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Valaciclovir

The standard treatment for genital herpes, taken either as a short course during an outbreak or daily to reduce how often outbreaks occur.

Class
Antiviral
Sold as
Sold as: Valtrex
Prescription only

From the approved label

Valtrex

Approved uses
  • VALTREX is a deoxynucleoside analogue DNA polymerase inhibitor indicated for: Adult Patients
  • Cold Sores (Herpes Labialis)
  • Genital Herpes Treatment in immunocompetent patients (initial or recurrent episode)
  • Suppression in immunocompetent or HIV-1−infected patients Reduction of transmission Herpes Zoster Pediatric Patients
  • The efficacy and safety of VALTREX have not been established in immunocompromised patients other than for the suppression of genital herpes in HIV-1−infected patients.
Forms and strengths
  • Tablets: 1-gram: Each blue, film‑coated, capsule‑shaped tablet, with a partial scorebar on both sides, printed with "VALTREX 1 gram" contains 1.112 grams of valacyclovir hydrochloride equivalent to 1...
  • Tablets: 1 gram (partially scored)
How it is taken
  • VALTREX may be given without regard to meals. Valacyclovir oral suspension (25 mg/mL or 50 mg/mL) may be prepared extemporaneously from 500-mg VALTREX tablets for use in pediatric patients for whom a solid dosage form is not appropriate. Adult Dosage
  • Cold Sores 2 grams every 12 hours for 1 day Genital Herpes Initial episode 1 gram twice daily for 10 days Recurrent episodes 500 mg twice daily for 3 days Suppressive therapy Immunocompetent patients 1 gram once daily Alternate dose in patients with less than or equal to 9 recurrences/year 500 mg once daily HIV-1−infected patients 500 mg twice daily Reduction of transmission 500 mg once daily...
  • Cold Sores (aged greater than or equal to 12 years) 2 grams every 12 hours for 1 day Chickenpox (aged 2 to less than 18 years) 20 mg/kg 3 times daily for 5 days; not to exceed 1 gram 3 times daily Valacyclovir oral suspension (25 mg/mL or 50 mg/mL) can be prepared from the 500 mg VALTREX tablets.
Must not be used when
  • VALTREX is contraindicated in patients who have had a demonstrated clinically significant hypersensitivity reaction [e.g., anaphylaxis, severe cutaneous adverse reactions (SCARs)] to valacyclovir, acyclovir, or any component of the formulation.
  • Hypersensitivity to valacyclovir (e.g., anaphylaxis), acyclovir, or any component of the formulation.
Interactions
  • No clinically significant drug-drug or drug-food interactions with VALTREX are known.
Warnings and precautions
  • Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS): Has occurred in patients with advanced HIV-1 disease and in allogenic bone marrow transplant and renal transplant patients receiving 8 grams per day of VALTREX in clinical trials. Discontinue treatment if clinical symptoms and laboratory findings consistent with TTP/HUS occur.
  • Acute renal failure: May occur in elderly patients (with or without reduced renal function), patients with underlying renal disease who receive higher-than-recommended doses of VALTREX for their level of renal function, patients who receive concomitant nephrotoxic drugs, or inadequately hydrated patients. Use with caution in elderly patients and reduce dosage in patients with renal impairment.
  • Central nervous system adverse reactions (e.g., agitation, hallucinations, confusion, and encephalopathy): May occur in both adult and pediatric patients (with or without reduced renal function) and in patients with underlying renal disease who receive higher-than-recommended doses of VALTREX for their level of renal function.
  • Severe cutaneous adverse reactions (SCARs): Including acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS), toxic epidermal necrolysis (TEN), and Stevens-Johnson syndrome (SJS) have been reported during the postmarketing experience with valacyclovir.
Common side effects
  • most common adverse reactions reported in at least 1 indication by greater than 10% of adult subjects treated with VALTREX and observed more frequently with VALTREX compared with placebo are headache, nausea, and abdominal pain.
Pregnancy
Clinical data over several decades with valacyclovir and its metabolite, acyclovir, in pregnant women, have not identified a drug associated risk of major birth defects. There are insufficient data on the use of valacyclovir regarding miscarriage or adverse maternal or fetal outcomes (see Data). There are risks to the fetus associated with untreated herpes simplex during pregnancy (see Clinical Considerations).
How it acts
Valacyclovir is an antiviral drug active against α-herpes viruses.
Label holder:
REMEDYREPACK INC.
Label version:

This section reports the approved product information. The wording is condensed from the regulator's own summary, and the full document is linked under Sources.

Written by us

How it works

Valaciclovir is converted in the body into aciclovir, which interferes with the virus copying its own genetic material. It does not remove the virus, which stays in nerve cells between outbreaks, and the label reflects that by describing treatment of episodes and reduction of their frequency rather than a cure.

Original and generic

Off patent and cheap as a generic. The brand name still exists but there is no clinical argument for paying for it.

What it costs

One of the least expensive treatments in this catalogue, whether taken as a short course or continuously. In most European countries a course costs less than the consultation that leads to it.

How to get it legally

Prescription only across Europe and the United States. This is one of the clearest legitimate uses of an online consultation: a repeat prescription for someone with a diagnosis already made needs a conversation, not an examination. A first episode is different, because what looks like herpes is not always herpes, and testing changes the answer.

Comparison

See also

  1. Valaciclovir and aciclovir, compared from both labelsTwo antivirals for herpes compared from their approved labels: dosing frequency, approved indications, contraindications and cost.

Questions

What is the difference between episodic and suppressive treatment?
They are two dosing schedules in the same label, one taken during an outbreak and one taken continuously to reduce how often outbreaks happen. Both are set out in the dosing section above.
Does treatment reduce transmission to a partner?
The label addresses transmission directly for one of its indications. The wording there is precise about the conditions under which that was shown, and it is worth reading rather than summarising.
Why prescribe valaciclovir rather than aciclovir?
Because it is absorbed more efficiently, which allows fewer doses per day. Both are on this site and the labels state their own schedules.

Sources

  1. VALTREX: prescribing informationDailyMed, US National Library of Medicine. Label version 16 July 2026
  2. Drugs@FDA: NDA020487US Food and Drug Administration

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