Valacyclovir is an L-valyl ester of acyclovir that is converted to acyclovir after oral administration by first-pass intestinal and hepatic metabolism (Medical Letter 1996). Acyclovir targets a viral enzyme, thymidine kinase which inhibits DNA chain elongation. Acyclovir is activated intracellularly by the viral thymidine kinase to the monophosphate derivative, which is then converted by the cellular enzymes to the diphosphate and then to the triphosphate analog, which inhibits viral DNA polymerase (O'Brien and Campoli-Richards (1989)). Valacyclovir achieves a 3–5 fold higher plasma levels than acyclovir resulting in higher bioavailability and less frequent dosing. Valacyclovir produces a more rapid resolution of zoster-associated pain and a shorter duration of post-herpetic neuralgia (Beutner et al., 1995). It is used for prophylaxis therapy to reduce the risk of cytomegalovirus (CMV) disease in transplant recipients (Lowance et al., 1999). Valtrex is the hydrochloride salt of Valacyclovir and is offered in 250 mg, 500 mg, and 1 g tablets, primarily indicated for the treatment of HSV and VZV infections (Sweetman (2005)).
Other names for this medication:
Valacyclovir,
Valtrex,
Bagovir,
Herclov,
Rapivir,
Talavir,
Vadiral,
Valaciclovir,
Valavir,
Valcivir,
Valvir,
Valvirex,
Viranet,
Zelitrex,
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