From the Guidelines
Genital Herpes Prophylaxis with Valacyclovir
For genital herpes prophylaxis, the recommended dose of Valtrex (valacyclovir) is 500 mg administered once daily 1. Alternatively, 1 gram of Valtrex can be taken once daily for patients with a history of fewer than 10 recurrences per year.
- The dose may need to be adjusted in patients with renal insufficiency, with a recommended dose of 500 mg every 24-48 hours for those with a creatinine clearance of less than 30 mL/min 1.
- The duration of prophylactic therapy is individualized, but typically ranges from 6 to 12 months, with ongoing assessment of efficacy and safety.
- It is essential to note that valacyclovir is effective in preventing recurrences of genital herpes, and its use can also result in a decrease in HIV concentration in plasma and anal and genital secretions in HIV-infected persons 1.
- Patients should be asked if they have a history of HSV infection before commencing immunosuppressive therapy, and routine prophylaxis to suppress virus replication should be considered for patients with frequent recurrent attacks 1.
From the FDA Drug Label
- 1 Adult Dosing Recommendations ... 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
The valacyclovir (Valtrex) dose for genital herpes prophylaxis is 1 gram once daily in patients with normal immune function, or 500 mg once daily in patients with a history of 9 or fewer recurrences per year 2.
From the Research
Valacyclovir Dose for Genital Herpes Prophylaxis
- The recommended dose of valacyclovir for genital herpes prophylaxis is 500 mg once daily 3, 4, 5
- This dose has been shown to be effective in preventing or delaying recurrences of genital herpes in immunocompetent patients 3, 4
- For patients with a history of more than 10 recurrences per year, a dose of 1 g once daily may be more effective 3
- Valacyclovir has been shown to be well tolerated and safe for use in genital herpes prophylaxis, with a safety profile comparable to that of acyclovir 3, 4, 5
Alternative Dosing Regimens
- A dose of 250 mg twice daily has also been shown to be effective in preventing or delaying recurrences of genital herpes 3
- A study comparing once daily and twice daily dosing regimens found that 1 g once daily was as effective as 500 mg twice daily 6
- A 3-day course of 500 mg twice daily has been shown to be equivalent to a 5-day course in terms of efficacy for episodic treatment of recurrent genital herpes 7