Indications
- Treatment for Herpes simplex virus infections of the skin and mucous membranes including initial and recurrent genital herpes, Varicella (chickenpox) and Herpes zoster (shingles).
- Suppression of recurrent Herpes simplex infections in immunocompetent patients.
- Prophylaxis of Herpes simplex infections in immunocompromised patients.
Contraindications
Patients who develop hypersensitivity to acyclovir or valacyclovir.
Dosage and administration
- Primary Herpes simplex infections, including genital herpes: 200 mg five times daily (usually every 4 hours while awake) for 5 – 10 days.
Severely immunocompromised patients or those with impaired absorption: 400 mg five times daily for 5 days.
Renal impairment (CC < 10 ml/minute): 200 mg every 12 hours. - Suppression of recurrent Herpes simplex in immunocompetent patients: 800 mg daily in 2 – 4 divided doses (reduction to 400 – 600 mg daily can be tried, dosage > 1 g daily have also been used. Interrupt every 6 – 12 months for reassessment.
- Prophylaxis of Herpes simplex in immunocompromised patients: 200 to 400 mg four times daily. Children < 2 years old: Half the adult dose.
- Chronic suppressive treatment: 200 mg five times daily for 5 days, preferably initiated during the prodromal period.
- Chickenpox: 800 mg four or five times daily for 5 to 7 days.
- Renal impairment:|
CC < 10 ml/minute: 800 mg every 12 hours;
CC 10 – 25 ml/minute: 800 mg three times daily every 8 hours. - Herpes zoster: 800 mg five times daily may be given for 7 to 10 days.
Precaution
- Elderly patients and patients with renal impairment are at increased risk of developing neurological side effects and should be closely monitored.
- Pregnancy (only if the potential benefit justifies the potential risk).
- Nursing mother (only when indicated).
Storage
Store at temperature below 30°C, protect from light.
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