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SATURDAYOctober 16SESSION 18:35– 8:50Click here to return to Dermatology Update 2004 Schedule and Abstracts |
Stephen Tyring Valacyclovir is the prodrug of acyclovir; when taken orally it achieves blood levels of acyclovir that are equivalent to receiving intravenous acyclovir. Valacyclovir is indicated for the episodic therapy of herpes labialis at 2g BID for one day and for the episodic therapy of genital herpes at 500mg BID for three days. It is used to suppress recurrent genital herpes at 500mg daily, which results in a 90% reduction in both clinical outbreaks and asymptomatic viral shedding. This observation led to a recent study demonstrating that taking valacyclovir 500mg daily by a person with genital herpes could reduce transmission to a seronegative partner by 77%. This study was the first demonstration of an antiviral drug reducing the transmission of a sexually transmitted disease. Valacyclovir is also approved for the therapy of acute herpes zoster at 1g TID for seven days, which is more effective at reducing zoster associated pain than is acyclovir 800mg five times daily. Recently valacyclovir at 1g TID for seven days combined with gabapentin at escalating doses over one to two months was found to reduce (relative to valacyclovir monotherapy) the incidence of zoster associated pain by 80% at six months following the development of acute zoster. When valacyclovir is taken episodically for therapy of herpes labialis, genital herpes or herpes zoster or is used daily to suppress genital herpes, it is equally safe as placebo. Likewise, valacyclovir is used safely and effectively to treat herpes labialis, genital herpes and herpes zoster in immunocompromised patients. In conclusion, valacyclovir is safe and effective for treatment of herpes labialis, herpes genitalis and herpes zoster. It is the only antiviral drug proven to reduce transmission of a sexually transmitted disease. When combined with gabapentin for therapy of acute herpes zoster, it is very effective at preventing zoster associated pain. Click here to return to Dermatology Update 2004 Schedule and Abstracts |