Valtrex (valacyclovir hydrochloride) is a leading prescription antiviral medication designed to manage outbreaks of herpes viruses, including genital herpes, cold sores, shingles, and chickenpox. As a prodrug of acyclovir, it offers enhanced bioavailability, allowing for less frequent dosing and improved patient compliance. Trusted by healthcare professionals worldwide, Valtrex works by inhibiting viral replication, reducing symptom severity, and decreasing the frequency of outbreaks. It is a cornerstone in both episodic treatment and suppressive therapy for herpes infections.

Features

• Active ingredient: Valacyclovir hydrochloride
• Available in 500 mg and 1000 mg tablet formulations
• Prodrug design for improved oral bioavailability compared to acyclovir
• Rapid conversion to active form (acyclovir) in the body
• FDA-approved for treatment and suppression of herpes simplex and zoster infections
• Prescription-only medication requiring medical supervision

Benefits

• Reduces the duration and pain of active herpes outbreaks
• Lowers the risk of transmitting genital herpes to partners when used daily
• Decreases frequency of recurrent episodes with suppressive therapy
• Helps prevent postherpetic neuralgia when treating shingles promptly
• Supports faster healing of cold sore lesions
• Minimizes overall viral shedding during treatment periods

Common use

Valtrex is primarily prescribed for the treatment of herpes simplex virus type 2 (genital herpes), herpes simplex virus type 1 (oral herpes/cold sores), herpes zoster (shingles), and chickenpox. It is used both as episodic therapy (treating active outbreaks) and as chronic suppressive therapy (preventing recurrent outbreaks). Off-label uses may include prevention of cytomegalovirus (CMV) infection in immunocompromised patients.

Dosage and direction

Dosage varies based on condition being treated:

• Genital herpes (initial episode): 1000 mg twice daily for 10 days
• Genital herpes (recurrent episodes): 500 mg twice daily for 3 days
• Genital herpes (chronic suppression): 1000 mg once daily (500 mg once daily may be used in some cases)
• Cold sores: 2000 mg twice daily for 1 day (doses 12 hours apart)
• Shingles: 1000 mg three times daily for 7 days
• Chickenpox (children 2-18 years): 20 mg/kg three times daily for 5 days (maximum 1000 mg three times daily)

Take with or without food, with a full glass of water. Begin treatment at earliest symptom onset for optimal results. Complete the full prescribed course even if symptoms improve.

Precautions

• Inform your healthcare provider of kidney problems; dosage adjustment may be necessary
• Maintain adequate hydration during treatment to prevent kidney issues
• Notify your doctor if you are HIV-positive or immunocompromised
• Use with caution in elderly patients due to potential age-related kidney function decline
• May cause dizziness; avoid driving or operating machinery until effects are known
• Inform your doctor of all medications you are taking, including over-the-counter drugs
• Regular blood tests may be required during long-term therapy

Contraindications

• Hypersensitivity to valacyclovir, acyclovir, or any component of the formulation
• Patients with advanced HIV disease or bone marrow transplants (higher risk of thrombotic microangiopathy)
• Severe renal impairment (creatinine clearance <15 mL/min) without appropriate dosage adjustment
• History of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome

Possible side effect

Common side effects (≥1%):

• Headache (13%)
• Nausea (6%)
• Abdominal pain (3%)
• Dizziness (3%)
• Vomiting (2%)
• Diarrhea (2%)
• Rash (1%)

Less common but serious side effects:

• Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (rare)
• Neurological symptoms (agitation, hallucinations, confusion, seizures)
• Renal impairment, including acute renal failure
• Hepatitis and elevated liver enzymes
• Severe skin reactions including Stevens-Johnson syndrome
• Hematological abnormalities (anemia, leukopenia, thrombocytopenia)

Drug interaction

• Nephrotoxic drugs (aminoglycosides, cyclosporine, tacrolimus, NSAIDs): Increased risk of renal toxicity
• Probenecid: May decrease acyclovir clearance, increasing valacyclovir exposure
• Other drugs eliminated by active renal secretion: Potential for increased concentrations of either medication
• Zidovudine: May cause increased drowsiness or fatigue
• Mycophenolate mofetil: Potential additive effect on immunosuppression

Missed dose

Take the missed dose as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose to make up for a missed one. For the one-day cold sore treatment regimen, contact your healthcare provider for guidance if you miss a dose.

Overdose

Overdose may lead to renal impairment (elevated creatinine, acute renal failure), neurological symptoms (agitation, hallucinations, coma, seizures), and nausea. Management includes supportive care and hemodialysis, which significantly enhances acyclovir elimination. Contact poison control (1-800-222-1222) or seek emergency medical attention immediately if overdose is suspected.

Storage

Store at room temperature (20-25°C or 68-77°F) in the original container. Keep tightly closed and protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Do not flush medications down the toilet or pour down a drain unless instructed to do so.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Valtrex is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual results may vary. Always consult with your healthcare provider for proper diagnosis, treatment recommendations, and to discuss potential risks and benefits based on your specific medical condition and history.

Reviews

“After years of struggling with frequent genital herpes outbreaks, Valtrex has been life-changing. On suppressive therapy, I’ve had only one minor outbreak in two years compared to monthly episodes before treatment. The peace of mind is invaluable.” - Sarah T., 34

“As a physician, I prescribe Valtrex regularly for appropriate patients. The improved bioavailability over acyclovir means better compliance and more consistent results. It’s particularly effective when initiated promptly at symptom onset.” - Dr. M. Chen, Infectious Disease Specialist

“I used Valtrex for my shingles outbreak and noticed significant pain reduction within 48 hours. The convenience of twice-daily dosing made it easy to complete the full course despite the discomfort.” - Robert L., 62

“While Valtrex works well for my cold sores, I did experience some nausea initially. Taking it with food completely resolved this issue. Starting treatment at the first tingling sensation prevents full blister development.” - Jennifer K., 28

“After my transplant, my medical team prescribed Valtrex for CMV prevention. I’ve remained infection-free for over a year with minimal side effects. Regular monitoring ensures my kidney function remains stable.” - Michael R., 51