacyclovir 500 mg can be used for the suppression of genital herpes recurrences in immunocompetent individuals 3
- Valacyclovir dosages of ≥ 500 mg daily are recommended for suppression of genital herpes recurrences in immunocompetent individuals 3
Treatment of Genital Herpes
- Valacyclovir is effective in the treatment of genital herpes, reducing the duration of viral shedding, hastening lesion healing, and decreasing lesion-associated pain 4, 5, 6, 7
- Valacyclovir is also effective in suppressing recurrent episodes of genital herpes and significantly prolonging the time to a recurrent episode of infection compared with placebo 4, 5, 6, 7
Treatment of Herpes Zoster
- Valacyclovir is effective in the treatment of herpes zoster, reducing the duration and severity of zoster-associated pain and postherpetic neuralgia 4, 5, 6, 7
- Valacyclovir is more effective than acyclovir and equally effective as famciclovir at hastening the healing of zoster-associated pain and postherpetic neuralgia 5, 6, 7
Dosage and Administration
- Valacyclovir can be administered in a less frequent oral dosage regimen than acyclovir due to its higher bioavailability 3, 4
- A 3-day course of valacyclovir 500 mg twice daily is effective in the episodic treatment of recurrent genital herpes 5, 6, 7
- Once-daily dosing of valacyclovir 500 mg is effective for suppressive therapy of genital herpes 5, 6, 7