Valacyclovir renal dosing
Common Questions and Answers about Valacyclovir renal dosing
valtrex
Please note Tenofovir is principally cleared through the kidney and dosing adjustments due to renal impairment have not been clinically tested.
The followings are extracts from the label information for Tenofovir:
2.3 Dose Adjustment for Renal Impairment in Adults
Significantly increased drug exposures occurred when VIREAD was administered to subjects with moderate to severe renal impairment [See Clinical Pharmacology (12.3)].
I believe (though I could be wrong) valacyclovir is the only drug that is approved by the FDA for suppressive therapy, because it's the only drug that has had an FDA registered clinical trial performed for this purpose. However, it is well documented that valtrex and acyclovir perform very similarly. Valtrex is actually converted into acyclovir by the liver, so essentially, the two drugs act the same way in the body to suppress the virus.
My husband and I both have an outbreak every time we have sex which is ruining our sex life. Long term effects of valtrex use is unknown outside of possible renal/liver imparement & I'm just not sure if I should continue taking it. Anyone else have similar experience or advice? Thanks!
I am not aware that impaired renal function precludes treatment for HCV. I have read that kidney disease is a negative predictor of SVR but, so too are a lot of conditions yet people have overcome them. I have seen articles which discuss the plasma levels of ribavirin with renal impaired patients. The suggestion is that rather than weight base dose these patients the dose should be arrived at by considering GFR (glomerular filtration rate).
This is from Clinical Care Options @ http://tiny.
By "AGE" I'm assuming you mean a persons age in years. I don't believe age has anything to do with Janumet's "effectiveness" but age has a larger role with renal function. To make it clear for other readers, Janumet is combination of two drugs; Sitagiptin and Metformin.
This a brief from the Merck web site - makers of Janumet - Section 8.5 - Geriatric Use JANUMET.
I also have kidney damage from a bout of high blood pressure 4 years ago, and I am a frequent kidney stone former, so I am being watched carefully by a nephrologist too. I have renal panels frequently too. I was wondering if any of this could increase my stone risk. I was reading about the cytomel and stones. The nephrologist wants me to remain on the synthroid and cytomel.
I think it depends on some individual factors, particularly renal clearance of the drug. I found this information in the drug reference:
According to the manufacturer's tests, the drug reaches maximum serum levels between 15 and 44 hours after subcutaneous injection of a single dose. The mean elimination half-life is 22 to 60 hours (mean = 40 hours). So, I would expect that after 7 days (4.2 half-lifes) that the concentration would be about 5.5% (0.5^4.2) of the maximum levels.
1) Take suppressive therapy, preferably with valacyclovir (acyclovir would be OK, but is less convenient because of more frequent dosing); 2) Inform each and every parnter of your HSV2 infection; and 3) always use condoms, unless your partner is willing to take the chance of not doing so.
Although your apparently doesn't know herpes or its management very well, this doesn't necessarily mean she otherwise "sucks" as a caring and effective doctor.
Is once or twice a day more or less effective, morning or night dosing or both. Are there long term health problems related to suppressive therapy? I have read extensive information on Immunovex and Acambis working on Vaccines of a preventative and therapeutic modality. They are utilizing different and emerging technologies than past attempts.
Glomerular filtration rate or its approximation of the creatinine clearance are measured whenever renal disease is suspected or careful dosing of nephrotoxic drugs is required. The normal ranges of GFR, adjusted for body surface area for males is 70 ± 14 mL/min/m2 (56-84) . Risk factors for kidney disease include diabetes, high blood pressure, family history and older age.
Take care and keep us posted.
We both suggested you get a culture of PCR test from an outbreak when it occurs. Have you done this. I would hate to think that you have suffered and taken all of this valacyclovir for something that was not HSV and there are other problems which can cause sores resembling HSV. My primary advice for you is that you need a culture or PCR from a lesion and if nothing else, a repeat blood test.
s doctor, but I would not hesitate to recommend acyclovir or valacyclovir to a patient like your partner, assuming his renal function is reasonably nomal (e.g. serum creatinine under 2.0).
Such frequent outbreaks are rare, even without valacyclovir, and I suspect something else is going on. You should see a doctor, preferably one experienced in herpes, such as a dermatologist. Set it up so you can be seen promptly (within a day or two) when the next oubreak starts so you can be examined and have an HSV PCR test from the outbreak (or culture, but PCR is preferred).
There are preferred opiates drugs that are use in patients with liver disease that have shorter half-lives and have less harmful side effects on the renal system. Your liver doctor should be aware of these drugs and be able to determine if you may be able to use them.
With regards to OTC medications, normal recommended doses of acetaminophen can be safely given to patients who suffer from cirrhosis in the short term.
What would you recommend I do as far as dosing the Valtrex? Do you think this is still the inital outbreak manifesting itself? Is there anything you can suggest as far as relief from the neuropathic pain? I have found NSAIDs and narcotics to be largely ineffective. Thank you!
But regarding this Vit D , should i need to take along with calcium supllements Or no need? I have renal stones of 0.5mm. Does this have any effect on this?
I talk valacyclovir for herpes out breaks I have a high dosage one for when I get them it doesn't harm the baby.
Though this is my first pregnancy and I'm 7 weeks.
They told me once I get closer to my due date to take them daily so there is no break out.
t want it there so I started to take Valacyclovir it would keep breaking out every month or so I went on a daily maintenance of 500mg a day. When ever I would miss a pill I start feeling the sensation which I felt when I was going to get an outbreak. I would keep taking it for 5 years. I wanted to stop taking it so I had read some Medical Article's online that Valtrex can rebound.
I'm not sure that I understand your response.
1. I think that you meant to say that "experience tells us that when people ?quit? taking the valacyclovir, they sometimes do have an outbreak soon after that." This is my concern, that the valacyclovir takes over and that the body's immune response is less engaged in fighting the infection. Do you see what I mean?
2.
If you are stage 3 you can take any analgesic within dosing limits. Your liver function has not been altered by your liver disease yet. If you become stage 4 (cirrhosis) then you will have to modify what drugs you can take because the liver is no longer able to process drugs in a normal manner.
Tramadol is an synthetic opiate and should not be taken for "mild" pain.
As such I contacted my doctor and was prescribed valacyclovir hcl which I took (2 1 gram tablets twice daily). The cold sore remained small and eventually went away. After this I went 1-2 days without taking any Lysine or valacyclovir and on the second day I noticed the cold sore coming back again and now appears to have come back and crusted over. I did not think the new cold sore was actually one but then it crusted over.
Call your local pharmacist. We at MedHelp are not allowed to give out dosing instructions. Your pharmacist will be able to tell you exactly how to dose the medications. If your regular pharmacy is closed on Sunday, call any pharmacist availabe at your local grocery store or drug store such as Walgreens, CVS, or RiteAid.
I was diagnosed with Herpes 33 years ago and have been using 1000 mg Valacyclovir a day for the past 4 years and have been free of outbreaks until a few weeks ago when I lost my job and became quite stressed.
I was able to take one extra tablet of 500 mg which stopped the outbreak from turning into blisters, but I am concerned if this medication is not working for me anymore.
I also wonder if Valacyclovir is the same as Valtrex or if Valtrex is stronger?
I appreciate your help.
I'm on daily 1 gram valacyclovir for suppressive therapy. I can feel a new outbreak coming. Would it help if a take the valacyclovir twice daily for a couple of days to help with the OB?
RENAL RISK
TORADOL is CONTRAINDICATED in patients with advanced renal impairment and in patients at risk for renal failure due to volume depletion (see WARNINGS).
RISK OF BLEEDING
TORADOL inhibits platelet function and is, therefore, CONTRAINDICATED in patients with suspected or confirmed cerebrovascular bleeding, patients with hemorrhagic diathesis, incomplete hemostasis and those at high risk of bleeding (see WARNINGS and PRECAUTIONS).
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