{"id":2267,"date":"2023-06-25T17:55:01","date_gmt":"2023-06-25T17:55:01","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/valaciclovir\/"},"modified":"2023-06-25T18:05:16","modified_gmt":"2023-06-25T18:05:16","slug":"valaciclovir","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/valaciclovir\/","title":{"rendered":"Valaciclovir"},"content":{"rendered":"

<\/p>\n

CLINICAL USE<\/h3>\n

Antiviral: Herpes zoster and simplex Prevention of cytomegalovirus (CMV) disease after renal transplantation<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

Herpes simplex: 500 mg twice daily for 5\u201310 days Herpes zoster: 1 g 3 times a day for 7 days Herpes simplex suppression: 500 mg daily in 1\u20132 divided doses (500 mg twice daily in the immunocompromised) Prevention of CMV disease: 1 g 3 times a day for 90 days<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           : 360.8 (as hydrochloride)<\/li>\n
  • %Protein binding                           : 15<\/li>\n
  • %Excreted unchanged in urine     : <1<\/li>\n
  • Volume of distribution (L\/kg)       : 0.7<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      : 3\/14
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n

    30\u201350 Dose as in normal renal function 15\u201330 Herpes simplex: Dose as in normal renal function Herpes zoster: 1 g every 12 hours CMV prophylaxis: 1 g every 12 hours <15 Herpes simplex: 500 mg daily Herpes zoster: 1 g every 24 hours CMV prophylaxis: 1 g every 24 hours Herpes simplex suppression: Immunocompetent \u2013 250 mg daily Immunocompromised \u2013 500 mg daily<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                : Likely dialysability. Dose as in GFR<15 mL\/min<\/li>\n
  • HD                     : Dialysed. Dose as in GFR<15 mL\/min post dialysis<\/li>\n
  • HDF\/high flux   : Dialysed. Dose as in GFR<15 mL\/min post dialysis<\/li>\n
  • CAV\/VVHD      : Likely dialysability. Dose as in GFR=15\u201330 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Ciclosporin: may alter ciclosporin levels Mycophenolate: higher concentrations of both aciclovir and mycophenolic acid on concomitant administration
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n

    Almost completely (80%) converted to aciclovir \u2013 see aciclovir monograph for further information<\/li>\n

  • Bioavailability of aciclovir from 1 g oral dose of valaciclovir is 54% Mean peak aciclovir concentrations occur 1.5 hours post dose; peak plasma concentrations of valaciclovir are 4% of aciclovir levels, occur at a median of 30\u201360 minutes post dose, and are at or below the limit of quantification 3 hours post dose The dose quoted in the literature for CMV prophylaxis in transplant recipients is 2 g 4 times a day. However, in practice this results in severe aciclovir toxicity, especially in patients with poorly functioning grafts .<\/li>\n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Antiviral: Herpes zoster and simplex Prevention of cytomegalovirus<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-2267","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2267","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=2267"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2267\/revisions"}],"predecessor-version":[{"id":2332,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2267\/revisions\/2332"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=2267"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=2267"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=2267"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}