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Medical Forum / Diseases and Disorders / Herpes / December 2003Valtrex maximum dosages & concerns
I have been taking Valtrex for about 5 months and have just stepped the dosage up to 1 g daily, as 500 mg was not doing ANYTHING. I was having outbreaks every 10 days or so. I read some research: http://www.rxlist.com/cgi/generic3/valacyclovir_ids.htm and it indicated that 1 gram dosage was appropriate for Suppressive Therapy. I would like to know if anyone has taken 1 gram for an extended period of time and their pros and cons in their experience. I would also like to know if anyone can shed any light on liver issues with a higher dosage such as this, as my OB/GYN has requested a liver function test every 3 months due to the higher dosage. Thanks....=) >I have been taking Valtrex for about 5 months and have just stepped >the dosage up to 1 g daily, as 500 mg was not doing ANYTHING. >I was having outbreaks every 10 days or so. >I read some research: >http://www.rxlist.com/cgi/generic3/valacyclovir_ids.htm >and it indicated that 1 gram dosage was appropriate for Suppressive >Therapy. >I would like to know if anyone has taken 1 gram for an extended period >of time and their pros and cons in their experience. >I would also like to know if anyone can shed any light on liver issues There are no liver issues. The only "liver issue" is the fake one that certain trolls and scaremongers use to scare people away from Valtrex and Acyclovir in favor of more "natural" products which their pals are just waiting to sell. Repeated searches for information on livers and Valtrex come up empty. >with a higher dosage such as this, as my OB/GYN has requested a liver >function test every 3 months due to the higher dosage. Chalk it up to a careful doctor and the modern tendency for excessive testing. As I understand it, keeping tabs on your liver may help show a problem somewhere else, but Valtrex and Acyclovir are not themselves dangerous to your liver. Also, I don't consider a 1 gram daily dose particularly high, but then again I'm not a doctor either. I predict you'll have normal liver results and fewer outbreaks. Take care, Mike >There are no liver issues. The only "liver issue" is the fake one >that certain trolls and scaremongers use to scare people away from >Valtrex and Acyclovir in favor of more "natural" products which their >pals are just waiting to sell. Repeated searches for information on >livers and Valtrex come up empty. Some websites indicate that the presence of liver disease should be told to your dr or pharmacist, indicating to me that the liver is harder hit. However, there is no such information on the valtrex.com site, or a few other helpful sites. Could it have something to do with the liver being an important part of how one's body deals with medications, etc.? Just a thought.... My information came from my OB and my pharmacist. The OB spoke with her Valtrex rep and that is what the rep said -- because the 1 gram dose is not commonly used. >>with a higher dosage such as this, as my OB/GYN has requested a liver >>function test every 3 months due to the higher dosage. [quoted text clipped - 7 lines] >again I'm not a doctor either. I predict you'll have normal liver >results and fewer outbreaks. Thanks for your input Mike. Although I am a newbie, your posts are some of the more informative. >Take care, > >Mike R. >>There are no liver issues. The only "liver issue" is the fake one >>that certain trolls and scaremongers use to scare people away from >>Valtrex and Acyclovir in favor of more "natural" products which their >>pals are just waiting to sell. Repeated searches for information on >>livers and Valtrex come up empty. >Some websites indicate that the presence of liver disease should be >told to your dr or pharmacist, indicating to me that the liver is >harder hit. However, there is no such information on the valtrex.com >site, or a few other helpful sites. >Could it have something to do with the liver being an important part >of how one's body deals with medications, etc.? Just a thought.... Apparently it is just one standard way to monitor the general state of the body. The following link will give the Google Groups history for this group with the word "liver" and the author being our very own learned Tim Fitzmaurice: http://babyurl.com/TuzUoi >My information came from my OB and my pharmacist. The OB spoke with >her Valtrex rep and that is what the rep said -- because the 1 gram >dose is not commonly used. Glaxo says either 1000mg or 500mg, depending on the frequency of outbreaks. It sounds like you've had a bad five months, but with any luck the severity or frequency of your outbreaks will lesson as time goes on, thereby reducing your need for the higher dose. >>>with a higher dosage such as this, as my OB/GYN has requested a liver >>>function test every 3 months due to the higher dosage. >>Chalk it up to a careful doctor and the modern tendency for excessive >>testing. As I understand it, keeping tabs on your liver may help show >>a problem somewhere else, but Valtrex and Acyclovir are not themselves >>dangerous to your liver. >>Also, I don't consider a 1 gram daily dose particularly high, but then >>again I'm not a doctor either. I predict you'll have normal liver >>results and fewer outbreaks. >Thanks for your input Mike. Although I am a newbie, your posts are >some of the more informative. Thanks. I try, and sometimes get off track, but I do like trying to find answers to legitimate questions. For some reason there seems to be a sudden upsurge in people concerned about their livers here and I'm perplexed to understand why. A woman I know with hepatitis is prescribed Valtrex (1 gram a day) with no undue worries. There is nothing in any of the literature that I've seen that suggests that Valtrex or Acyclovir pose any more than a very slight risk of any side effects. One should always be aware that there always are the possibility of side effects with most medicines and report anything unusual to one's doc. Take care, Mike > >There are no liver issues. The only "liver issue" is the fake one > >that certain trolls and scaremongers use to scare people away from [quoted text clipped - 5 lines] > told to your dr or pharmacist, indicating to me that the liver is > harder hit. However, there is no such information on the valtrex.com Thats possibly overassuming...the liver being involved doesn;t always mean it hardest hit. The primary organ thats adversely affected is the kidney and poor renal function is a problem as thats how you get rid of the stuff. IIRC Valacyclovir is converted to its active form in the liver...hence poor liver function is relevant in that if it aint working well its not going to necessarily do enough conversion to make the drug work....so dose adjustment or a different drug may be appropriate... Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568 I spoke with my endocrinologist today about the importance of the liver testing (she and my OB are friends and in cahoots, LOL). She stated basically the same thing that Tim and MLS were speaking of....the involvement of the kidneys and liver. Her thought is more of concern with the kidney. I will happily get my liver tested every three months as I already have to anyway. I am going through the archives, very informative. As a side note: being a diabetic seems to make the outbreaks more frequent and harder to heal....which sucks lots. cheers all.... r. >> >There are no liver issues. The only "liver issue" is the fake one >> >that certain trolls and scaremongers use to scare people away from [quoted text clipped - 17 lines] > >Tim > I spoke with my endocrinologist today about the importance of the > liver testing (she and my OB are friends and in cahoots, LOL). > > She stated basically the same thing that Tim and MLS were speaking > of....the involvement of the kidneys and liver. Her thought is more > of concern with the kidney. It was the first big side effect spotted for acyclovir. It can crystallise in the kidneys. The risk area for that is generally considered to be when its given IV or if the patient already has a kidney problem. It is considered reversible, usually by withdrawal of drug and decent hydration of the patient. As such you will often hear docs talking about keeping good hydration when on acyclovir (not that that isnt a good idea anyway). Some species this is particularly marked - its one reason why equine herpesvirus which do respond to acyclovir in vitro don't get treated with it....in horses it can crystallise easily. > As a side note: being a diabetic seems to make the outbreaks more > frequent and harder to heal....which sucks lots. Not sure if there is a defined link known there. Wouldn't surprise me though. Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568 >> I spoke with my endocrinologist today about the importance of the >> liver testing (she and my OB are friends and in cahoots, LOL). [quoted text clipped - 19 lines] >Not sure if there is a defined link known there. Wouldn't surprise me >though. I don't think there is a defined link, per se, other than the way diabetes wears down one's immune systems and the way HSV will take advantage of it. I wouldn't be surprised if someone did a study of diabetics with HSV that some interesting patterns would show up.... >Tim Tim: what is IIRC Valacyclovir? Also: do the medical journals, which laypeople like myself do not have ready access to, indicate as the most useful anti-viral? My pharmcist says Valtrex is the most common but if it is not helping with the outbreaks, IE I get 2-3 a month, then would changing meds be a better option or just wait it out? I have heard the info that the outbreaks get better with time and I am hitting my 6 month mark and don't have expectations to be perfect, etc....but would love to be able to go a week or two without an outbreak or to not have to worry about an outbreak following sex. Seems my herpes is running my life.... Thanks, r. >> >There are no liver issues. The only "liver issue" is the fake one >> >that certain trolls and scaremongers use to scare people away from [quoted text clipped - 17 lines] > >Tim > Tim: what is IIRC Valacyclovir? IIRC is a newsgroup acronym for If I Remember Correctly. Valacyclovir is the actual name fo the drug thats marketed as Valtrex. > Also: do the medical journals, which laypeople like myself do not > have ready access to, Actually with Pubmed you have fairly good access to them. Complete citation database plus the abstracts which gives a potted summary of the paper (and most have published abstracts). PLus a number that are then accessible freely in full text form linked from Pubmed (though that number is much smaller) > indicate as the most useful anti-viral? Depends who you talk to....I've always been taken with Famciclovir myself but it is the most expensive by a long way. When it comes to clinical use though the difference pretty much disappear as they used the extra bioavailability and better drug halflifes etc etc to allow you to use the second generation of antivirals (Valacyclovir and famciclovir) to give the same efficacy with a less awkward dosing - so cut the 5 doses a day of acyclovir down to 2 or one. At that point it becomes a combination of economics and personal response that defines the drug used. > I have heard the info that the outbreaks get better with time and I am > hitting my 6 month mark and don't have expectations to be perfect, That is a tendency with the virus. You and it tend to reach an accomodation, yes..... Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568 Ohhh, DUUUUH on the IIRC....I haven't heard that in a zillion years but then again, it has been a long time since I have been on an 'alt.' group. I will have a squizz at the www.pubmed.com site, thank you for the information!! I am lucky enough to have a great type of insurance so my meds are very reasonably priced. If the Valtrex does not help over the span of two years, I will ask about switching meds. Thanks again for your concise and helpful information.... Cheers, r. >> Tim: what is IIRC Valacyclovir? > [quoted text clipped - 31 lines] > >Tim > Ohhh, DUUUUH on the IIRC....I haven't heard that in a zillion years > but then again, it has been a long time since I have been on an 'alt.' > group. > > I will have a squizz at the www.pubmed.com site, thank you for the > information!! Its address is www.ncbi.nlm.nih.gov/pubmed Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568 www.pubmed.com got me to the same site....=) >> Ohhh, DUUUUH on the IIRC....I haven't heard that in a zillion years >> but then again, it has been a long time since I have been on an 'alt.' [quoted text clipped - 6 lines] > >Tim > www.pubmed.com got me to the same site....=) My word...someone halfway sensible about th domain name purchases.... the other one is so wired into my brain that I tend to have input it faster than I can pull out a bookmark anyway so I've never gone looking for alternates... Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568 r, There are other things you can do to help with outbreaks. First, yes, some people do much better on a different med - other than Valtrex. You mentioned that you were a diabetic. Then I know that food is an issue for you. The healthier your body is, the more chance you have of keeping herpes under control. Make sure that you cut all processed foods out. No caffeine, nuts, or chocolate. Eat as much veggies as you can. Salads - raw veggies will do wonders for your health. And eat whatever fruit you can. I do know raw foodist diabetics (type 1 and 2) who are completely off their insulin due to eating a raw food diet high in fruits and veggies. It just takes a while for the body to heal enough to handle the foods. Do you have type 1 or 2? Type 1 seems to respond well to adding Lysine to the diet. Also, are you taking any protein powders or things like that? What about vitamins high in arginine? 6 months is actually a short amount of time. My first year was awful and my second year was not much better. Take care, ar > Tim: what is IIRC Valacyclovir? > [quoted text clipped - 34 lines] > > > >Tim >r, > >There are other things you can do to help with outbreaks. > >First, yes, some people do much better on a different med - other than >Valtrex. I am going to give the Valtrex a shot of time -- and analyze it around one year to see it's effectiveness. Part of me knows deeply in my head that I need to get and keep my diabetes under control before I look to an antiviral to take care of the HSV. Given that it is a disease of opportunity, my diabetes is giving it an opportunity every week I am not vigilant about caring for myself. >You mentioned that you were a diabetic. Then I know that food is an issue >for you. The healthier your body is, the more chance you have of keeping [quoted text clipped - 4 lines] >insulin due to eating a raw food diet high in fruits and veggies. It just >takes a while for the body to heal enough to handle the foods. I do eat a high protein, low carb diet with a LOT of fresh veggies. I will say that I eat better on a low carb diet than I ever did in every day life. Lots of steamed veggies and good cuts of meat. >Do you have type 1 or 2? Type 1 seems to respond well to adding Lysine to >the diet. I have type 2. I have heard the suggestions of Lysine but with varied results. >Also, are you taking any protein powders or things like that? What about >vitamins high in arginine? I eat a lot of meat....I am not aware of the arginine levels in meat....any input? >6 months is actually a short amount of time. My first year was awful and my >second year was not much better. After slowly going through the archives, it is becoming obvious to me that this is a LONG term journey for the most of us. It seems my OB, of whom I am very fond, was very quick in covering the disease with me....probably because there is little that can be done....other than playing with lifestyle, like eating and exercise, etc. The rest of it is left to the hands of the Universe .... >Take care, >ar |
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