Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Valacyclovir is an oral
antiviral
drug which is active against the herpes viruses. It is used to treat
infections
with herpes zoster (shingles), herpes simplex genitalis (genital herpes), and herpes labialis (cold
sores).
Valacyclovir inhibits the replication of viral DNA which is
necessary for
viruses to reproduce themselves. Valacyclovir is actually a
"prodrug,"
in that it is not active itself. Rather, it is converted to
acyclovir (Zovirax) in the body,
and it is the acyclovir that is active against the viruses. (Acyclovir itself is
available as a topical, oral and intravenous medication.) Valacyclovir,
therefore, is active against the same viruses as acyclovir, but valacyclovir has
a longer duration of action than acyclovir, and, therefore, can be taken fewer
times each day. Valacyclovir
was approved for use by the FDA in 1995.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: Caplets (blue): 500 mg
STORAGE: Valacyclovir should be kept between 2 and
30 C
(36 and 86 F).
PRESCRIBED FOR:
Valacyclovir is used
to treat infections
with herpes zoster (shingles), herpes simplex genitalis (genital herpes),
and
herpes labialis (cold sores).
DOSING: Valacyclovir may be taken with or without
food. Dosages need to be reduced in patients with kidney disease. For the
treatment of herpes zoster (shingles), the usual dose is 1 gm three times a day
for 7 days. Treatment should begin at the first symptom and is most effective if
started within 48 hours of the onset of rash.
For the treatment of an initial episode of
herpes, the
usual dose is 1 gm twice daily for 10 days. For the treatment
of
recurrent herpes, the usual dose is 500 mg twice daily for 5
days. For
best results, treatment should be initiated within 12 hours of
the start
of symptoms.
DRUG INTERACTIONS:Probenecid (Benemid) and cimetidine
(Tagamet)
may reduce the kidney's clearance of valacyclovir, leading to
higher
concentrations in the blood. This may lead to side effects of
valacyclovir.
PREGNANCY: Valacyclovir showed no effects on the fetus
in animal
studies, however, there has been no adequate evaluation of
valacyclovir or
(acyclovir) in pregnant women. The incidence of birth defects
in women
taking acyclovir is about the same as in the general population.
Valacyclovir should only be used during pregnancy when the
benefits to the
mother outweigh risks to the fetus.
NURSING MOTHERS: It is not
known whether valacyclovir is excreted into
breast milk. It is known, however, that among
women taking
acyclovir, concentrations of acyclovir in breast milk are about
four times
higher than in the mother's blood. The safety of valacyclovir in
breast-feeding infants has not been established. Methods other
than breast
feeding should be considered if Valacyclovir must be taken while
nursing.
SIDE EFFECTS: The side effect profile of valacyclovir
is similar
to that of acyclovir. The most commonly reported side effects
are
headache, nausea, and vomiting. Less common side effects are
diarrhea,
abdominal pain, and dizziness.
Shingles (herpes zoster) is a skin rash caused by the same virus that causes chickenpox. Under certain circumstances, such as emotional stress, immune deficiency, or with cancer, the virus re-activates causing shingles. Shingles are catching and can spread from an infected person to others who have not had chickenpox. There are a variety of treatments for shingles.
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
Genital herpes, a viral infection by the herpes simplex virus (HSV), is transmitted during sexual contact with the mucous-covered linings of the mouth, vagina, or the genital skin. A typical outbreak begins with an itching or tingling sensation followed by redness of the skin and blister formation. The blisters and ulcers that form when the blisters break are painful to the touch, and last from 7 days to 2 weeks. Though there is no cure for herpes, there are ways to treat outbreaks.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Sexually transmitted diseases, or STDs, are infections that are transmitted during any
type of sexual exposure, including intercourse (vaginal or anal), oral sex, and
the sharing of sexual devices, such as vibrators. Although treatment exists for many STDs, others currently are
usually incurable, such as those caused by HIV, HPV, hepatitis B and C, and HHV-8.
Ramsay Hunt syndrome is an infection of a facial nerve that causes a red painful rash with blisters and facial paralysis. The herpes zoster virus causes the infection. The infection is treated with antiviral agents, steroids, and pain medications.
Becoming infected with chickenpox during pregnancy could cause birth defects in your unborn child. Likewise, shingles could also cause problems for your unborn child. If you are pregnant and haven't had chickenpox, avoid exposure to infected people. Zostavax, the shingles vaccine, can reduce the incidence of shingles by half. Women should wait at least three months after receiving the vaccine before trying to get pregnant.
When you are pregnant, many sexually transmitted diseases (STDs) can be especially harmful to you and your baby. These STDs include herpes, HIV/AIDS, genital warts (HPV), hepatitis B, chlamydia, syphilis, gonorrhea, and trichomoniasis. Symptoms include bumps, sores, warts, swelling, itching, or redness in the genital region. Treatment of STDs while pregnant depends on how far along you are in the pregnancy and the progression of the infection.
Herpes simplex virus (HSV) can cause infections that affect the mouth, the face, the genitals, the skin, the buttocks, and the anal area. This article will concentrate on non-genital herpes. Many people acquire the virus and have no symptoms. For others, painful blisters appear near the area where the virus entered the body. Typically, the blisters heal completely but reappear at some point in the future when least expected (or desired). In between attacks, the virus resides deep in the roots of the nerves that supply the involved area. When herpes simplex lesions appear in their most common location, around the mouth and lips, people often refer to them as "cold sores" and "fever blisters."
What causes cold sores?
There are two types of HSV, type I and type II. In general, type I, also known as herpes labialis, causes infections above the waist, most commonly as oral "cold sores." Type II infectio...
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