Valacyclovir for the Management of Herpes Viral Infections

A. Chakrabarty, MD; N. J. Anderson, MD; R. Beutner, MD, PhD; S. K. Tyring, MD, PhD, MBA

Disclosures

Skin Therapy Letter. 2005;10(1):1-4. 

In This Article

Abstract and Introduction

Abstract

The Herpesviridae family (Types 1-8) continues to inflict considerable morbidity and social stigma upon humanity. Once infected with the herpes viruses, especially Types 1-3, they establish permanent residence within our nervous system and reactivate during periods of stress, trauma, and/or other precipitating factors. To date, there is no cure for herpes viral infections but antivirals can attenuate the symptoms and duration of episodic outbreaks. Prophylactic therapy can suppress recurrences. The first antiviral with selective activity against virus-infected cells is considered to be acyclovir. Our article will highlight the clinical indications of the current generation, valacyclovir, which is a prodrug of acyclovir. We consider valacyclovir as a second-generation antiviral, having taken into account the initial selectivity and safety profile of its progenitor, acyclovir.

Introduction

The hallmark of the herpes viruses is their ability to establish permanent residency within the neuronal ganglia of our nervous system and to reactivate during times of stress, trauma, and other precipitating factors. The herpes simplex virus-1 (HSV-1), herpes simplex virus-2 (HSV-2), and varicella-zoster virus (VZV) can be associated with painful, blistering outbreaks that, although they are self-limiting, have been associated with considerable morbidity.

Antiviral medications are the standard of practice in the management of herpes viral infections. Orally administered antivirals, such as valacyclovir (Valtrex®, GlaxoSmithKline) are prescribed to attenuate the signs and symptoms, reduce the duration of outbreak, and hasten lesion resolution. Our article will focus on the pharmacologic mechanism and diverse clinical indications of one of the second generation antivirals, valacyclovir. The development of the second generation antivirals has been tailored towards enhancing the oral bioavailability and intracellular pharmacokinetics. Valacyclovir provides an excellent safe and effective alternative to its more traditionally prescribed parent compound, acyclovir.

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