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Valaciclovir

Valaciclovir, also spelled valacyclovir, is an antiviral medication used to treat outbreaks of herpes simplex or herpes zoster (shingles).[2] It is also used to prevent cytomegalovirus following a kidney transplant in high risk cases.[2] It is taken by mouth.[2]

Clinical data

Valtrex, Zelitrex, others

valacyclovir, valacyclovir hydrochloride (USAN US)

  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
  • US: ℞-only[1]
  • In general: ℞ (Prescription only)

13–18%

<30 minutes (valaciclovir);
2.5–3.6 hours (aciclovir)

Kidney 40–50% (aciclovir),
faecal 47% (aciclovir)

C13H20N6O4

324.341 g·mol−1

Common side effects include headache and vomiting.[2] Severe side effects may include kidney problems.[2] Use in pregnancy appears to be safe.[2] It is a prodrug, which works after being converted to aciclovir in a person's body.[2]


Valaciclovir was patented in 1987 and came into medical use in 1995.[3][4] It is on the World Health Organization's List of Essential Medicines.[5] It is available as a generic medication.[6] In 2021, it was the 114th most commonly prescribed medication in the United States, with more than 5 million prescriptions.[7][8]

Oral and genital (treatment and prevention)

herpes simplex

Reduction of HSV transmission from people with recurrent infection to uninfected individuals

(shingles): the typical dosage for treatment of herpes is 1,000 mg orally three times a day for seven consecutive days.[10]

Herpes zoster

Prevention of following organ transplantation

cytomegalovirus

Prevention of herpesviruses in immunocompromised people (such as those undergoing cancer chemotherapy)

[11]

Chickenpox in children (ages 2–18)

[1]

Valaciclovir is used for the treatment of HSV and VZV infections, including:[9]


It has shown promise as a treatment for infectious mononucleosis[12][13][14] and is preventively administered in suspected cases of herpes B virus exposure.[15]


Bell's palsy does not seem to benefit from using valaciclovir as its only treatment.[16][17]

Adverse effects[edit]

Common adverse drug reactions (≥1% of people) associated with valaciclovir are the same as for aciclovir, its active metabolite. They include: nausea, vomiting, diarrhea and headache. Infrequent adverse effects (0.1–1% of patients) include: agitation, vertigo, confusion, dizziness, edema, arthralgia, sore throat, constipation, abdominal pain, rash, weakness and/or renal impairment. Rare adverse effects (<0.1% of patients) include: coma, seizures, neutropenia, leukopenia, tremor, ataxia, encephalopathy, psychotic symptoms, crystalluria, anorexia, fatigue, hepatitis, Stevens–Johnson syndrome, toxic epidermal necrolysis and/or anaphylaxis.[9]

type I (HSV-1)

Herpes simplex virus

Herpes simplex virus type II (HSV-2)

(VZV)

Varicella zoster virus

(EBV)

Epstein–Barr virus

(CMV)

Cytomegalovirus

History[edit]

Valaciclovir was patented in 1987 and came into medical use in 1995.[3][4] It is available as a generic medication.[6] In 2021, it was the 114th most commonly prescribed medication in the United States, with more than 5 million prescriptions.[7][8]

Society and culture[edit]

Brand names[edit]

It is marketed by GlaxoSmithKline under the brand names Valtrex[1] and Zelitrex. Valaciclovir has been available as a generic drug in the U.S. since November 2009.[25]