Valaciclovir Tablets for Genital Herpes

Valaciclovir is:

• a prescription-only medication
• antiviral (works on infections caused by viruses)
• the generic (cheaper) version of Valtrex
• useful for genital herpes, cold sores, and shingles

Valaciclovir is an antiviral medication (meaning it works against viruses) and is used to manage HSV (herpes simplex virus) and VZV (varicella-zoster) infections.

Valaciclovir for herpes

Valaciclovir is used to treat outbreaks of symptoms (flare-ups) or taken every day over 6 to 12 months to prevent herpes outbreaks if you get them often. It can help you by reducing the time to heal from an outbreak and lowers the chances of you passing the virus on to someone else.

While valaciclovir eases the symptoms, it does not cure herpes. There’s no current cure for genital herpes or cold sores. But it can help you by treating outbreaks or suppressing the virus to keep it in a dormant (inactive) state to prevent outbreaks and stop you from getting symptoms.

Valaciclovir for cold sores

Like with genital herpes, valaciclovir can also treat and prevent cold sore outbreaks. It’s used as a cream on cold sores directly or as a tablet to treat and prevent outbreaks.

Valaciclovir for shingles

Additionally, valaciclovir can be effective against shingles outbreaks. If used at the start of the infection, valaciclovir can help make the symptoms less severe and stop them lasting as long.

Valaciclovir is known as a prodrug, which means your body changes it into another substance after you take it. Valaciclovir turns into aciclovir, which works by blocking the virus from reproducing and slowing down how fast it spreads. This helps to control your symptoms and prevent outbreaks.

How long does it take for valaciclovir to work?

You should see the first results around 48 hours after you start taking valaciclovir.

For genital herpes, it can take up to 10 days for sores to fully heal, even with valaciclovir.

For cold sores, valaciclovir does speed up recovery but it can still take 7 to 10 days before the sores go away completely.

Valaciclovir is an effective herpes treatment. It reduces the time for sores to clear up by about 20%. Of the people who use it, 59% have no visible herpes symptoms after five days.

You may get fewer or less serious side effects with valaciclovir compared to the other genital herpes medications.

It’s important to remember that valaciclovir cannot cure herpes. No treatment can. But, if you take valaciclovir, it can help you control the virus and reduce your symptoms.

Valaciclovir is prescription-only, which means you need to go to your doctor or use an online service like ZAVA to get valaciclovir prescribed to you. If your regular GP gives you a physical prescription, you can get it filled at most pharmacies in the UK.

You should swallow the valaciclovir tablet whole with a glass of water at the same time each day. Follow the instructions given to you by your doctor or pharmacist. Check the patient information leaflet that comes with your medication if you’re not sure.

The sooner you start treatment, the better the effect will be. Try to take the first tablet as soon as you notice your symptoms. Starting it 2 hours after the infection begins can reduce how long you have symptoms by a whole day.

Make sure you complete your full course of treatment, even if your symptoms go away. This will reduce the risk of the infection coming back.

How do I know if my treatment is working?

You should notice your symptoms improve and the blistering dies down while you’re taking the treatment. If you’re still getting new blisters after finishing treatment, you should speak to a doctor.

Can I still have sex during herpes treatment?

You should avoid having sex while taking herpes treatment because you may spread it to your partner. This includes oral and anal sex. If you do have sex, you must use protection.

Can I drink alcohol on valaciclovir?

You can drink alcohol while taking valaciclovir. Alcohol does not interact with valaciclovir in the body. But, it does make your immune system weaker making it harder for you to recover.

Valaciclovir and pain medication

Valaciclovir can be taken with pain medication but some will interact with valaciclovir and increase the risk of kidney problems. Don’t take medications containing ibuprofen or naproxen. There’s no evidence that valaciclovir reacts with paracetamol or aspirin, so they should be safe to take.

Taking valaciclovir when pregnant

There’s no evidence that valaciclovir causes birth defects, so it should be safe to take when pregnant. Always tell your doctor you’re pregnant when getting herpes treatment so they recommend the right treatment course for you.

How much valaciclovir you need will depend on:

• if you’re using it to treat cold sores, genital herpes, or shingles
• if this is your first outbreak (flare-up)
• if you get recurring outbreaks
• if you’re taking it to prevent outbreaks

A doctor will tell you how much you should take, so it’s important to follow their instructions.

500mg

This dose twice a day is best for people who have already had their first genital herpes outbreak and are having repeat outbreaks. It can also be used once a day to prevent genital herpes outbreaks.

1000mg (1g)

This dose can be used to prevent genital herpes outbreaks when taken twice a day. It is also used twice a day when you’re having your first outbreak. For shingles treatment patients usually take this dose three times a day for seven days.

Dosage for cold sores

When used to treat cold sores, valaciclovir is taken every twelve hours for one day at a strength of 2000mg.

Nearly all medications can cause side effects, but not everyone will get them.

Common side effects include:

• diarrhoea
• dizziness
• headache (1 in 10 may experience headaches)
• feeling sick (nausea) and being sick (vomiting)
• sensitivity to light (photosensitivity)
• skin reactions (rashes and itching)

Make sure you drink plenty of fluids during the treatment. You should not drive or use heavy machinery if you feel dizzy or sleepy while taking valaciclovir.

A full list of more, less common side effects is below. If you get a serious allergic reaction (symptoms are facial swelling, itchy skin and difficulty breathing), stop taking valaciclovir immediately and call 999 straight away.

Uncommon side effects:

• Abdominal (tummy) discomfort
• Agitation or confusion
• Shortness of breath
• Blood in your pee
• Hallucinations
• Changes in your blood like a lower number of white blood cells (mainly seen in people with a weakened immune system) or reduced platelet count
• Feeling drowsy
• Kidney pain
• Tremor
• Hive-like rash

Rare or very rare side effects:

• Swelling under the skin
• Unsteadiness while walking or a lack of coordination
• Coma
• Delirium (disturbed thoughts) and psychosis
• Slow or slurred speech
• Altered brain function
• Kidney problems or kidney stones
• Fits or seizures

Side effects affecting your brain or nervous system are generally seen in people taking high doses (8000mg daily) and are usually reversible.

Always read the patient information leaflet that comes with your medicine for more information about side effects.

You should always speak to a doctor if you get any of these side effects or any other changes.

Long-term side effects

Generally, valaciclovir is safe for long-term use and well-tolerated by people using it over a longer period of time.

Problems mainly show up in people who have pre-existing health issues: If taken long-term by people who are often dehydrated or already have kidney problems, valaciclovir can cause renal toxicity. It can also cause liver inflammation in people who have liver problems.

Other medications can affect the way valaciclovir works in your body. You must tell a doctor if you’re on any of the following medications before taking valaciclovir:

• anything you’re taking without a prescription, including herbal medicines
• medications that affect the kidneys, including aminoglycosides, organoplatinum compounds, iodinated contrast media, methotrexate, pentamidine, foscarnet, ciclosporin, tacrolimus, cimetidine and probenecid

Tell a doctor about other medicines you’re using if you’re taking valaciclovir for shingles or after having an organ transplant.

You must not take valaciclovir if you’re allergic to any of its ingredients which can be found in the patient information leaflet that comes with your medicine. Speak to a doctor, pharmacist or nurse before taking valaciclovir if you:

• are over 65
• have kidney problems
• have liver problems
• have a weak immune system

Try and avoid becoming dehydrated while taking valaciclovir since this makes kidney problems more likely.

Speak to a doctor if you’re pregnant, trying to get pregnant or breastfeeding and wish to take valaciclovir.

Valaciclovir:

• From £29.95 at ZAVA
• 59% effective*
• The dosage for regular herpes outbreak is 500mg twice a day for three days

Aciclovir:

• From £19.95 at ZAVA
• 54% effective*
• The dosage for regular herpes outbreak is 400mg twice a day for five days

*from research comparing aciclovir and valaciclovir, which shows the amount of patients who didn’t have any of the herpes virus visible in their body after five days of treatment.

Valaciclovir works in a similar way to other genital herpes treatments, including aciclovir. Some reports show that people get fewer or less serious side effects with valaciclovir compared to the other genital herpes medications.

Aciclovir and famciclovir (also known by the brand names Zovirax and Famvir, respectively) are the other approved treatments for genital herpes in the UK. Famciclovir is more commonly used to treat shingles or herpes and cold sores in people who have weakened immune systems.

Valaciclovir can also be more convenient than other medications, like aciclovir, because you don’t need as many tablets a day for herpes. Many doctors prefer prescribing valaciclovir over aciclovir, because of the simplified dosing schedule.