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How to Use Valacyclovir

by MICHELLE KONSTANTINOVSKY

 If you’ve been diagnosed with Herpes Simplex Virus type 1 (HSV-1) or Herpes Simplex Virus type 2 (HSV-2), your doctor might have prescribed you a medication called Valacyclovir. The medication can do a lot in terms of keeping symptoms under control and even preventing outbreaks and the risk of transmission. Here’s what you need to know about this effective medication. 

What is Valacyclovir?

Maybe you’ve heard of valacyclovir by its brand name, Valtrex. This FDA-approved medication is used to treat cold sores and genital herpes that may arise in people with HSV-1 and/or HSV-2. The medication is also sometimes used to treat a different virus in the same family, herpes zoster (aka shingles). Valacyclovir comes in 500 mg and 1,000 mg tablets. Here’s why your doctor might prescribe the meds:

  1. To treat or stop an outbreak in its tracks. If you experience an outbreak of oral or genital herpes, valacyclovir can cut it short and reduce its severity. If you’ve experienced outbreaks in the past, you may know what they feel like just before they erupt — if you start to notice early signs of an outbreak, taking valacyclovir may stop the outbreak from happening altogether. 
  2. To prevent an outbreak during a specific important time. Sometimes you know your body so well, you know what sets you up for an outbreak. And sometimes you really can’t take a risk with a potential outbreak. If you have herpes and you’re prepping for a major life event (think: honeymoon!), you probably don’t want a sudden unexpected outbreak to rain on your parade. This might merit taking valacyclovir as a preventive measure to suppress any potential outbreaks while you’re in prep mode. Some people with herpes also find that triggers like stress, lack of sleep, too much sunlight, etc. can set their virus off. If you have herpes and have been particularly stressed, sleep-deprived, or otherwise exposed to potential triggers, then your doctor may recommend taking valacyclovir as a preventative measure during that particular period of time. Sometimes taking the tablets for a week or two until the stressful scenario is over can reduce your chances of having an outbreak. 
  3. To keep outbreaks at bay for an extended period. For some people, taking valacyclovir on a regular basis can prevent outbreaks altogether. So regardless if you have a big event coming up or have been under extra stress, a daily dose could reduce the potential for an outbreak.
  4. To prevent spreading the virus. Valacyclovir doesn’t just prevent outbreaks; it also helps reduce the risk of spreading genital herpes to uninfected people. The thing about herpes is that it can be spread from person to person even when symptoms aren’t present — taking meds can significantly cut the risk of shedding the virus and spreading it to someone else. 

How was Valacyclovir Developed?

The first highly effective medication to treat herpes was acyclovir, which targeted the virus’s DNA. One serious limitation of the medication, however, was that it wasn’t well absorbed in the intestines — in fact, only 20% of it could be used by the body. Scientists overcame this issue by creating  something called a “prodrug” of acyclovir, meaning an inactive compound that is metabolized in the body to produce acyclovir. Enter valacyclovir. This drug is made by slightly modifying the acyclovir molecule, and once it is absorbed in the body, it gets converted to acyclovir and attacks the herpes DNA. The advancement was a big deal: when taken twice a day — or even once! — valacyclovir works better than 3–5 daily doses of acyclovir. 

How Do I Take Valacyclovir?

Your doctor will explain your dosing and directions. Since different people take valacyclovir for different reasons, treatment plans may vary. But in the case of oral herpes (HSV-1), a typical way to use valacyclovir to stop an outbreak is to take two 1,000 mg tablets at the first sign of trouble, followed by two more 1,000 mg tablets 12 hours later. 

The way you take your medication, the dose, and the schedule all depend on your specific needs and whether you’re treating cold sores or genital herpes. Your doctor will help you figure out a plan that works for you and gets you back to living life to the fullest.