eMedExpert Home > Compare Drugs > Valacyclovir (Valtrex)

• Recurrent genital herpes: The study has demonstrated that valaciclovir 500 mg twice daily is equivalent in efficacy to aciclovir 200 mg five times daily as episodic treatment of recurrent genital HSV infection. Valaciclovir maintains the established efficacy and safety of aciclovir but offers a much more convenient twice daily dosing regimen. 1
• First-episode genital herpes: Twice-daily valaciclovir is as effective and well tolerated in the treatment of first-episode genital herpes as five-times-daily acyclovir. Valaciclovir provides a useful alternative to acyclovir with the advantage of a more convenient dosing regimen and the potential for improved compliance.2
• Suppression of HSV shedding: Although the suppression of viral replication is not complete, valacyclovir and acyclovir are highly effective in suppressing the frequency and quantity of genital HSV shedding. No significant differences in frequency and quantity of HSV were detected by polymerase chain reaction (PCR) between the valacyclovir and acyclovir. 3
• Herpes zoster: The study showed that valaciclovir significantly accelerate the resolution of herpes zoster-associated pain compared with acyclovir. In the management of herpes zoster valaciclovir is superior to acyclovir.5
• Post-transplantation cytomegalovirus prophylaxis: Valacyclovir appears to be more effective than acyclovir in preventing CMV reactivation in bone marrow transplant recipients. 4

• Herpes zoster: Valacyclovir treatment is comparable to famciclovir treatment in speeding the resolution of zoster-associated pain and postherpetic neuralgia. Safety profiles for valacyclovir and famciclovir are similar, with headache and nausea the most common adverse events 7.
• Genital herpes: Valacyclovir appears to be somewhat better than famciclovir for suppression of genital herpes and associated shedding. 6

• Valacyclovir (Valtrex) Medical Facts

• 1. Bodsworth NJ, Crooks RJ, Borelli S, Vejlsgaard G, Paavonen J, Worm AM, Uexkull N, Esmann J, Strand A, Ingamells AJ, Gibb A. Valaciclovir versus aciclovir in patient initiated treatment of recurrent genital herpes: a randomised, double blind clinical trial. International Valaciclovir HSV Study Group. Genitourin Med. 1997 Apr;73(2):110-6. PubMed
• 2. Fife KH, Barbarash RA, Rudolph T, Degregorio B, Roth R. Valaciclovir versus acyclovir in the treatment of first-episode genital herpes infection. Results of an international, multicenter, double-blind, randomized clinical trial. The Valaciclovir International Herpes Simplex Virus Study Group. Sex Transm Dis. 1997 Sep;24(8):481-6. PubMed
• 3. Gupta R, Wald A, Krantz E, Selke S, Warren T, Vargas-Cortes M, Miller G, Corey L. Valacyclovir and acyclovir for suppression of shedding of herpes simplex virus in the genital tract. J Infect Dis. 2004 Oct 15;190(8):1374-81. Epub 2004 Sep 20. PubMed
• 4. Ljungman P, de La Camara R, Milpied N, Volin L, Russell CA, Crisp A, Webster A; Valacyclovir International Bone Marrow Transplant Study Group. Randomized study of valacyclovir as prophylaxis against cytomegalovirus reactivation in recipients of allogeneic bone marrow transplants. Blood. 2002 Apr 15;99(8):3050-6. PubMed
• 5. Lin WR, Lin HH, Lee SS, Tsai HC, Huang CK, Wann SR, Chen YS, Chiang SC, Yen MY, Liu YC. Comparative study of the efficacy and safety of valaciclovir versus acyclovir in the treatment of herpes zoster. J Microbiol Immunol Infect. 2001 Jun;34(2):138-42. PubMed
• 6. Wald A, Selke S, Warren T, Aoki FY, Sacks S, Diaz-Mitoma F, Corey L. Comparative efficacy of famciclovir and valacyclovir for suppression of recurrent genital herpes and viral shedding. Sex Transm Dis. 2006 Sep;33(9):529-33. PubMed
• 7. Tyring SK, Beutner KR, Tucker BA, Anderson WC, Crooks RJ. Antiviral therapy for herpes zoster: randomized, controlled clinical trial of valacyclovir and famciclovir therapy in immunocompetent patients 50 years and older. Arch Fam Med. 2000 Sep-Oct;9(9):863-9. PubMed

Published: March 31, 2008
Last updated: January 09, 2010