Is Valaciclovir compatible with breastfeeding? Do we have alternatives for Valaciclovir?

Valaciclovir

July 1, 2015 (Very Low Risk)

Precursor of Aciclovir which is used for treatment of infections due to Herpes zoster and Herpes simplex viruses and the prevention of Cytomegalovirus infection in immunocompromised patients.

It is excreted into breast milk as Aciclovir in non-significant clinical amount, with no side-effects observed among breastfed infants from treated mothers. Urine levels of Aciclovir in those infants were shown to be very low.

Alternatives

We do not have alternatives for Valaciclovir since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Valacyclovir Hydrochloride

Writings

  • βολακυκλοβίρη υδροχλωρική (Greek)
  • Валацикловира Гидрохлорид (Cyrillic)
  • バラシクロビル塩酸塩 (Japanese)

Drug trade names

References

  1. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
  2. GSK. Valacyclovir. Drug Summary 2013 Full text (in our servers)
  3. Drake AL, Roxby AC, Kiarie J, Richardson BA, Wald A, John-Stewart G, Farquhar C. Infant safety during and after maternal valacyclovir therapy in conjunction with antiretroviral HIV-1 prophylaxis in a randomized clinical trial. PLoS One. 2012Abstract Full text (link to original source) Full text (in our servers)
  4. Drake AL, Roxby AC, Ongecha-Owuor F, Kiarie J, John-Stewart G, Wald A, Richardson BA, Hitti J, Overbaugh J, Emery S, Farquhar C. Valacyclovir suppressive therapy reduces plasma and breast milk HIV-1 RNA levels during pregnancy and postpartum: a randomized trial. J Infect Dis. 2012Abstract Full text (link to original source) Full text (in our servers)
  5. Valaciclovir. Ficha técnica. 2010 Full text (in our servers)
  6. Sheffield JS, Fish DN, Hollier LM, Cadematori S, Nobles BJ, Wendel GD Jr. Acyclovir concentrations in human breast milk after valaciclovir administration. Am J Obstet Gynecol. 2002Abstract
  7. Mactal-Haaf C, Hoffman M, Kuchta A. Use of anti-infective agents during lactation, Part 3: Antivirals, antifungals, and urinary antiseptics. J Hum Lact. 2001Abstract