Valaciclovir headache

In a randomised, double-blind controlled trial, 373 immxmocompetent adults with onset of a herpes zoster rash within the preceding 72 h were assigned to receive seven days of valomaciclovir at one of three doses or valaciclovir Ig three times daily [49 -]. Nausea (10% of patients receiving valaciclovir), headache (7%) and vomiting (3%) were reported. One patient in the valaciclovir group discontinued due to severe abdominal cramps. 

In a double-bhnd comparison of two regimens of valaciclovir 500 mg bd for recurrent genital herpes, a 5-day course (n = 398) and a 3-day course (n = 402), there were no significant differences in therapeutic outcome or adverse events between the two regimens (4). The most common adverse events were headache (10%), nausea (4%), diarrhea (3%), and fatigue (1.5%). 

The effects of aciclovir and valaciclovir for anogenital herpes have been studied in HIV-infected individuals in two controlled trials (5). In the first study, 1062 patients with CD4-I- counts over 100 x 10 /1 received valaciclovir or aciclovir for 1 year and were assessed monthly. In the second study, 467 patients were treated episodically for at least 5 days with valaciclovir or aciclovir and were assessed daily. Valaciclovir was as effective as aciclovir for suppression and episodic treatment of herpesvirus infections. Hazard ratios for the time to recurrence with valaciclovir 500 mg bd and 1000 mg od compared with aciclovir were 0.73 (95% Cl = 0.50, 1.06) and 1.31 (0.94, 1.82). Valaciclovir 1000 mg bd and aciclovir had similar effects on the duration of infective episodes (HR = 0.92 Cl = 0.75, 1.14). The most common adverse events, which occurred at similar rates with all regimens, were diarrhea, headache, infections, rashes, nausea, rhinitis, pharyngitis, abdominal pain, fever, depression, and cough. 

Combination studies In a randomized study of the single-dose pharmacokinetics of valaciclovir alone or in combination with twice-daily ritonavir-boosted tipranavir at steady state in healthy volunteers, 70 adverse events were reported in 24/29 subjects treated [24 ]. The most common events included increased alanine aminotransferase activity (8/29 subjects) headache (7/29) increased aspartate aminotransferase activity (4/29) diarrhea, flatulence, and nausea (each 4/29) and renal pain (3/29). All recovered fully. 

Placebo-controlled studies In a doubledummy, randomized, placebo-controUed study of 839 patients aged 18-75 years with Bell s palsy, prednisolone, alone and in combination with valaciclovir, shortened the time to recovery [6 ]. Headache and... 

A randomised trial assessing the safety of ASP2151 in recurrent genital herpes compared it with placebo or valaciclovir 500 mg twice daily for three days [48 j. Headache n=6,9%), nausea n=2,3%), diarrhoea (n=2,3%), dizziness (n = 1,1.5%), back pain (n = 1,1.5%) and somnolence (n = 2,3%) were reported in the subjects taking valaciclovir. None of these symptoms led to discontinuation of the valaciclovir. Transient increases in alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels less than the upper limit of normal (ULN) were seen in six valaciclovir patients (9%). Elevations in ALT or AST of greater than three times but less than five times the ULN were observed in two patients taking valaciclovir. 

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