Valacyclovir in the Treatment of Herpes Simplex, Herpes Zoster, and Other Viral Infections

Wu, Jashin J.; Brentjens, Mathijs H; Torres, Gisela; Yeung-Yue, Kimberly A.; Lee, Patricia; Tyring, Stephen K.

doi:10.1007/s10227-002-0140-3

Cited by 11 publications

(5 citation statements)

References 56 publications

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“…Valacyclovir is an L-valyl ester and oral prodrug of ACV, converted to ACV and L-valine by first-pass intestinal and/or hepatic metabolism, and 89% of ACV is excreted in the urine [1]. It is more efficiently absorbed and increases serum concentrations more rapidly than ACV, and is effective with less frequent administration [2]. Vigilance is required, however, to avoid adverse events.…”

Section: Discussionmentioning

confidence: 99%

Valacyclovir neurotoxicity: clinical experience and review of the literature

Asahi

Tsutsui

Wakasugi

et al. 2009

Euro J of Neurology

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Valacyclovir (VACV) is used increasingly to treat herpes zoster, although neuropsychiatric symptoms [VACV neurotoxicity (VAN) or acyclovir neurotoxicity], may accompany use of this drug. To promote awareness of this rare condition, we describe here two clinical cases of VAN we previously reported and review 20 cases from the literature. In all cases, chronic or acute renal failure preceded VAN. The symptoms of VAN varied, but disturbances of consciousness and hallucination occurred most commonly. When acute renal failure was due to the drug, recovery from both the disturbance of consciousness and renal failure followed within several days after discontinuation of VACV. Early recognition and diagnosis will ensure effective treatment of VAN.

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Section: Discussionmentioning

confidence: 99%

Valacyclovir neurotoxicity: clinical experience and review of the literature

Asahi

Tsutsui

Wakasugi

et al. 2009

Euro J of Neurology

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“…VCV is more efficiently absorbed, and serum concentrations are increased more rapidly than ACV; VCV is effective with less frequent administration. 16 In a clinical setting in which VCV, the L-valyl ester of acyclovir, was orally administered to humans, approximately 54% of the dose was absorbed. Of the absorbed VCV, more than 99% was rapidly converted to acyclovir to give high plasma acyclovir concentrations and low plasma VCV concentrations, which became undetectable at 3 hours after the dose was administered.…”

Section: Discussionmentioning

confidence: 99%

Effect of High versus Low Oral Doses of Valacyclovir on Herpes Simplex Virus-1 DNA Shedding into Tears of Latently Infected Rabbits

Kumar

Kaufman²,

Clément

et al. 2010

Invest. Ophthalmol. Vis. Sci.

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There was no observable toxicity in any group. The 70- and 140-mg/kg doses of VCV significantly reduced the HSV-1 DNA copy number, compared with that of the other three groups. A daily dose of 500 mg (approximately 7 mg/kg) VCV in healthy human volunteers did not suppress HSV-1 DNA shedding in tears and saliva. Thus, higher doses of VCV may be necessary to reduce asymptomatic shedding in healthy human subjects.

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“…Valacyclovir is an antiviral medication used for treating herpes zoster and herpes simplex infections (24). In multiple case reports, most cases of VAN occurred in patients with impaired renal function (4,(8)(9)(10)(11)25).…”

Section: Discussionmentioning

confidence: 99%

Valacyclovir-associated neurotoxicity among patients on hemodialysis and peritoneal dialysis: A nationwide population-based study

Wang

Juan

et al. 2022

Front. Med.

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Whether valacyclovir-associated neurotoxicity (VAN) occurs more frequently in patients with end-stage renal disease (ESRD) on dialysis is unknown. This is the first population-based study to examine the risk of VAN associated with ESRD patients on dialysis. Among 2,284,800 patients diagnosed as having herpes zoster from 2002 to 2016, patients with ESRD on dialysis and individuals with normal renal function were enrolled in this study. Following propensity score matching, we compared the risk of altered mental status between valacyclovir users and non-users in the ESRD and normal renal function cohorts over a 30-day follow-up period. In the ESRD cohort, the incidence of altered mental status was 1.68 and 0.52 per 1,000 person-day in valacyclovir users and non-users, respectively, with an adjusted hazard ratio (HR) of 3.22 (95% confidence interval [CI]: 2.04–4.99, P < 0.001). The incidence of altered mental status of valacyclovir users on hemodialysis (HD) and peritoneal dialysis (PD) was higher than that of non-users. The adjusted HR was 3.20 (95% CI: 1.98–5.15, P < 0.001) for those on HD and 3.44 (95% CI: 1.13–10.49, P = 0.030) for those with PD. However, altered mental status was not observed in patients on HD receiving ≤500 mg of valacyclovir three times per week or in those on PD receiving ≤500 mg of valacyclovir per day. The findings demonstrate that adjusting the valacyclovir dosage and monitoring VAN in patients with HD and PD who have herpes zoster is crucial.

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Valacyclovir in the Treatment of Herpes Simplex, Herpes Zoster, and Other Viral Infections

Abstract: Valacyclovir is safe and effective in the therapy of patients with herpes simplex and herpes zoster and may be useful in other viral infections.

Cited by 11 publications

References 56 publications

Valacyclovir neurotoxicity: clinical experience and review of the literature

Valacyclovir neurotoxicity: clinical experience and review of the literature

Effect of High versus Low Oral Doses of Valacyclovir on Herpes Simplex Virus-1 DNA Shedding into Tears of Latently Infected Rabbits

Valacyclovir-associated neurotoxicity among patients on hemodialysis and peritoneal dialysis: A nationwide population-based study

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