Genital herpes is a chronic, life-long viral infection. Two types of HSV can cause genital herpes: HSV-1 and HSV-2. Most cases of recurrent genital herpes are caused by HSV-2, and approximately 50 million persons in the United States are infected with this type of genital herpes . Most persons infected with HSV-2 have not had the condition diagnosed. Many such persons have mild or unrecognized infections but shed virus intermittently in the anogenital area. As a result, most genital herpes infections are transmitted by persons unaware that they have the infection or who are asymptomatic when transmission occurs. Management of genital HSV should address the chronic nature of the disease rather than focusing solely on treatment of acute episodes of genital lesions. The dose in immunocompromised patients is 1000 mg three times daily for at least seven days (3000 mg total daily dose) and for 2 days following crusting of lesions. This dose should be reduced according to creatinine clearance (see Renal impairment below). For recurrent episodes, treatment should be for three to five days. For initial episodes, which can be more severe, treatment may have to be extended to ten days. For recurrent episodes of herpes simplex, this should ideally be during the prodromal period or immediately upon appearance of the first signs or symptoms. Valtrex can prevent lesion development when taken at the first signs and symptoms of an HSV recurrence. For herpes labialis (cold sores), valaciclovir 2000 mg twice daily for one day is effective treatment in adults and adolescents. The second dose should be taken about 12 h (no sooner than 6 h) after the first dose.
Chief Complaint: Right eye pain A 36-year-old female presented to the Emergency Treatment Center (ETC) of the University of Iowa Hospitals and Clinics (UIHC) with one day of right eye pain, photophobia and decreased vision. The ETC physician performed fluorescein staining and made a diagnosis of a corneal abrasion. The patient was treated with topical trimethoprim-polymyxin (Polytrim) four times daily and oral acetaminophen-hydrocodone 10/500 (Lortab) as needed for pain relief. She was instructed to follow-up with her eye care provider the next day if symptoms did not improve or resolve. The following day, her symptoms did not resolve and was therefore referred to the UIHC Cornea service for further evaluation. During the first ten days of treatment, all subjective symptoms resolved with the exception of mild blurring of vision. On Day 11, the best-corrected spectacle visual acuity (BCSVA) had improved to 20/30 with further pinhole improvement to 20/25. On slit lamp examination, the epithelium was intact without residual dendrites. Valacyclovir is used to treat infections caused by certain types of viruses. In children, it is used to treat cold sores around the mouth (caused by herpes simplex) and chickenpox (caused by varicella zoster). In adults, it is used to treat shingles (caused by herpes zoster) and cold sores around the mouth. The viruses that cause these infections continue to live in the body even between outbreaks. Valacyclovir is also used to treat outbreaks of genital herpes. Valacyclovir decreases the severity and length of these outbreaks. In people with frequent outbreaks, this medication is used to reduce the number of future episodes. It helps the sores heal faster, keeps new sores from forming, and decreases pain/itching. This medication may also help reduce how long pain remains after the sores heal. Read the Patient Information Leaflet if available from your pharmacist before you start taking valacyclovir and each time you get a refill.
Medscape - Herpes simplex, zoster-specific dosing for Valtrex valacyclovir, frequency-based adverse effects, comprehensive interactions, contraindications. The dose is 500 mg of Valtrex to be taken twice daily 1000 mg total daily dose. This dose should be reduced according to creatinine clearance see Renal.