Valacyclovir
Renal

Renal

Not On Dialysis

Herpes zoster (shingles)
  • CrCl 30-49: 1 g PO q12h
  • CrCl 10-29: 1 g PO q24h
  • CrCl <10: 500 mg PO q24h
Herpes labialis
  • CrCl 30-49: 1 g PO q12h x 2 doses
  • CrCl 10-29: 500 mg PO q12h x 2 doses
  • CrCl <10: 500 mg PO as a single dose
Primary genital herpes
  • CrCl 30-49: 1 g PO q12h
  • CrCl 10-29: 1 g PO q24h
  • CrCl <10: 500 mg PO q24h
Recurrent genital herpes
  • CrCl 30-49: 500 mg PO q12h x 3 days OR 1 g PO q24h x 5 days
  • CrCl <30: 500 mg PO q24h
Herpes simplex/Varicella zoster treatment in oncology patients
  • CrCl 30-49: 1 g PO q12h
  • CrCl 10-29: 1 g PO q24h
  • CrCl <10: 500 mg PO q24h
Herpes simplex/Varicella zoster prophylaxis in oncology patients
  • CrCl 30-49: 500 mg PO q8-12h
  • CrCl 10-29: 500 mg PO q12h
  • CrCl <10: 500 mg PO q24h

Intermittent Hemodialysis

HSV: 500 mg PO daily

VZV: 1 g PO daily

Give after dialysis on dialysis days

Intermittent Hemodialysis (HD), Peritoneal Dialysis

Dose for CrCl less than 10 mL/min

Give dose after dialysis session for HD patients