Select a medication above to begin.
valacyclovir
generic
Adult Dosing .
Dosage forms: TAB: 500 mg, 1000 mg
genital HSV, immunocompetent patients
- [1st episode]
- Dose: 1000 mg PO q12h x7-10 days; Start: ASAP w/in 72h of symptom onset, maximum efficacy w/in 48h; Info: may extend tx if not healed after 10 days
- [recurrence]
- Dose: 500 mg PO q12h x3 days; Start: ASAP w/in 24h of symptom onset; Alt: 1000 mg PO qd x5 days
- [suppression]
- Dose: 1000 mg PO qd; Info: give 500 mg PO bid in pregnant patients, start at 36 wk gestation; decr. dose to 500 mg PO qd if <10 outbreaks/y; reassess tx need at 1y
genital HSV, immunocompromised patients
- [1st episode (off-label)]
- Dose: 1000 mg PO q12h x7-10 days; Start: ASAP w/in 72h of symptom onset, maximum efficacy w/in 48h; Info: may extend tx if not healed after 10 days
- [recurrence (off-label)]
- Dose: 1000 mg PO q12h x5-10 days
- [suppression]
- Dose: 500 mg PO q12h; Info: reassess tx need at 1y
herpes labialis (cold sores)
- [recurrence]
- Dose: 2000 mg PO q12h x1 day; Start: ASAP after symptom onset
- [suppression (off-label)]
- Dose: 500 mg PO qd; Info: reassess tx need at 4mo
herpes zoster (shingles)
- [1000 mg PO q8h x7 days]
- Start: ASAP w/in 72h of rash onset, maximum efficacy w/in 48h; Info: may use for herpes zoster ophthalmicus
renal dosing
- [if usual dose 500 mg qd]
- CrCl <29: 500 mg q48h
- HD: 500 mg q48h, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 500 mg q12h]
- CrCl <29: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 1000 mg qd]
- CrCl <29: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 1000 mg q12h]
- CrCl 10-29: 1000 mg qd; CrCl <10: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 1000 mg q8h]
- CrCl 30-49: 1000 mg q12h; CrCl 10-29: 1000 mg qd; CrCl <10: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [if usual dose 2000 mg q12h x1 day]
- CrCl 30-49: 1000 mg q12h x1 day; CrCl 10-29: 500 mg q12h x1 day; CrCl <10: 500 mg x1
- HD: 500 mg x1 after dialysis; no supplement; PD: 500 mg q48h; no supplement
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: TAB: 500 mg, 1000 mg
herpes labialis (cold sores)
- [12 yo and older]
- Dose: 2000 mg PO q12h x1 day; Start: ASAP after symptom onset
varicella (chicken pox), immunocompetent patients
- [2 yo and older]
- Dose: 20 mg/kg/dose PO q8h x5 days; Start: ASAP w/in 24h of rash onset; Max: 1000 mg/dose
genital HSV (off-label)
- [1st episode, preadolescents >45 kg and adolescents]
- Dose: 1000 mg PO q12h x10 days; Start: ASAP w/in 72h of symptom onset, maximum efficacy w/in 48h; Info: may extend tx if not healed after 10 days
- [recurrence, preadolescents >45 kg and adolescents]
- Dose: 500 mg PO q12h x3 days; Alt: 1 g q24h x5 days; Start: ASAP w/in 24h of symptom onset
- [suppression, preadolescents >45 kg and adolescents]
- Dose: 1000 mg PO qd; Info: give 500 mg PO bid in pregnant patients, start at 36 wk gestation; decr. dose to 500 mg PO qd if <10 outbreaks/y; reassess tx need at 1y
renal dosing
- [varicella (chicken pox)]
- CrCl 30-50: give usual dose q12h; CrCl 10-29: give usual dose q24h; CrCl <10: give 50% usual dose q24h
- HD: give 50% usual dose q24h, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: give 50% usual dose q24h; no supplement
- [all other indications, usual dose 500 mg q12h]
- CrCl <29: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [all other indications, usual dose 1000 mg qd]
- CrCl <29: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [all other indications, usual dose 1000 mg q12h]
- CrCl 10-29: 1000 mg qd; CrCl <10: 500 mg qd
- HD: 500 mg qd, on dialysis days admin. after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: 500 mg q48h; no supplement
- [all other indications, usual dose 2000 mg q12h x1 day]
- CrCl 30-49: 1000 mg q12h x1 day; CrCl 10-29: 500 mg q12h x1 day; CrCl <10: 500 mg x1
- HD: 500 mg x1 after dialysis; no supplement; PD: 500 mg q48h; no supplement
hepatic dosing
- [no adjustment]