Sign Out
Hydration status: Care should be taken to ensure adequate fluid intake in patients who are at risk of dehydration, particularly the elderly.
Use in patients with renal impairment and in elderly patients: Aciclovir is eliminated by renal clearance, therefore the dose of valaciclovir must be reduced in patients with renal impairment (see Dosage & Administration). Elderly patients are likely to have reduced renal function and therefore the need for dose reduction must be considered in this group of patients. Both elderly patients and patients with renal impairment are at increased risk of developing neurological side effects and should be closely monitored for evidence of these effects. In the reported cases, these reactions were generally reversible on discontinuation of treatment (see Adverse Reactions).
Use of higher doses of Valaciclovir in hepatic impairment: There are no data available on the use of higher doses of Valaciclovir (4 g or more/day) in patients with liver disease.
Caution should therefore be exercised when administering higher doses of Valaciclovir to these patients. Specific studies of Valaciclovir have not been conducted in liver transplantation.
Use in genital herpes: Suppressive therapy with Valaciclovir reduces the risk of transmitting genital herpes. It does not cure genital herpes or completely eliminate the risk of transmission. In addition to therapy with Valaciclovir, it is recommended that patients use safer sex practices.
Drug reaction with eosinophilia and systemic symptoms (DRESS): DRESS, which can be life-threatening or fatal, has been reported in association with valaciclovir treatment. Patients should be advised of the signs and symptoms and monitored closely for skin reactions. If signs and symptoms suggestive of DRESS appear, valaciclovir should be withdrawn immediately and an alternative treatment considered (as appropriate). If the patient has developed DRESS with the use of valaciclovir, treatment with valaciclovir must not be restarted in this patient at any time.
