How Long Can I Stay on Valacyclovir? A Guide to Long-Term Use

October 10, 2025 •

3 min read

Genital herpes is one of the most prevalent sexually transmitted diseases, with about 1 in 5 adults in the United States being seropositive for HSV-2. For many, this raises the question: how long can I stay on valacyclovir for management?

Quick Summary

Long-term daily use of valacyclovir, known as suppressive therapy, is considered safe and effective for many years under medical guidance to reduce herpes outbreaks and transmission risk. The duration is a personalized medical decision.

Key Points

Long-Term Safety: Daily suppressive therapy with valacyclovir has been shown to be safe and effective for long periods, even up to 10 years for its active component, acyclovir.
Two Treatment Types: Treatment can be 'episodic' (short-term, for an outbreak) or 'suppressive' (daily, to prevent outbreaks).
Reduces Outbreaks: Suppressive therapy can reduce the frequency of genital herpes recurrences by 70-80%.
Lowers Transmission: Taking valacyclovir daily can lower the chances of transmitting the genital herpes virus to a partner.
Medical Supervision is Key: The duration of treatment is a decision made with a doctor, who will perform regular check-ups, especially for kidney function.
Common Side Effects: The most common side effects are generally mild and include headache, nausea, and stomach pain.
Stay Hydrated: It is important to drink plenty of fluids while taking valacyclovir to help protect your kidneys.

What is Valacyclovir?

Valacyclovir is a prescription antiviral medication used to treat infections caused by the herpes virus family, including cold sores, shingles, and genital herpes. It works by converting to acyclovir in the body, which stops the virus from multiplying. While it doesn't cure herpes, it helps manage symptoms, speeding up healing and reducing pain and itching.

Understanding Valacyclovir Treatment Approaches

Valacyclovir can be used in two main ways to manage genital herpes: episodic and suppressive therapy.

Episodic Therapy: This involves taking valacyclovir for a short period at the first sign of an outbreak to reduce its duration and severity. This is typically a course lasting a few days.
Suppressive Therapy: This involves taking a daily dose of valacyclovir over a long period to prevent outbreaks and lower the risk of transmission to sexual partners.

How Long Can I Stay on Valacyclovir for Suppressive Therapy?

For those with frequent herpes recurrences, long-term suppressive therapy is a common and generally safe option. Studies have shown the safety and effectiveness of daily acyclovir for up to 10 years, and valacyclovir has been extensively studied for long-term use.

Healthcare providers usually reassess the need for continued suppressive therapy periodically, considering factors like outbreak frequency and severity, overall health, and individual preference. Some individuals may be able to stop the medication and experience fewer outbreaks, while others may choose to continue for ongoing management. The appropriate duration of suppressive therapy is a decision made in consultation with a healthcare professional.

Benefits of Long-Term Use

Long-term suppressive therapy significantly reduces the frequency of herpes outbreaks, potentially by 70% to 80% for those with frequent episodes. Many individuals on this therapy experience no symptomatic outbreaks, leading to an improved quality of life. It also notably lowers the risk of transmitting the virus to a sexual partner.

Potential Risks and Side Effects of Long-Term Use

Long-term valacyclovir use is typically well-tolerated, with common side effects being mild, such as headache, nausea, and abdominal pain.

Less common but more serious risks can occur, particularly in certain individuals:

Kidney Issues: As valacyclovir is processed by the kidneys, there's a risk of kidney problems with long-term use, especially in older adults, those with existing kidney disease, or when dehydrated. Staying well-hydrated is important.
Neurological Effects: Rarely, confusion, hallucinations, or agitation can occur, with a higher risk in older adults and those with kidney impairment.
Blood Disorders: Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome (TTP/HUS) is a rare but serious condition reported in severely immunocompromised patients, particularly with very high doses.

Regular medical monitoring, including potential kidney function tests, is advised for individuals on long-term suppressive therapy.

Episodic vs. Suppressive Therapy: A Comparison


Feature	Episodic Therapy	Suppressive Therapy
Primary Goal	Treat active outbreaks to shorten duration and severity.	Prevent or reduce the frequency of future outbreaks.
Dosing Schedule	Taken only at the start of an outbreak for a short course.	Taken daily, long-term.
Key Benefit	Convenience for infrequent outbreaks, less medication overall.	Significantly fewer outbreaks, reduced transmission risk, improved quality of life.
Ideal Candidate	Individuals with infrequent or mild outbreaks.	Individuals with frequent or severe outbreaks, or those concerned about transmission.

Conclusion: A Personalized Decision

Deciding how long to stay on valacyclovir involves consulting with a healthcare provider. Long-term daily suppressive therapy is a safe and effective option for managing herpes for extended periods. It significantly reduces outbreak frequency and enhances quality of life. Regular medical check-ups are important to monitor for side effects and ensure the treatment plan remains appropriate.

For more information on treatment guidelines, you can visit the CDC's STI Treatment Guidelines for Herpes.

Disclaimer: This information is for general knowledge and should not be taken as medical advice. Consult with a healthcare professional before starting any new supplement regimen.

Frequently Asked Questions

Not necessarily. While you can take it daily for many years for suppressive therapy, the need for it should be re-evaluated periodically with your doctor. Some people may stop and find their outbreaks are less frequent.

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed one and continue your regular schedule. Do not take a double dose to make up for it. Always follow your doctor's instructions regarding missed doses.

The most commonly reported side effects include headache, nausea, and abdominal pain. These are typically mild.

While rare, valacyclovir can cause kidney problems, especially in older adults, those with existing kidney issues, or those who are dehydrated. It's important to drink plenty of water and have regular check-ups.

Yes, you can still be contagious. While daily therapy significantly reduces the risk of transmission, it does not eliminate it entirely. Safer sex practices, like using condoms, are still recommended.

There are no specific warnings against moderate alcohol consumption while taking valacyclovir. However, both can cause dizziness, so it's wise to be cautious. Always consult your healthcare provider.

Hair loss was not a side effect reported in the original drug studies. However, it has been reported as a possible side effect since the drug was approved, though it's not confirmed that valacyclovir was the direct cause.