Valacyclovir hydrochloride

Generic Name : valacyclovir hydrochloride Brand Name: Valtrex Classification: Antiviral Pregnancy Category B

Dosage & Route

ADULTS

Herpes zoster: 1 g tid PO for 7 days; most effective if started within 48 hr of onset of symptoms (rash). Genital herpes: 1 g PO bid for 710 days. Episodic treatment of recurrent genital herpes: 500 mg PO bid for 3 days. Suppression of recurrent episodes of genital herpes: 1 g PO daily; patients with history of less than nine episodes in 1 yr may respond to 500 mg PO daily. Reduction of risk of transmission: 500 mg/day PO daily for the source partner. Cold sores: 2 g PO bid for 1 day.

PEDIATRIC PATIENTS

Safety and efficacy not established.

Therapeutic actions
Antiviral activity; inhibits viral DNA replication and deactivates viral DNA polymerase.

Indications
Treatment of herpes zoster (shingles) Episodic treatment of first-episode or recurrent genital herpes in immunocompetent patients Suppression of recurrent episodes of genital herpes in HIV patients Reduction of risk of heterosexual transmission of genital herpes to healthy partners when combined with safe sex practices Treatment of cold sores (herpes labialis) in healthy adults and adolescents

Adverse effects

Available forms :Tablets500 mg, 1 g ADULTS

Herpes zoster: 1 g tid PO for 7 days; most effective if started within 48 hr of onset of symptoms (rash). Genital herpes: 1 g PO bid for 710 days. Episodic treatment of recurrent genital herpes: 500 mg PO bid for 3 days. Suppression of recurrent episodes of genital herpes: 1 g PO daily; patients with history of less than nine episodes in 1 yr may respond to 500 mg PO daily. Reduction of risk of transmission: 500 mg/day PO daily for the source partner. Cold sores: 2 g PO bid for 1 day.

PEDIATRIC PATIENTS

Safety and efficacy not established.

Contraindications
Contraindicated with allergy to valacyclovir or acyclovir. Use cautiously with pregnancy, renal impairment, thrombotic thrombocytopenic purpura, lactation.

Nursing considerations
CLINICAL ALERT! Name confusion has been reported with Valtrex (valacyclovir) and Valcyte (valganciclovir); use caution. Assessment

History: Allergy to valacyclovir, acyclovir; renal disease; lactation; thrombotic thrombocytopenic purpura, pregnancy Physical: Orientation; urinary output; abdominal examination, normal output; BUN, creatinine clearance

Interventions

Begin treatment within 72 hr of onset of symptoms of shingles. Administer without regard to meals; administer with meals to decrease GI upset if needed.

Provide appropriate analgesics for headache, discomfort of shingles. Advise continued use of safe sex practices.

Teaching points

Take this drug without regard to meals; if GI upset is a problem, take with meals. Take the full course of therapy as prescribed. Avoid contact with lesions and avoid intercourse when lesions or symptoms are present to avoid infecting others. Start therapy at first sign of an episode when treating recurrent herpes. You may experience these side effects: Nausea, vomiting, loss of appetite, diarrhea; headache, dizziness. Report severe diarrhea, nausea; headache; worsening of the shingles.