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Valacyclovir for Herpes: Everything You Need To Know

No one wants genital herpes. If you've been recently diagnosed, your head is likely spinning. You want to avoid spreading the virus if at all possible, of course, and you're also concerned about your own health.

Fortunately, many treatment options are available for herpes, and there is life after diagnosis. Valacyclovir is among the most common drugs prescribed to treat genital herpes.

Today we're looking at what valacyclovir is, why it's prescribed, and some side effects to be aware of. We'll also address a few pros and cons of taking valacyclovir for herpes.

What Is Valacyclovir?

Valacyclovir is a prescription medication most commonly available in oral tablet or liquid form. This drug can be used to treat cold sores, shingles (herpes zoster), chickenpox, and genital herpes. Valacyclovir can be used to treat active genital herpes outbreaks or to help prevent the spread of genital herpes between sexual partners.

Valacyclovir is a generic drug whose brand name is Valtrex.

Valacyclovir is an oral antiviral drug. Antivirals work to prevent viruses like herpes from entering new healthy cells in your body and spreading. They can also help keep the herpes virus from replicating inside your body.

Even though valacyclovir can help to treat and prevent herpes outbreaks, there is no known cure for herpes. The virus continues to live in a dormant state in your body until it's activated again.

Valacyclovir can help to prevent these future herpes outbreaks, however. It can also ease uncomfortable symptoms like itching and burning, and encourage sores to heal more quickly.


Valacyclovir Dosage and Usage

Valacyclovir dosing can differ depending on your diagnosis and body weight. Valacyclovir doses for children, specifically, are calculated by a pediatrician according to the child's body weight.

Because valacyclovir is a prescription medication, your health care provider will prescribe the specific dose that they believe will be safest and most effective for your situation. But you can see some typical doses in the handy infographic we've provided below.

Mayo Clinic is credited for the data used in this graphic.

Because the initial outbreak of genital herpes is usually more severe, physicians often prescribe 1,000 milligrams of valacyclovir tablets to be taken twice per day for 10 days. Subsequent outbreaks, on the other hand, may only require 500 milligrams of valacyclovir tablets twice per day for a shorter duration of time (about three days).

Valacyclovir can also be prescribed for long-term use to prevent future outbreaks of genital herpes. This dosage is usually between 500 and 1,000 milligrams once per day.

Possible Side Effects of Valacyclovir

Like any medication, valacyclovir can cause some unwanted side effects. The most common side effects are nausea and headache. Kidney impairment is a possible more severe side effect.

Two rare but dangerous complications are the blood disorders hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP). Signs of HUS and TTP include:

  • Bleeding gums.
  • Nosebleeds.
  • Blood in the urine.
  • Bloody diarrhea.
  • Weakness and lethargy.
  • Abdominal pain.
  • Vomiting.
  • Swelling in the limbs or face.
  • Decreased urination.
  • Fever.
  • Pallor.
  • Reddish-purple spots on the skin (other than the herpes sores being treated).
  • Yellowing of the skin or eyes.
  • Hallucinations.
  • Confusion.
  • Unsteady motions.

Side effects, particularly hallucination and confusion, may be more common and pronounced in patients over age 60.

If you experience any of these symptoms, stop taking valacyclovir and contact your prescribing doctor immediately.


Interactions With Other Drugs

Drug interactions happen when two or more drugs combine in the body and to create unintended effects or symptoms. Interactions can range from mild to severe and dangerous. See the chart below for some examples.


Valacyclovir can interact with over 60 different drugs, which is why it's important to let your physician know about any medications you're taking. For example, valacyclovir can cause serious negative interactions with several medications used to treat HIV, including:

  • Emtricitabine.
  • Lopinavir.
  • Ritonavir.
  • Tenofovir.

Be sure to tell your physician if you have HIV and if you're taking medications or taking treatment to control it.

Valacyclovir can also be dangerous when taken in combination with a class of drugs called aminoglycoside antibiotics. This includes drugs such as:

  • Amikacin.
  • Gentamicin.
  • Neomycin.
  • Tobramycin.

Aminoglycosides — along with certain other antibiotics, like bacitracin — and valacyclovir can potentially cause kidney damage, and this risk increases when the drugs are taken together.

This is not a full list of possible drug interactions. If you're using any other medications, consult a more complete list of possible interactions and speak with your doctor and pharmacist for more information.

The Pros and Cons of Treating Herpes With Valacyclovir

When considering whether or not to take valacyclovir for herpes, here are a few pros and cons to consider.

Benefits of Valacyclovir

Severe side effects are rare, and valacyclovir is very effective at reducing the length and severity of herpes outbreaks for most people. This both reduces your own discomfort and makes transmission to sexual partners less likely.

Because valacyclovir is available in generic form, your out-of-pocket cost will likely be lower than if only the brand name version — Valtrex — were available.

Valacyclovir is also available in a liquid suspension, which can be used for children and others who find swallowing pills difficult.

Most physicians prescribe valacyclovir to be taken once or twice daily, with or without food. This means you're less likely to forget a dose than if you had to take it every few hours.

Drawbacks of Valacyclovir

For some people, the risk of side effects from taking valacyclovir may outweigh the benefits. Particularly for older adults, the risk of hallucinations, disorientation, and delirium are concerning.

People with known kidney problems may need to take lower doses of valacyclovir to prevent further damage to their kidneys.


Talk With Your Doctor if You're Interested in Valacyclovir

Valacyclovir is a prescription medication, so you'll need to consult with your health care provider to see if it's the right drug for you. Be sure to let them know if you're using any other medications or natural treatments for your herpes to avoid any unintended interactions.

Many natural treatments can be safely used in conjunction with valacyclovir. Low-level light therapy (LLLT), for example, shines specific wavelengths of light onto herpes lesions in order to speed healing and ease inflammation. You can use a handheld red light therapy device like the Luminance RED Genital Treatment Device that makes this kind of proven treatment available in the privacy of your home.

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