Valacyclovir (Valtrex) Dosage, Side Effects, and How to Order Online

By Dr. Diana Rangraves

Valacyclovir (brand name Valtrex) is an antiviral medication commonly prescribed for infections of herpes simplex and varicella-zoster viruses. It can help reduce symptoms and prevent future outbreaks, making it an essential treatment option for genital herpes, cold sores, and shingles.

While these medications are reported to be effective [1], it’s important to understand how to use them correctly to avoid any potential complications. In this article, you’ll have detailed information on proper dosing, administration, side effects, and more.

Valtrex: How It Works and Its Role in Herpes Treatment

Valtrex (brand name) and valacyclovir (the generic equivalent) refer to the same medication, with the latter being the active ingredient. When you take Valtrex, the body converts valacyclovir into acyclovir, the active antiviral agent [2]. Acyclovir works by blocking the replication of viral DNA, which prevents the herpes virus from multiplying the severity of symptoms during an outbreak [3].

Valtrex is also effective in reducing the frequency of future outbreaks when used as suppressive therapy, as evidenced by two recent studies [4,5]. Regular use of this medication reduces the risk of transmitting genital herpes to a sexual partner when taken as prescribed, along with other preventive measures [6]. However, understand that neither Valtrex nor valacyclovir (or any medication currently available) can cure herpes. Once infected, the virus remains dormant in the body and can reactivate at any time.

How Do I Get a Prescription for Valtrex or Valacyclovir?

You need a prescription from a healthcare provider to obtain Valtrex or valacyclovir. Here’s how you can get one:

• In-Person Consultation: Visit your healthcare provider to discuss your symptoms. They may recommend Valtrex for an initial outbreak or for managing recurring episodes.
• Telehealth Services: Many platforms now offer online consultations, during which licensed healthcare providers can assess your condition and issue a prescription if deemed appropriate.
• Refills and Long-Term Use: If you need Valtrex for long-term suppressive therapy, regular check-ins with your healthcare provider may be required to adjust the dosage or renew your prescription.

Valtrex Dosage for Herpes and Other Conditions

Here are some FDA-approved Valtrex dosages for herpes [7]:

Cold Sores (Herpes Labialis)

• Initial Outbreak: 2,000 mg every 12 hours for 1 day (total of 2 doses)

Genital Herpes

• First Outbreak: 1,000 mg twice a day for 10 days
• Recurrent Episodes: 500 mg twice a day for 3 days
• Suppressive Therapy: 500 mg or 1,000 mg once daily, depending on the frequency of outbreaks

Shingles (Herpes Zoster)

• Standard Dose: 1,000 mg three times a day for 7 days

Reduction of Transmission

• Daily Suppression: 500 mg once daily can reduce the risk of transmitting genital herpes to a partner

As always, you should follow the instructions given to you by your healthcare provider about the medication you are prescribed.

How Much Valtrex Do I Need for Suppression?

For people with frequent outbreaks, suppressive therapy involves taking Valtrex daily to reduce the chances of future episodes. Current clinical guidelines usually recommend the following:

• For Individuals with 9 or Fewer Outbreaks a Year: 500 mg once daily [8]
• For Individuals with 10 or More Outbreaks a Year: 1,000 mg once daily [9]

Suppressive therapy may also reduce the likelihood of transmitting the virus, especially when combined with safe sexual practices. It’s important to note, however, that oral and genital herpes can be transmitted even when no sores are present, and even if the virus has lain dormant for years.

How Fast Does Valtrex Work?

Valtrex (valacyclovir) typically begins working quickly, but the specific timeline depends on the condition being treated. For cold sores, it works best when taken at the first sign of symptoms, such as tingling or itching, and can shorten the outbreak by 1-2 days [10]. When treating shingles, starting Valtrex within 72 hours of rash onset can help reduce pain and speed healing [10]. For genital herpes, it can shorten a first outbreak by up to 50% if taken promptly, and for recurrent episodes, it can reduce symptoms significantly within 3-5 days [11].

For optimal results, guidelines advise that Valtrex should be taken as early as possible during an outbreak. Delaying treatment reduces its effectiveness in shortening recovery time.

Valtrex Side Effects: What to Know Before Taking Valacyclovir

Valtrex (valacyclovir) can cause a range of side effects, which vary from mild to serious. Common side effects include abdominal pain, runny nose, scratchy throat, headache, nausea, and dizziness [10]. In many cases, these are mild and manageable, but if they persist or worsen, it’s important to notify a healthcare provider. Some serious side effects include changes in urine output (a sign of kidney issues), agitation, confusion, or hallucinations, especially in older adults [10].

Does Valtrex Affect the Kidneys?

In rare cases, Valtrex can impact kidney function, especially in people with preexisting kidney conditions or those who are dehydrated [10]. To reduce the risk:

• Stay Hydrated: Drink plenty of water while taking Valtrex.
• Dosage Adjustments: Your doctor may adjust your dose if you have kidney issues.

Symptoms of kidney problems include swelling, reduced urine output, or difficulty urinating. If these occur, seek medical attention immediately.

What Is the Difference Between the White and Blue Valtrex Pills?

Valtrex is available in two strengths:

• Valacyclovir M122 White Pill: 500 mg dosage
• Valacyclovir Blue Pill: 1,000 mg dosage

Your healthcare provider will prescribe the appropriate strength based on your condition. For example, 500 mg is often used for suppressive therapy, while 1,000 mg is typically prescribed for shingles or severe outbreaks [10].

How Do I Get Valtrex Online?

You can legally obtain Valtrex through licensed telehealth providers and get help assessing your symptoms online. Here are some tips to order Valtrex online:

• Look for Verified Platforms: Use legitimate telehealth services that require a consultation with a licensed provider.
• Avoid Suspicious Websites: Be cautious of sites offering Valtrex without a prescription — these could be selling counterfeit or unsafe medications.
• Check for Reviews: Look for reviews or certifications from reputable health organizations to ensure the platform is trustworthy.

Lifestyle Considerations

In addition to taking Valacyclovir (m122 pill) as prescribed, certain lifestyle changes can enhance the effectiveness of the medication and help manage herpes outbreaks. The following are some key considerations.

Maintain a Healthy Immune System

A robust immune system can help reduce the frequency and severity of herpes outbreaks. Focusing on a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can support healthy immune system function.

Nutrients such as vitamins C and E, zinc, and antioxidants also play a role in supporting immune health. Getting adequate sleep is also crucial, as a lack of sleep can hamper the immune system [13].

Reduce Stress

Stress is a known trigger for herpes outbreaks. Incorporating stress management techniques such as mindfulness, meditation, yoga, or deep-breathing exercises can be beneficial. Finding healthy outlets or physical activities can also improve overall well-being [13].

Practice Safe Sex

To reduce the risk of transmitting herpes to sexual partners, it is important to practice safe sex (or safe oral hygiene, if you have outbreaks of oral herpes). This includes using condoms, even when asymptomatic, and discussing your herpes status with potential partners. Informing partners helps facilitate informed decisions about sexual health [13].

Stay Hydrated

Water supports overall health and may help the body manage viral infections more effectively. Aim for adequate fluid intake, especially during outbreaks, to help reduce the risk of complications such as dehydration [13].

Avoid Known Triggers

Individuals may have unique triggers that can provoke an outbreak. Common triggers include excessive sun exposure, illness, hormonal changes, and certain foods. Keeping a journal to track outbreaks can help identify personal triggers [13].

Regular Check-Ups

Regular check-ups with your healthcare provider ensure that your treatment plan remains effective and allow for adjustments if needed. They can also provide valuable insights into managing your condition and overall health [13].

Stay Informed

Staying informed about herpes and its management can empower you to make better health decisions. Regularly educating yourself through reputable sources or support groups can provide valuable insights into the condition and new treatment options. Consider joining online forums or local support groups where individuals share their experiences and coping strategies [13].

Get Same-Day Herpes Treatment

Valtrex (valacyclovir) is a medication for managing herpes infections. It provides relief from symptoms, reduces outbreak frequency, and lowers the risk of transmission. Understanding its mechanism of action and incorporating lifestyle changes can help individuals better manage their condition and improve their overall quality of life.

If you’re looking for convenient treatment for HSV outbreaks, consider seeking a prescription through Everlywell. You can take our symptoms quiz and quickly find out if you’re eligible for treatment.

Valtrex FAQs

Is Valtrex effective for suppressing herpes outbreaks?

• Valtrex is effective in reducing the frequency of future outbreaks when used as suppressive therapy, as evidenced by two recent studies [4,5].

How does valacyclovir differ from acyclovir in herpes treatment?

• Acyclovir and Valacyclovir are antiviral drugs that target herpes viruses by preventing them from multiplying in the body [14]. Although they treat similar infections, there are differences in their chemical structure and how the body processes them.

  Valacyclovir is a prodrug of Acyclovir, meaning it converts into Acyclovir after being metabolized in the liver [14]. Because of this, Valacyclovir has higher bioavailability (more of the drug is absorbed by the body), which makes it more efficient.

  Acyclovir, in contrast, requires more frequent dosing since it is absorbed less effectively [14]. It works directly to inhibit the replication of the herpes virus but has a shorter half-life in the bloodstream, meaning it leaves the body faster than Valacyclovir.

Can Valtrex prevent herpes transmission to my partner?

• Herpes infection of the genitals can be caught from or spread to your partner during any sexual activity. Even though you may get herpes if your partner has no symptoms, the infection is more likely to be spread if sores are present. Therefore, it is best to avoid any sexual activity if either you or your sexual partner has any symptoms of herpes. The use of a latex condom (“rubber") may help prevent the spread of herpes. However, spermicidal (sperm-killing) jelly or a diaphragm will probably not help [10].

Can Valtrex be taken long-term?

• If you need Valtrex for long-term suppressive therapy, regular check-ins with your healthcare provider may be required to adjust the dosage or renew your prescription.

Does Valtrex affect fertility or pregnancy?

• Use of acyclovir/valacyclovir is not expected to increase the chance of birth defects above the background risk. The manufacturer and the Centers for Disease Control and Prevention (CDC) looked at the effects of acyclovir on the developing fetus. No increase in birth defects was seen in over 500 births [15].

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References

1. Perry CM, Faulds D. Valaciclovir. A review of its antiviral activity, pharmacokinetic properties and therapeutic efficacy in herpesvirus infections. Drugs. 1996;52(5):754-772. doi:10.2165/00003495-199652050-00009
2. National Institute of Diabetes and Digestive and Kidney Diseases. Valacyclovir. LiverTox - NCBI Bookshelf. Published October 20, 2020. Medical Citation URL.
3. Gnann JW Jr, Barton NH, Whitley RJ. Acyclovir: mechanism of action, pharmacokinetics, safety and clinical applications. Pharmacotherapy. 1983;3(5):275-283. doi:10.1002/j.1875-9114.1983.tb03274.x
4. Handsfield HH, Warren T, Werner M, Phillips JA. Suppressive therapy with valacyclovir in early genital herpes: a pilot study of clinical efficacy and herpes-related quality of life. Sex Transm Dis. 2007;34(6):339-343. doi:10.1097/01.olq.0000243620.13718.56
5. Fife KH, Warren TJ, Justus SE, Heitman CK; HS2100275 STUDY TEAM. An international, randomized, double-blind, placebo-controlled, study of valacyclovir for the suppression of herpes simplex virus type 2 genital herpes in newly diagnosed patients. Sex Transm Dis. 2008;35(7):668-673. doi:10.1097/OLQ.0b013e31816d1f42
6. Bonnar PE. Suppressive valacyclovir therapy to reduce genital herpes transmission: good public health policy? Mcgill J Med. 2009;12(1):39-46.
7. Valtrex® (valacyclovir) Prescribing Information. Research Triangle Park, NC: GlaxoSmithKline; 2021. Accessed October 29, 2024. Medical Citation URL.
8. Valtrex Dosage. Drugs.com. Updated November 14, 2022. Accessed October 29, 2024. Medical Citation URL.
9. Nagarakanti SR, Zikri AM. Is there a role for chronic suppressive therapy in herpes simplex virus infection? Cleve Clin J Med. 2024;91(3):151-153. doi:10.3949/ccjm.91a.23099
10. Mayo Clinic. Valacyclovir (oral route). Mayo Clinic. Accessed November 7, 2024. Medical Citation URL.
11. Leone PA, Trottier S, Miller JM. Valacyclovir for episodic treatment of genital herpes: a shorter 3-day treatment course compared with 5-day treatment. Clin Infect Dis. 2002;34(7):958-962. doi:10.1086/339326
12. Kakos D. Side effects of valacyclovir oral tablet. MedicalNewsToday.Updated February 8, 2024. Accessed October 29, 2024. Medical Citation URL.
13. Cleveland Clinic. What To Do During a Genital Herpes Outbreak. Accessed November 8, 2024. Medical Citation URL.
14. Schuster AK, Harder BC, Schlichtenbrede FC, Jarczok MN, Tesarz J. Valacyclovir versus acyclovir for the treatment of herpes zoster ophthalmicus in immunocompetent patients. Cochrane Database Syst Rev. 2016;11(11):CD011503. doi:10.1002/14651858.CD011503.pub2
15. National Library of Medicine. Mother to Baby Fact Sheet: Acyclovir (Zovirax®) / Valacyclovir (Valtrex®). Published February 24, 2024. Medication Citation URL.