valacyclovir hydrochloride Nursing Considerations & Management

Drug Name

Generic Name : valacyclovir hydrochloride

Brand Name: Valtrex

Classification: Antiviral

Pregnancy Category B 

Dosage & Route

Available forms :Tablets—500 mg, 1 g

  • Herpes zoster: 1 g tid PO for 7 days; most effective if started within 48 hr of onset of symptoms (rash).
  • Genital herpes: 1 g PO bid for 7–10 days.
  • Episodic treatment of recurrent genital herpes: 500 mg PO bid for 3 days.
  • Suppression of recurrent episodes of genital herpes: 1 g PO daily; patients with history of less than nine episodes in 1 yr may respond to 500 mg PO daily.
  • Reduction of risk of transmission: 500 mg/day PO daily for the source partner.
  • Cold sores: 2 g PO bid for 1 day.
  • Safety and efficacy not established.
Therapeutic actions
  • Antiviral activity; inhibits viral DNA replication and deactivates viral DNA polymerase.
  • Treatment of herpes zoster (shingles)
  • Episodic treatment of first-episode or recurrent genital herpes in immunocompetent patients
  • Suppression of recurrent episodes of genital herpes in HIV patients
  • Reduction of risk of heterosexual transmission of genital herpes to healthy partners when combined with safe sex practices
  • Treatment of cold sores (herpes labialis) in healthy adults and adolescents
  • Contraindicated with allergy to valacyclovir or acyclovir.
  • Use cautiously with pregnancy, renal impairment, thrombotic thrombocytopenic purpura, lactation.
Nursing considerations

CLINICAL ALERT! Name confusion has been reported with Valtrex (valacyclovir) and Valcyte (valganciclovir); use caution.

  • History: Allergy to valacyclovir, acyclovir; renal disease; lactation; thrombotic thrombocytopenic purpura, pregnancy
  • Physical: Orientation; urinary output; abdominal examination, normal output; BUN, creatinine clearance
  • Begin treatment within 72 hr of onset of symptoms of shingles.
  • Administer without regard to meals; administer with meals to decrease GI upset if needed.
  • Provide appropriate analgesics for headache, discomfort of shingles.
  • Advise continued use of safe sex practices.
Teaching points
  • Take this drug without regard to meals; if GI upset is a problem, take with meals.
  • Take the full course of therapy as prescribed.
  • Avoid contact with lesions and avoid intercourse when lesions or symptoms are present to avoid infecting others.
  • Start therapy at first sign of an episode when treating recurrent herpes.
  • You may experience these side effects: Nausea, vomiting, loss of appetite, diarrhea; headache, dizziness.
  • Report severe diarrhea, nausea; headache; worsening of the shingles.