Valtrex Dosage
Generic name: valacyclovir
Drug class: Purine nucleosides
Recommended Adult Dosing
Dosage forms: TAB: 500 mg, 1000 mg
Genital HSV, immunocompetent pts
- [1st episode]
- Dose: 1000 mg PO q12h x7-10 days; Start: ASAP w/in 72h of sx onset, maximum efficacy w/in 48h; Info: may extend tx if not healed after 10 days
- [recurrence]
- Dose: 500 mg PO q12h x3 days; Start: ASAP w/in 24h of sx onset; Alt: 1000 mg PO qd x5 days
- [suppression]
- Dose: 1000 mg PO qd; Info: give 500 mg PO bid in pregnant pts, start at 36 wk gestation; decr. dose to 500 mg PO qd if <10 outbreaks/y; reassess tx need at 1y
Genital HSV, immunocompromised pts
- [*1st episode]
- Dose: 1000 mg PO q12h x7-10 days; Start: ASAP w/in 72h of sx onset, maximum efficacy w/in 48h; Info: may extend tx if not healed after 10 days
- [*recurrence]
- Dose: 1000 mg PO q12h x5-10 days
- [suppression]
- Dose: 500 mg PO q12h; Info: reassess tx need at 1y
Herpes labialis (cold sores)
- [episode]
- Dose: 2000 mg PO q12h x1 day; Start: ASAP after sx onset
- [*suppression]
- Dose: 500 mg PO qd; Info: reassess tx need at 4mo
Herpes zoster (shingles)
- [1000 mg PO q8h x7 days]
- Start: ASAP w/in 72h of rash onset, maximum efficacy w/in 48h; Info: may use for herpes zoster ophthalmicus
Renal dosing
- [if usual dose 500 mg qd]
- CrCl <29: 500 mg q48h
- HD: 500 mg q48h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 500 mg q12h]
- CrCl <29: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 1000 mg qd]
- CrCl <29: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 1000 mg q12h]
- CrCl 10-29: 1000 mg qd; CrCl <10: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 1000 mg q8h]
- CrCl 30-49: 1000 mg q12h; CrCl 10-29: 1000 mg qd; CrCl <10: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 2000 mg q12h x1 day]
- CrCl 30-49: 1000 mg q12h x1 day; CrCl 10-29: 500 mg q12h x1 day; CrCl <10: 500 mg x1
- HD: 500 mg x1 after dialysis; no supplement; PD: 500 mg q48h; no supplement
Hepatic dosing
- [no adjustment]
Recommended Peds Dosing
- Dosage forms: TAB: 500 mg, 1000 mg
Herpes labialis (cold sores)
- [12 yo and older]
- Dose: 2000 mg PO q12h x1 day; Start: ASAP after sx onset
Varicella (chicken pox), immunocompetent pts
- [2 yo and older]
- Dose: 20 mg/kg/dose PO q8h x5 days; Start: ASAP w/in 24h of rash onset; Max: 1000 mg/dose
Genital HSV
- [1st episode, preadolescents >45 kg and adolescents]
- Dose: 1000 mg PO q12h x10 days; Start: ASAP w/in 72h of sx onset, maximum efficacy w/in 48h; Info: may extend tx if not healed after 10 days
- [recurrence, preadolescents >45 kg and adolescents]
- Dose: 500 mg PO q12h x3 days; Alt: 1 g q24h x5 days; Start: ASAP w/in 24h of sx onset
- [suppression, preadolescents >45 kg and adolescents]
- Dose: 1000 mg PO qd; Info: give 500 mg PO bid in pregnant pts, start at 36 wk gestation; decr. dose to 500 mg PO qd if <10 outbreaks/y; reassess tx need at 1y
Renal dosing
- [varicella (chicken pox)]
- CrCl 30-50: give usual dose q12h; CrCl 10-29: give usual dose q24h; CrCl <10: give 50% usual dose q24h
- HD: give 50% usual dose q24h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: give 50% usual dose q24h; no supplement
- [all other indications, usual dose 500 mg q12h]
- CrCl <29: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [all other indications, usual dose 1000 mg qd]
- CrCl <29: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [all other indications, usual dose 1000 mg q12h]
- CrCl 10-29: 1000 mg qd; CrCl <10: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [all other indications, usual dose 2000 mg q12h x1 day]
- CrCl 30-49: 1000 mg q12h x1 day; CrCl 10-29: 500 mg q12h x1 day; CrCl <10: 500 mg x1
- HD: 500 mg x1 after dialysis; no supplement; PD: 500 mg q48h; no supplement
Hepatic dosing
- [no adjustment]