Dose For Normal Renal Function
500 mg q12h
Second Dose
Second Dose: to 1000 mg q8h (depends on indication)
Adjustment For Renal Failure Method
D, I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [D]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
Full dose q12-24h [D]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
0.5 g q24h [D]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Not applicable, recommend IV form
References
Soul-Lawton J, Seaber E, On N, Wootton R, Rolan P, Posner J. Absolute bioavailability and metabolic disposition of valaciclovir, the L-valyl ester of acyclovir, following oral administration to humans. Antimicrob Agents Chemother. 1995; 39: 2759-64. [PMID: 8593015] / Weller S, Blum MR, Doucette M, Burnette T, Cederberg DM, de Miranda P, et al. Pharmacokinetics of the acyclovir pro-drug valaciclovir after escalating single-and multiple-dose administration to normal volunteers. Clin Pharmacol Ther. 1993; 54: 595-605. [PMID: 8275615]
Toxicity Notes
Rapidly and extensively converted to acyclovir. Bioavailability of valacyclovir is 50-55% versus 10-20% for standard oral acyclovir (q.v.) preparations. Other pharmacokinetic variables and toxicities as for acyclovir.