Valovir 500

Introduction
Valovir 500 is an antiviral medicine used in the treatment of herpes labialis, genital herpes infection and herpes zoster infections. It prevents the multiplication of virus in human cells and clears up the infection. Valovir 500 should be taken in the dose and duration as advised by your doctor. Do not skip any doses and finish the full course of treatment even if you feel better. It may be taken with or without food, but it is better to take it at a fixed time. If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose. You should drink plenty of water while on treatment with this medicine as it helps to prevent dehydration and kidney damage. It may lead to a few common side effects like headache, nausea and stomach pain. Inform your doctor if these side effects persist for a longer duration. Please consult your doctor if you are pregnant, planning to conceive or breastfeeding.

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Uses of Valovir 500
Herpes labialis
Genital herpes infection
Herpes zoster
Side effects of Valovir 500
Common
Headache
Nausea
Abdominal pain
How to use Valovir 500
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Valovir 500 may be taken with or without food, but it is better to take it at a fixed time.
How Valovir 500 works
Valovir 500 is an antiviral medication. It prevents the multiplication of virus in human cells. This stops the virus from producing new viruses and clears up your infection.
What if you forget to take Valovir 500?
If you miss a dose of Valovir 500, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
Do not skip any doses and finish the full course of treatment even if you feel better.
Drink plenty of water while on treatment with this medicine. This helps to prevent dehydration and kidney damage.
If you have genital herpes, use barrier methods (condoms) for contraception and avoid sexual contact while the sores are present.
Inform your doctor if you are pregnant or planning to conceive or breastfeeding.
Brief Description
Indication
Genital herpes, Herpes zoster, Herpes labialis, CMV infections
Administration
May be taken with or without food. May be taken w/ meals to reduce GI discomfort.
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.

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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

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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 _ Contraindication Hypersensitvity to valaciclovir, aciclovir. Mode 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. Precaution 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 _ Side Effect >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. _ Interaction 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.