Indications
Valcivir Tablet is used for:
Genital herpes, Herpes zoster, Herpes labialis, CMV infections
Adult Dose
Oral
Herpes zoster (shingles)
Adult: 1 g tid for 7 days. Immunocompromised patients: Continue treatment for a further 2 days after crusting of lesions.
Herpes simplex infections of skin and mucous membranes; Genital herpes
Adult: 500 mg bid for 3-5 days for recurrent episodes or up to 10 days for initial episodes. Immunocompromised patients: 1 g bid for at least 5 days for recurrent episodes or up to 10 days for initial episodes.
Prophylaxis of cytomegaloviral infections in immunocompromised patients
Adult: 2 g 4 times daily, begin as soon as possible post-transplant and usually continued for 90 days.
Herpes labialis
Adult: 2 g 12 hrly for 1 day.
Suppression of recurrent herpes simplex
Adult: 500 mg daily as a single or in 2 divided doses. Immunocompromised patients: 500 mg bid. Treatment is re-evaluated after 6-12 mth of therapy.
Child Dose
Herpes simplex infections of skin and mucous membranes; Genital herpes
Child: >12 yr: 500 mg bid for 3-5 days for recurrent episodes or up to 10 days for initial episodes. Immunocompromised patients: 1 g bid for at least 5 days for recurrent episodes or up to 10 days for initial episodes.
Prophylaxis of cytomegaloviral infections in immunocompromised patients
Child: >12 yr: 2 g 4 times daily, begin as soon as possible post-transplant and usually continued for 90 days.
Herpes labialis
Child: >12 yr: 2 g 12 hrly for 1 day.
Suppression of recurrent herpes simplex
Adult:
Child: >12 yr: 500 mg daily as a single or in 2 divided doses. Immunocompromised patients: 500 mg bid. Treatment is re-evaluated after 6-12 mth of therapy.
Chickenpox
<2 years: Safety and efficacy not established
>2 years: 20 mg/kg PO q8hr for 5 days; not to exceed 1 g PO q8hr
Renal Dose
Herpes labialis
CrCl 30-49 mL/min: 1 g PO q12hr for 1 day
CrCl 10-29 mL/min: 500 mg PO q12hr for 1 day
CrCl <10 mL/min: 500 mg PO once
Herpes zoster
CrCl 30-49 mL/min: 1 g PO q12hr
CrCl 10-29 mL/min: 1 g/day PO
CrCl <10 mL/min: 500 mg/day PO
Genital herpes (initial episode)
CrCl 10-29 mL/min: 1 g/day PO
CrCl <10 mL/min: 500 mg/day PO qDay
Genital herpes (recurrent episodes)(suppressive therapy, immunocompetent patients)
CrCl <29 mL/min: 500 mg/day PO
Administration
May be taken with or without food. May be taken w/ meals to reduce GI discomfort.
Contra Indications
Hypersensitvity to valaciclovir, aciclovir.
Precautions
Patient at risk of dehydration. Renal impairment. Pregnancy and lactation. Patient Counselling Avoid sexual intercourse when symptoms of genital herpes are present. Monitoring Parameters Monitor renal, hepatic and haematological functions.
Lactation: Drug excreted in breast milk; use with caution
Pregnancy-Lactation
Interactions
Increased risk of renal failure w/ nephrotoxic drugs (e.g. aminoglycosides, organoplatinum compounds, iodinated contrast media, methotrexate, pentamidine, foscarnet, ciclosporin, tacrolimus). Probenecid and cimetidine may increase peak plasma concentrations and AUC of aciclovir.
Adverse Effects
Side effects of Valacyclovir :
>10%
Headache (14-35%),Neutropenia (<18%),Elevated aspartate transaminase (AST) (2-16%),Nasopharyngitis (<16%),Nausea (6-15%),Elevated alanine transaminase (ALT) (<14%),Abdominal pain (2-11%)
1-10%
Dysmenorrhea (1-8%),Depression (<7%),Arthralgia (<1-6%),Vomiting (<1-6%),Dizziness (2-4%),Rash (<8%),Rhinorrhea (<2%),Thrombocytopenia (<3%),Leukopenia (<1%)
<1%
Agitation,Aggression,Alopecia,Confusion,Erythema multiforme,Hypertension,Tachycardia,Tremor,Visual disturbances
Potentially Fatal: Hepatitis; renal failure; blood dyscrasias; thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.
Mechanism of Action
Valaciclovir is the L-valine ester of aciclovir. A prodrug, it is rapidly converted to aciclovir by intestinal and hepatic metabolism. Aciclovir inhibits DNA synthesis and viral replication and has antiviral activity against herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) and varicella-zoster virus.
Note
Valcivir 1gm Tablet manufactured by Cipla Ltd.. Its generic name is Valacyclovir. Valcivir is availble in Nepal.
Farmaco Nepal drug index information on Valcivir Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.