Adults: Treatment of herpes zoster (shingles): The dosage in adults is 1000 mg of VALTREX to be taken 3 times daily for 7 days.
Treatment of herpes simplex infections: Immunocompetent adults: The dosage in adults is 500 mg of VALTREX to be taken twice daily.
For recurrent episodes, treatment should be for three or five days. For initial episodes, which can be more severe, treatment may have to be extended to ten days. Dosing should begin as early as possible. For recurrent episodes of herpes simplex, this should ideally be during the prodromal period or immediately the first signs or symptoms appear.
Prevention (suppression) of recurrences of herpes simplex infections: Immunocompetent adults: In immunocompetent patients, 500 mg of VALTREX to be taken once daily.
Some patients with very frequent recurrences (eg 10 or more per year) may gain additional benefit from the daily dose of 500 mg being taken as a divided dose (250 mg twice daily).
Immunocompromised adults: For immunocompromised adult patients the dose is 500 mg twice daily.
Reduction of transmission of genital herpes: In immunocompetent heterosexual adult with 9 or fewer recurrences per year, 500 mg of VALTREX to be taken once daily by the infected partner.
There are no data on the reduction of transmission in other patient populations.
Children: There are no data available on the use of VALTREX in children.
Elderly: The possibility of renal impairment in the elderly must be considered and the dosage should be adjusted accordingly (see Renal impairment as follows).
Adequate hydration should be maintained.
Renal impairment: Caution is advised when administering valaciclovir to patients with impaired renal function. Adequate hydration should be maintained.
The dosage of VALTREX should be reduced in patients with significantly impaired renal function as shown in the table as follows: (See table.)
Click on icon to see table/diagram/image
In patients on intermittent haemodialysis, the VALTREX dosage recommended for patients with a creatinine clearance of less than 15 mL/min should be used. This should be administered after the haemodialysis has been performed.
The creatinine clearance should be monitored frequently, especially during periods when renal function is changing rapidly, e.g. immediately after transplantation or engraftment. The VALTREX dosage should be adjusted accordingly.
Hepatic impairment: Studies with a 1 g unit dose of VALTREX show that dose modification is not required in patients with mild or moderate cirrhosis (hepatic synthetic function maintained). Pharmacokinetic data in patients with advanced cirrhosis, (impaired hepatic synthetic function and evidence of portal-systemic shunting) do not indicate the need for dosage adjustment; however, clinical experience is limited. For higher doses (4 g or more/day), see Precautions.