Z

Zostiva-500

Rx

500 mg • Tablet

Valacyclovir • Unimed Unihealth Pharmaceuticals Ltd.

Therapeutic class: Herpes simplex & Varicella-zoster virus infections

🌐 বাংলায় দেখুন

Available as: 500 mg

Indications & Uses

Zostiva-500 is indicated for:

Viral Infection

Pharmacology

Valacyclovir is the hydrochloride salt of the L-valyl ester of acyclovir, a well-established antiviral medicine. Once in the body, it works by slowing the growth and spread of the herpes virus, giving the immune system the chance to bring the infection under control. This helps ease symptoms and shortens how long the illness lasts. Valacyclovir is prescribed to treat and help prevent recurrences of genital herpes, shingles, and cold sores.

Dosage Reference

Reference Information Only

Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.

Adults:

Varicella zoster virus (VZV) infections, herpes zoster: Patients should start treatment as soon as possible after a diagnosis of herpes zoster, since there are no data on treatment started more than 72 hours after the zoster rash appears. In immunocompetent adults, the dose is Valacyclovir 1000mg (1 Valacyclovir 1000mg tablet) three times daily for 7 days, giving a total daily dose of 3000mg. In immunocompromised adults, the dose is Valacyclovir 1000mg (1 Valacyclovir 1000mg tablet) 3 times daily for at least 7 days, again a total daily dose of 3000mg, continued for 2 days after the lesions have crusted over. In immunocompromised patients, antiviral treatment is recommended for those presenting within one week of vesicle formation or at any point before the lesions have fully crusted.

For treatment of herpes simplex virus (HSV) infections in adults and adolescents aged 12 years and older who are immunocompetent, the dose is Valacyclovir 500mg (1 Valacyclovir 500mg tablet) taken twice daily, for a total daily dose of 1000mg; this dose should be reduced according to creatinine clearance. Recurrent episodes should be treated for 3 to 5 days, while initial episodes, which can be more severe, may need treatment extended to 10 days. Dosing should begin as early as possible, and for recurrent episodes of herpes simplex this is ideally during the prodromal period or as soon as the first signs or symptoms appear, since Valacyclovir can prevent a lesion from developing if taken at that point.

For herpes labialis (cold sores), an effective treatment in adults and adolescents is Valacyclovir 2000mg (2 Valacyclovir 1000mg tablets) twice daily for one day, with the second dose taken about 12 hours (no sooner than 6 hours) after the first; this dose should also be reduced according to creatinine clearance. With this regimen, treatment should not continue beyond one day, since going longer has not been shown to give any extra benefit, and therapy should be started at the earliest symptom of a cold sore, such as tingling, itching or burning.

In immunocompromised adults, the dose for herpes labialis is Valacyclovir 1000mg (1 Valacyclovir 1000mg tablet) twice daily for at least 5 days, with the duration guided by an assessment of how severe the condition is and the patient's immune status; initial episodes, which can be more severe, may need treatment extended to 10 days. Dosing should begin as early as possible and be reduced according to creatinine clearance, and for the best clinical benefit treatment should start within 48 hours, with the lesions monitored closely as they evolve.

For suppression of recurrent herpes simplex virus (HSV) infections in immunocompetent adults and adolescents aged 12 years and older, the dose is Valacyclovir 500mg (1 Valacyclovir 500mg tablet) once daily. Patients with very frequent recurrences, 10 or more a year without therapy, may get extra benefit from splitting this into 250mg twice daily instead. Treatment should be reviewed after 6 to 12 months. In immunocompromised adults, the dose for suppression is Valacyclovir 500mg (1 Valacyclovir 500mg tablet) twice daily, again reviewed after 6 to 12 months.

For prophylaxis of cytomegalovirus (CMV) infection and disease in adults and adolescents aged 12 years and older, the dose is Valacyclovir 2000mg (2 Valacyclovir 1000mg tablets) four times a day, started as early as possible after transplant and reduced according to creatinine clearance. Treatment usually lasts 90 days, though this may need to be extended in patients at high risk.

Side Effects

The most common side effects seen in clinical trials with Zostiva, in at least one of its uses, were headache and nausea. Other side effects are grouped below by the part of the body they affect. Blood and lymphatic system: low white blood cell count (leucopenia) and low platelet count (thrombocytopenia). Leucopenia is mainly seen in people whose immune system is weakened. Immune system: anaphylaxis, a severe allergic reaction. Brain and nerves: dizziness, confusion, hallucinations, reduced concentration, tremor, agitation, ataxia, dysarthria, convulsions, encephalopathy, coma and psychotic symptoms. Breathing: shortness of breath (dyspnea). Stomach and bowel: vomiting, diarrhea and abdominal discomfort. Liver: reversible rises in liver function tests. Skin: rashes, including those made worse by sunlight (photosensitivity), itching (pruritus) and hives (urticaria). Kidneys: kidney pain and kidney impairment. Kidney impairment is more likely in older people, or in people who already have kidney problems and take higher doses than recommended. Kidney pain can go along with kidney failure.

Cautions & Contraindications

Warnings & Precautions

Hydration status Take care that patients at risk of dehydration, particularly the elderly, get enough fluid. Use in patients with renal impairment and in elderly patients Aciclovir is cleared from the body by the kidneys, so the dose of Zostiva must be reduced in patients with renal impairment. Elderly patients are likely to have reduced kidney function, so the need for a lower dose should be considered in this group too. Both elderly patients and patients with renal impairment are at higher risk of neurological side-effects and should be watched closely for them. In the reported cases, these reactions were generally reversible once treatment was stopped. Use of higher dose of Zostiva in hepatic impairment and liver transplantation There are no data on higher doses of Zostiva (4000mg or more per day) in patients with liver disease. Zostiva has not been studied specifically in liver transplantation, so be careful when giving these patients daily doses greater than 4000mg. Use for zoster treatment Monitor the clinical response closely, particularly in immunocompromised patients. If the response to oral therapy seems insufficient, think about intravenous antiviral therapy. Patients with complicated herpes zoster should receive intravenous antiviral therapy. That means those with visceral involvement, disseminated zoster, motor neuropathies, encephalitis and cerebrovascular complications. Immunocompromised patients with ophthalmic zoster, or those at high risk of disease dissemination and visceral organ involvement, should also be given intravenous antiviral therapy. Transmission of genital herpes Patients should be advised to avoid intercourse while symptoms are present, even if an antiviral has already been started. Use of ocular HSV infections Monitor the clinical response closely in these patients. Consider intravenous antiviral therapy when oral therapy is unlikely to be sufficient. Use in CMV infections Data on the efficacy of Zostiva in transplant patients at high risk of CMV disease show that it should only be used in them when safety concerns rule out valganciclovir or ganciclovir. The high dose of Zostiva needed for CMV prophylaxis may cause adverse events more often than the lower doses used for other indications. Patients should be closely monitored for changes in renal function, and the dose adjusted accordingly.

Contraindications

Don't give Valacyclovir to anyone who is hypersensitive to Valacyclovir, aciclovir or any of the excipients.

Pregnancy & Breastfeeding

Valacyclovir has been studied in pregnancy through a limited amount of direct data, along with a moderate amount of data on aciclovir (into which it is converted in the body). Pregnancy registries and experience after the drug reached the market have not shown any increase in birth defects or harm to the foetus or newborn, and animal studies have not shown reproductive toxicity with Valacyclovir. Even so, it should be used during pregnancy only when the expected benefit justifies the possible risk.

Regarding breastfeeding: aciclovir, the main substance the body converts Valacyclovir into, does pass into breast milk. At the doses used to treat infections, however, the amount reaching a breastfed baby is expected to be less than 2% of the dose that would be given directly to a newborn by vein for herpes treatment, so no ill effects are expected at these levels. Valacyclovir should still be used cautiously while breastfeeding, and only when there is a clear medical need for it.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Overdose

People who have taken too much Valacyclovir have developed acute renal failure and neurological symptoms. These include confusion, hallucinations, agitation, decreased consciousness and coma. Nausea and vomiting can also happen.

Care is needed to avoid giving too much by mistake. Many of the reported cases were in elderly patients or those with poor kidney function, who got repeated overdoses because the dose was not lowered as it should have been. Patients should be watched closely for signs of toxicity.

Hemodialysis removes aciclovir from the blood to a significant degree, so it may be considered as a way to manage a symptomatic overdose.

⚠️ In an emergency call 999 or go to the nearest hospital emergency department.

Storage

Keep Valacyclovir in a cool, dry place, and keep it away from children.

Drug Interactions

Open checker →

Moderate Methotrexate

Moderate Cimetidine

Moderate Tacrolimus

Moderate Tenofovir Alafenamide

Moderate Lamivudine + Zidovudine + Nevirapine

Moderate Cyclosporine

Common questions about Zostiva-500 500 mg

What is Zostiva-500 500 mg Tablet?

Zostiva-500 500 mg Tablet is a medicine that contains Valacyclovir. It is made by Unimed Unihealth Pharmaceuticals Ltd. It belongs to the Herpes simplex & Varicella-zoster virus infections group of medicines.

What is Zostiva-500 used for?

Zostiva-500 is used for: Viral Infection.

What are the side effects of Zostiva-500?

The most common side effects seen in clinical trials with Zostiva, in at least one of its uses, were headache and nausea. Other side effects are grouped below by the part of the body they affect.

Can I take Zostiva-500 during pregnancy or while breastfeeding?

Valacyclovir has been studied in pregnancy through a limited amount of direct data, along with a moderate amount of data on aciclovir (into which it is converted in the body). Pregnancy registries and experience after the drug reached the market have not shown any increase in birth defects or harm to the foetus or newborn, and animal studies have not shown reproductive toxicity with Valacyclovir. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

What happens if I take too much Zostiva-500?

People who have taken too much Valacyclovir have developed acute renal failure and neurological symptoms. These include confusion, hallucinations, agitation, decreased consciousness and coma. In an emergency call 999 or go to the nearest hospital emergency department.

How should I store Zostiva-500?