Genital herpes is the most prevalent
sexually transmitted infection in the USA. While sometimes mild in severity, it can be a distressing and painful
chronic condition. Likewise,
herpes labialis and
herpes zoster can be both physically and psychologically painful. While there is no cure for these conditions, treatment to alleviate symptoms, suppress recurrences and reduce transmission has been drastically improved over the past 20 years with the use of
guanine nucleoside antivirals, such as
valacyclovir hydrochloride (
Valtrex), GlaxoSmithKline) the highly bioavailable
prodrug of
acyclovir (
Zovirax((R)), GlaxoSmithKline), and
famciclovir (
Famvir, Novartis), a highly bioavailable
prodrug of
penciclovir (
Denavir, Novartis). Clinical trials involving approximately 10,000 patients (including patients from nongenital herpes studies, such as
herpes zoster) have assessed the safety and efficacy of
valacyclovir in the treatment of initial
genital herpes outbreaks, episodic treatment of recurrent episodes and daily suppressive
therapy. It was shown that
valacyclovir has similar efficacy to
acyclovir in the episodic and suppressive treatment of
genital herpes.
Valacyclovir is the only
antiviral drug approved for a once-daily dose of suppressive
therapy for
genital herpes, as well as the only
antiviral drug US FDA approved for a 3-day regimen of episodic treatment of recurrent
genital herpes. In addition,
valacyclovir is also indicated in the reduction of the sexual transmission of
herpes simplex virus infection and for the treatment of
herpes labialis. In
herpes zoster,
valacyclovir is more effective than
acyclovir or placebo (and as equally effective as
famciclovir) in shortening the length and severity of
herpes zoster-associated
pain and
postherpetic neuralgia.
Valacyclovir has an acceptable safety profile in patients with
herpes simplex and
herpes zoster. The less frequent dosing regimen makes it an attractive option in the treatment of
genital herpes and other
viral infections, and may contribute to increased patient adherence to
therapy.