Antimicrobials
Valacyclovir

Valacyclovir

N/A
Moderate (40 to 70%)
$ (<$25/day)

Spectrum of Activity

Dosing

General Information

  • Renal function

  • LFTs

  • CBC

  • Acute kidney injury

  • Neurotoxicity

  • Thrombotic microangiopathy (TTP and HUS)

  • Abdominal pain

  • Nausea

  • Neutropenia

  • Increased LFTs

  • Headache

  • Absorption: Rapid
  • Distribution: Acyclovir is widely distributed throughout the body including brain, kidney, lungs, liver, spleen, muscle, uterus, vagina, and CSF
  • Protein Binding: ~14% to 18%
  • Metabolism: 
    • Hepatic
    • Valacyclovir is rapidly and nearly completely converted to acyclovir and L-valine by first-pass effect; acyclovir is hepatically metabolized to a very small extent by aldehyde oxidase and by alcohol and aldehyde dehydrogenase (inactive metabolites)
  • Bioavailability: ~55% once converted to acyclovir
  • Half-Life Elimination: 2.5-3.3 hours
  • Time to Peak: 1.5 hours
  • Excretion: Urine, primarily as acyclovir (89%)