Valtrex (Valacyclovir hcl), the valine ester of acyclovir, is an antiviral agent active against herpes viruses, varicella-zoster virus, Epstein-Barr virus and to a lesser extent cytomegalovirus. It slows the replication and spread of the virus.
Valtrex is used to treat genital herpes, orofacial herpes (cold sores), and herpes zoster (shingles). It is effective and safe for long-term suppression of recurrent genital herpes. Suppressive therapy is appropriate when outbreaks are frequent, severe, or emotionally disturbing.
Valtrex is proven to reduce the risk of transmission of genital herpes. Valacyclovir suppresses shedding of HSV-2 on genital mucosal surfaces and may prevent sexual transmission of HSV.
In herpes zoster, valacyclovir is more effective than acyclovir and equally effective as famciclovir in shortening the length and severity of shingles-associated pain and postherpetic neuralgia.
Prompt treatment with valacyclovir can abort impending outbreak of both cold sores or genital herpes.
The main limitation of Valtrex - it is not a cure for herpes infections.
Valtrex vs Famvir
Valacyclovir and famciclovir (Famvir) are therapeutically equivalent in the treatment of herpes zoster. Both antivirals have demonstrated the superiority to acyclovir in accelerating the resolution of shingles pain and post-herpetic neuralgia (PHN). Taking into account the difference in price, valacyclovir is a better choice for herpes zoster.
Research suggests that valacyclovir may have a small advantage over famciclovir for suppression of genital herpes and associated viral shedding .
Valtrex vs Acyclovir
Main advantages of valacyclovir over acyclovir:
First episode genital herpes: Valacyclovir and acyclovir are equally effective in accelerating the resolution of initial episode genital herpes.
Recurrent genital herpes: Both valacyclovir and acyclovir are highly effective in decreasing the length of HSV episode, healing lesions, and suppressing viral shedding.
Suppression of recurrent genital herpes: Both antivirals are similarly effective in suppressing recurrences. Valacyclovir 1 g once daily reduces the yearly recurrence rate by 78% relative to placebo compared with 79% for acyclovir 400 mg twice daily .
Shingles: Valacyclovir is more efficacious in alleviating both acute and post herpetic pain, when compared with acyclovir.
So, what to choose: Valtrex or acyclovir? If your primary concern is cost then acyclovir will help you to save money.
However, for suppressive therapy, which will continue for several months, Valtrex would be much more convenient.