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Valacyclovir hydrochlorideGeneric 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 ofsymptoms (rash).

Genital herpes: 1 g PO bid for 7 10 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 immunocompetentpatients

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

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Available forms :Tablets 500 mg, 1 g

ADULTS

Herpes zoster: 1 g tid PO for 7 days; most effective if started within 48 hr of onset ofsymptoms (rash).

Genital herpes: 1 g PO bid for 7 10 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; thromboticthrombocytopenic 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.

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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.