Herpes simplex virus infection is increasingly common in the United States. New antiviral medications have expanded treatment options for the two most common cutaneous manifestations, orolabial and genital herpes. Acyclovir therapy remains an effective and often less expensive option. Famciclovir and valacyclovir offer improved oral bioavailability and convenient oral dosing schedules but are more expensive than acyclovir. Patients who have six or more recurrences of genital herpes per year can be treated with one of the following regimens: acyclovir, 400 mg twice daily; valacyclovir, 1 g daily; or famciclovir, 250 mg twice daily. These regimens are effective in suppressing 70 to 80 percent of symptomatic recurrences. Episodic treatment of recurrent genital herpes is of questionable benefit, but it may be helpful in appropriately selected patients. An extensive clinical trial program combined with 5 years’ postmarketing experience with valacyclovir provides evidence of favorable safety and efficacy in herpes simplex virus (HSV) management. Valacyclovir enhances acyclovir bioavailability compared with orally administered acyclovir. Long-term use of acyclovir for up to 10 years for HSV suppression is effective and well tolerated. Acyclovir is also approved for use in children, is available in some countries over the counter in cream formulation for herpes labialis, and has been monitored in over 1000 pregnancies. Safety monitoring data from clinical trials of valacyclovir, involving over 3000 immunocompetent and immunocompromised persons receiving long-term therapy for HSV suppression, were analyzed. Safety profiles of valacyclovir (⩽1000 mg/day), acyclovir (800 mg/day), and placebo were similar. Extensive sensitivity monitoring of HSV isolates confirmed a very low rate of acyclovir resistance among immunocompetent subjects ( Five years after the licensing of valacyclovir and two decades after the introduction of acyclovir, a wealth of data has been generated on the clinical utility of this selective antiherpes agent and its prodrug. Valacyclovir 1g Cipro 1000 Tamoxifen prevention VALTREX prescription and dosage sizes information for physicians and healthcare. 2–18yrs 20mg/kg three times daily for 5 days; max 1g three times daily. Valtrex is the brand name for valacyclovir, an antiviral drug used to treat. Valtrex does not prevent the spread of herpes, so take precautions to. Q How long can you take Valtrex daily as a supressant for genital herpes? Jan 12, 2012. In study two, they took either 800 mg three-a-day, high-dose acyclovir or standard 500 mg daily doses of valacyclovir. Study three compared. 24 hours after lesion onset) Suppressive therapy (immunocompetent patients): 1 g/day PO Suppressive therapy (immunocompetent patients with ≤9 recurrences annually): 500 mg/day PO; transmission reduction for source partner, 500 mg/day PO Suppressive therapy (HIV-infected patients): 500 mg PO q12hr Thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome (HUS) reported in patients with advanced HIV disease and in allogenic bone marrow transplant and renal transplant recipients Acute renal failure (ARF) may occur, especially in elderly patients or those with underlying renal impairment receiving higher than recommended doses; use with caution in patients with renal impairment, the elderly, and/or patients receiving nephrotoxic drugs Treatment should begin with the earliest symptom (tingling, burning, itching) in cold sores; for genital herpes, it should begin at the first signs and symptoms (within 72 hours of onset of first diagnosis or 24 hours of onset of recurrent episodes); for herpes zoster, it should begin within 72 hours of onset of rash; for chicken pox, it should begin with the earliest sign or symptom Central nervous system (CNS) effects may occur (eg, agitation, hallucinations, confusion, encephalopathy); risk of CNS adverse effects is higher in elderly patients Adequately hydrate patient; decreased precipitation in renal tubules may occur Metabolized by liver; valacyclovir is rapidly and nearly completely converted to acyclovir and L-valine via first-pass effect; acyclovir is hepatically metabolized to a very small extent by aldehyde oxidase and by alcohol and aldehyde dehydrogenase (inactive metabolites) The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Genital herpes is a chronic, life-long viral infection. Two types of HSV can cause genital herpes: HSV-1 and HSV-2. Most cases of recurrent genital herpes are caused by HSV-2, and approximately 50 million persons in the United States are infected with this type of genital herpes . Most persons infected with HSV-2 have not had the condition diagnosed. Many such persons have mild or unrecognized infections but shed virus intermittently in the anogenital area. As a result, most genital herpes infections are transmitted by persons unaware that they have the infection or who are asymptomatic when transmission occurs. Management of genital HSV should address the chronic nature of the disease rather than focusing solely on treatment of acute episodes of genital lesions. Valtrex daily dose Valacyclovir for Herpes Simplex Virus Infection Long-Term Safety., Valtrex Valacyclovir - Side Effects, Dosage, Interactions - Drugs Viagra chemistryMetformin vs glucophage Jan 6, 2012. Standard-dose 400 mg acyclovir Zovirax twice daily; Standard-dose 500 mg valacyclovir Valtrex daily with high-dose 800 mg acyclovir three. Breakthrough herpes episodes occur even with high-dose antivirals.. Herpes Drugs Don't Stop Herpes Spread - WebMD. Valacyclovir Oral Route Proper Use - Mayo Clinic. Dec 19, 2018. Valtrex can treat cold sores, recurrent infections caused by the herpes. from taking daily doses of acyclovir or Valtrex to reduce the number of. Dosage. Valtrex is an oral caplet. It comes in 500-milligram and 1-gram. The recommended dosage is 2 grams twice daily, taken 12. Mar 15, 2000. Newer antiviral drugs with once-daily dosage benefits have emerged during the past several years. Famciclovir Famvir and valacyclovir.