Valacyclovir

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Valaciclovir, Valdacir, Valtrex, Viropel; Belgium: Valaciclovir, Zelitrex; Bulgaria: Valtrex; Cyprus: Valtrex; Czech Republic: Valaciclovir, Valtrex; Denmark: Valaciclovir, Zelitrex; Estonia: Valaciclovir, Valtrex; Finland: Valaciclovir, Valavir, Valtrex; France: Valaciclovir, Zelitrex; Germany: Valaciclomed, Valaciclovir, Valtrex; Greece: Valaciclovir, Valtrex; Hungary: Rivacir; Ireland: Myval, Valaciclovir, Valherp, Valotix, Valtrex; Italy: Valaciclovir, Zelitrex; Latvia: Valaciclovir; Lithuania: Valaciclovir; Luxembourg: Zelitrex; Netherlands: Valaciclovir, Zelitrex; Poland: Acivalor, Vaciclor, Valaciclovir; Portugal: Crotax, Valaciclovir, Valavir, Valtrex; Romania: Valdacir, Valtrex; Slovakia: Valaciclovir, Valtrex; Slovenia: Valaciklovir, Valdacir, Valtrex; Spain: Valtrex; Sweden: Valaciclovir, Valtrex; UK: Valaciclovir, Valtrex.

North America

Canada: Valacyclovir, Valtrex; USA: Valaciclovir, Valtrex.

Latin America

Argentina: Valtrex, Viramixal, Viranet; Brazil: Valtrex; Mexico: Rapivir, Valinir.

Asia

Japan: Valtrex.

Drug combinations

Chemistry

Valacyclovir Hydrochloride: C~13~H~20~N~6~O~4~ HCl. Mw: 360.80. (1) L-Valine, 2-[(2-amino-1,6-dihydro-6-oxo-9H-purin-9-yl)methoxy]ethyl ester, monohydrochloride; (2) L-Valine, ester with 9-[(2-hydroxyethoxy)methyl]guanine, monohydrochloride. CAS-124832-27-5; CAS-124832-26-4 (valacyclovir)(1993).

Pharmacologic Category

Antivirals; Nucleosides and Nucleotides. (ATC-Code: J05AB11).

Mechanism of action

Converted to acyclovir. Acyclovir is converted to acyclovir monophosphate, then further converted to acyclovir triphosphate. Acyclovir triphosphate inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA.

Therapeutic use

Treatment of herpes zoster (shingles) in immunocompetent patients. Treatment of first-episode and recurrent genital herpes. Suppression of recurrent genital herpes and reduction of heterosexual transmission of genital herpes in immunocompetent patients. Suppression of genital herpes in HIV-infected individuals. Treatment of herpes labialis (cold sores). Chickenpox in immunocompetent children.

Pregnancy and lactiation implications

Teratogenic events not observed in animal studies. Use during pregnancy only if potential benefit to mother justifies risk to fetus. Enters breast milk (use with caution while breast-feeding).

Unlabeled use

Prophylaxis of cancer-related herpes simplex virus (HSV), varicella zoster virus (VZV), and cytomegalovirus (CMV) infections. Treatment of cancer-related HSV, VZV infection.

Contraindications

Hypersensitivity to valacyclovir, acyclovir, or any component of the formulation.

Warnings and precautions

Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome occurred in immunocompromised patients (at doses of 8 g/day). Decreased urinary precipitation may occur. Use caution in renal impairment, the elderly, and/or those receiving nephrotoxic agents. Acute renal failure and CNS effects observed in renal dysfunction. Safety and efficacy not established for treatment/suppression of recurrent genital herpes or disseminated herpes in profound immunosuppression.

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