Anti-infective Agents : Antiviral Agents
OVALT1 “Valtrex tablet” 500 mg/tab
適應症：帶狀庖疹、復發性生殖器庖疹的預防及治療。
Usual dose:
Adult:
Genital herpes simplex, Initial and recurrent episodes:
Initial episode, 1 g orally twice daily for 7 to 10 days; most effective when started within 48 hours of signs and symptoms.
Recurrent episode, 500 mg orally twice daily for 3 days, or 1 g once daily for 5 days; start within 24 hours after onset of signs and symptoms.
Genital herpes simplex, Initial and recurrent episodes – HIV infection:
1 g orally twice daily for 5 to 14 days.
Herpes labialis:
2 g orally twice daily for 1 day; separate doses by 12 hours; start at the earliest onset of symptoms.
Herpes labialis – HIV infection:
1 g orally twice daily for 5 to 10 days.
Herpes zoster, Shingles:
1 g orally 3 times daily for 7 days; start within 48 hours of rash onset.
Herpes zoster, Shingles – HIV infection:
(acute localized dermatomal) 1 g orally 3 times daily for 7 to 10 days; may treat longer if lesions are slow to resolve.
HIV infection – Recurrent genital herpes simplex, Suppression:
500 mg orally twice daily.
HIV infection – Varicella:
(uncomplicated cases) 1 g orally 3 times daily for 5 to 7 days.
Recurrent genital herpes simplex, Suppression and transmission reduction:
suppressive therapy: 1 g orally once daily; 9 or fewer recurrences/year, 500 mg orally once daily.
reduction of transmission: 9 or fewer recurrences/year, 500 mg orally once daily.
Pediatric:
Herpes labialis:
(12 years or older) 2 g ORALLY twice daily for 1 day; separate doses by 12 hours; start at the earliest onset of symptoms.
Varicella:
(2 years or older) 20 mg/kg ORALLY 3 times daily for 5 days; MAX dose 1 g 3 times daily; begin within 24 hours after rash onset.
Dose Adjustments:
Renal impairment, herpes zoster: CrCl 50 mL/min or greater, usual dose; CrCl 30 to 49 mL/min, 1 g every 12 hours; CrCl 10 to 29 mL/min, 1 g every 24 hours; CrCl less than 10 mL/min, 0.5 g every 24 hours .
Renal impairment, genital herpes: (initial episode) CrCl 30 mL/min or greater, usual dose; CrCl 10 to 29 mL/min, 1 g every 24 hours; CrCl less than 10 mL/min, 0.5 g every 24 hours .
Renal impairment, genital herpes: (recurrent episode and suppressive therapy) CrCl 30 mL/min or greater, usual dose; CrCl less than 30 mL/min, 0.5 g every 24 hours.
Renal impairment, genital herpes: (suppressive therapy, 9 or fewer recurrences/year) CrCl 30 mL/min or greater, usual dose; CrCl less than 30 mL/min, 0.5 g every 48 hours.
Renal impairment, genital herpes: (HIV-infected patient, suppressive therapy) CrCl 30 mL/min or greater, usual dose; CrCl less than 30 mL/min, 0.5 g every 24 hours.
Renal impairment, herpes labialis: CrCl 50 mL/min or greater, usual dose; CrCl 30 to 49 mL/min, 1 g every 12 hours for 1 day; CrCl 10 to 29 mL/min, 0.5 g every 12 hours for 1 day; CrCl less than 10 mL/min, single dose of 0.5 g.
Hemodialysis: give recommended renally adjusted dose after hemodialysis.
Peritoneal dialysis: supplemental doses not required following chronic ambulatory peritoneal dialysis or continuous arteriovenous hemofiltration/dialysis.
Hepatic impairment: dose reduction not recommended in patients with cirrhosis.
Geriatric: dose reduction may be necessary in patients with reduced renal function.
Contraindication:
hypersensitivity to valacyclovir, acyclovir, or any component of the product.
Adverse effect:
Common: rash, nausea and vomiting, abdominal pain, GOT/GPT raised, dizziness, headache, fatigue.
Serious: leukopenia, thrombotic thrombocytopenic purpura/hemolytic uremic syndrome, seizure, encephalopathy, acute renal failure.