{"id":4458,"date":"2025-03-31T18:12:09","date_gmt":"2025-03-31T18:12:09","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/valaciclovir-txt\/"},"modified":"2025-03-31T18:12:09","modified_gmt":"2025-03-31T18:12:09","slug":"valaciclovir-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/valaciclovir-txt\/","title":{"rendered":"Valaciclovir.txt"},"content":{"rendered":"

CLINICAL USE <\/H3> Antiviral: Herpes zoster and simplex Prevention of cytomegalovirus (CMV) disease after renal transplantation

DOSE IN NORMAL RENAL FUNCTION <\/H3> 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

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 360.8 (as hydrochloride) <\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 15 <\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : <1 <\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp : 0.7 <\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp : 3\/14

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4> 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

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Likely dialysability. Dose as in GFR<15 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Dialysed. Dose as in GFR<15 mL\/min post dialysis
  • HDF\/high flux &nbsp : Dialysed. Dose as in GFR<15 mL\/min post dialysis
  • CAV\/VVHD &nbsp &nbsp &nbsp: Likely dialysability. Dose as in GFR=15\u201330 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3> Potentially hazardous interactions with other drugs\n
  • Ciclosporin: may alter ciclosporin levels Mycophenolate: higher concentrations of both aciclovir and mycophenolic acid on concomitant administration

    ADMINISTRATION <\/H3>

    Reconstition<\/H4> \u2013

    Route <\/H4> Oral

    Rate of Administration <\/H4> \u2013

    Comments<\/H4> \u2013

    OTHER INFORMATION <\/H4> Almost completely (80%) converted to aciclovir \u2013 see aciclovir monograph for further information\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 .
    \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":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4458","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\/4458","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=4458"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4458\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4458"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4458"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4458"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}