Valtrex / Acyclovir is considered safe to use while pregnant
Posted on Wednesday, September 12th, 2007 at 5:53 amValtrex is actually a very well studied drug. It is a prodrug for acyclovir, which has been around for 30+ years. Valtrex turns into acyclovir after it is absorbed which allows your body to get more of the drug into your system for longer (which is why you take Valtrex less frequently than acyclovir).
Although it has not been officially tested for use during pregnancy (very few drugs ever are as to do this would require testing on pregnant women … not a thing most people are happy with), it is considered safe to use when pregnant — a category “B” medication. There was at one time a pregnancy registry for acyclovir (the drug your body converts Valtrex into) that followed pregnant women. Somewhere close to 1000 women taking Valtrex while pregnant were followed and the rate of defects amongst that group was considered to be the same as for women not taking any medication. There was for a while a registry for Valtrex as well, but it ran for a shorter period of time and, although the results were similar, the number of women followed was not enough to draw as strong of conclusions.
Taking Acyclovir or Valtrex suppressively during the last weeks of pregnancy is recommended. Even though you are passing the antibodies onto your infant, the suppressive therapy should prevent you from shedding the virus and/or having an outbreak. During the last weeks of pregnancy your child is less likely to suffer any ill effects from any medication you may take. This is not to say you should not weigh your options and make your own decisions.
I took Valtrex throughout my pregnancy and my child is fine and beautiful. I was comfortable enough with the drug’s profile that I told my doctor up front that I intended to take the drug throughout my pregnancy to protect my partner.
I doubt you need to be concerned about allergic reactions, especially if you’ve taken the drug before as you would have had the reaction then. Valtrex/Acyclovir have very low allergic profiles (aka even people with a bad history of allergies normally don’t react to them). Antivirals are completely different beasts from antibiotics and just don’t wreak the havoc on your body that an antibiotic can. Valtrex/Acyclovir very specifically targets herpes by mimicking a substance the virus needs to reproduce. When the virus grabs onto the antiviral, the antiviral gets in the way of the virus being able to reproduce. The substance Valtrex/acyclovir mimics is not a substance your body needs so your body doesn’t tend to react to the drug much.
I’m trying to break down a complex bit of biochemistry here, so I may be guilty of oversimplifying how Valtrex/acyclovir works. There are some resources on the net that go into this stuff in detail and you may want to read up on them if you are interested in a more advanced explanation. – Lorraine
If you have something to say about herpes and what it’s like to be pregnant when you have herpes I’d love to hear from you. You can send me bits of advice OR your own personal story and I would be more than happy to publish it so that we can work to help people that don’t know enough about this to make a decision for themselves.
As with anything health related please see your own doctor. Our personal experiences shared do not indicate truth for everybody that is in similar situations. The information shared is based on our own personal experiences. No two herpes cases are alike.
Send me your story for publishing today!
Meredith and Nate,
Wow, oh Wow!
out of all the things to freak out about – you decide to freak out on anti-viral treatment for ST of HSV infection while pregnant…The lack of actual backup of your statements is all that anyone needs to read to understand that you have no real idea what you are talking about.
Unfortunately Meredith and her smart husband Nate chose to harass me via my e-mail address. Apparently they are not happy with what I have shared and what the rest of you all shared. In their frustration they have become belligerent and hateful. Here’s the latest:
—– Original Message —–
From: Meredith Steckelberg passionatewifenmom78@hotmail.com
To: angela @ yoshi2me.com
Sent: Tuesday, December 23, 2008 6:36 PM
Subject: RE: [Sexual Health Buzz] New Comment On: Valtrex / Acyclovir is considered safe to use while pregnant
Actually you have no idea because your stupidity is sure speaking for itself in the effect of your lack of education and your grammar sure sucks too you should really shut your mouth about things you have no idea about and not to mention you are a woman speaking from your vagina so you should watch who you are addressing especially someone who has more educational background than you could ever imagine and yes this is Meredith’s husband and thank you so much for your limited intelligence. Truthfully there is a serum for stupidity and its called get your ass back in school. Don’t patronize people when you are in the wrong and then run your mouth like a garbage disposal. If you were smart you would keep your dumb ass comments to yourself. Read the pharmacology reports on the little informational packet that was supplied to you specifically when you went to the doctor to cry about your situation and ask for help from someone who will definitely give you a sample then get you to believe that this could actually work for you. Well, for instance it does say that birth defects have been reported but not in the simple logarithmic way that your little mind can understand. I have an education in chemistry, physics, and medical terminlology and thats a fact. Suppression therepy is actually referring to your metabolism, hemoglobin, oxygen levels, and nuerological responses between the communicative relays in the brain that cause you to get sleepy and tired and nauseated, and belates your appetite and not to mention the gastrointestinal system involving several factors including how you digest your food. You will experience these problems and when you do your baby will to. Do you actually think that suppression therapy means that your immune system does not go down making you more liable to get sick and get infections? Really, if this is not simple enough for you to understand especially for your simple mindedness is obviously telling me that is actually a very well known statement known as “Small minds are amused by simple matters” simply said. Women like you should be banned from making decisions at all when it comes to logic. You are a waste of skin and more properly said you are uneducated and “STUPID”!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Here is the next e-mail I received:
—– Original Message —–
From: Meredith Steckelberg passionatewifenmom78@hotmail.com
To: angela @ yoshi2me.com
Sent: Tuesday, December 23, 2008 6:42 PM
Subject: RE: [Sexual Health Buzz] New Comment On: Valtrex / Acyclovir is considered safe to use while pregnant
One more thing Ms. Yoshi2me or whatever the hell you call yourself sounds pretty slutty to me, but if you transmitted the virus while pregnant you either slept around on the dude you were dating or you cant keep your legs closed, one more thing stupid ass is this that if you contracted the virus at least one to three months before you were pregnant you will narrow the proportions down to contracting the virus to your unborn child down to .1 % which says that you would most likely not contract the virus. Unless you are still sleeping around. So Shut Up!!!!!!!!!
These people are crazy so be careful
Angela,
These people aren’t even worth responding too, why do they continue to harrass this board and now you via email? It really tells a lot about their character, I feel soooo sorry for the offspring they will produce. They have no first hand proof about what they are talking about. You have told your story and how both of your children have turned out just fine while taking suppressive medications. My son who was born three years ago is as perfect as can be, and I started taking acyclovir for suppression with him at 36 weeks. I am almost 36 weeks pregnant now with our third child and have been on suppressive therapy since 34 weeks. I just had my 4th ultrasound on Monday and the baby is perfectly healthy. I should be induced around 39 weeks (due to borderline high BP) and I will keep everyone posted as to how things go. My point is, Meredith and Nate know nothing of what they are talking about and I hope they see the light someday. All of the education in the world cannot take away a person’s ignorance or just plain hatred towards another person who does not share their opinion. I have enjoyed coming to this message board to read about everyone’s experiences and questions. It sucks that they had to make this a negative environment. For anyone that has had any experience with taking suppressive therapy while pregnant I, personally, (as one mom to another) would love to hear your story and furthermore be proof positive that these medications are safe for mother and child. I hope everyone has a great day! :)
First of all, it wasn’t fair to me to display my email address on a public website. It’s my own person privacy that you violated. Second of all, if you are going to complain about what my husband said then don’t post his email to flaunt your opinion. Our offspring will be more than happy to call us mom and dad. Don’t insult them because we can voice our opinion and the facts that we know to be true. It is a free country after all. I took one Valtrex pill in my 14th week and my immune system plummeted. Now I have a nasty cold because of my stupidity with taking it this early in my pregnancy. I’ve had it for the last four days. Those symptoms are in the packet. My blisters went away on their own after three days. We aren’t hateful people. If we were hateful we wouldn’t be on here trying to give you this information. It is not intended to criticize you by saying you are doing everything wrong. We just want to inform you of the possibilities and things to be on the lookout for. We don’t mean to scare you. We aren’t scared, we aren’t worried, we feel secure about our decision just like we understand you are secure about yours. We just thought there was no harm in hearing things from both sides. We are firm in our beliefs and understand that you are firm in yours. That’s fine. Best of luck to you and your family. I am very glad to hear that your babies have all been happy and healthy. From one mother to another I want the same thing. We will end up ensuring our baby’s safety in and out of the womb it what matters most. How we do it does not matter. We should all except each others choices on this board, even if we ultimately do not agree with them. I am sorry for any harsh words exchanged in the past. Emotions run high at times. I am sure you can all relate to that. Let’s put all our differences aside and try to find a common ground agree on. The fact that we all want the best for our kids. No matter what that means. Thank you for your time.
Hi Melanie,
Thank you for sharing! Yes, we are Mother’s that have actually had beautiful, healthy babies via vaginal deliveries AND while on suppressive therapy. Everything worked out great and the doctors do know what they are doing provided they and their patients are aware of their STD status prior to becoming pregnant.
I want to encourage all Mom’s that have had babies whether it be via vaginal delivery OR c-section, suppressive therapy OR not to share their birthing experiences.
I hope everybody had a wonderful Christmas!!!
Angela
Here is more information that a friend of mine shared that I think adds A LOT to this discussion:
Well basically Im not going to tell Meredith what to do, its her baby. However there are some basic factual issues which I think she has wrong that I’ll argue a case on – from which she can choose if they are relevant to her position.
OK first up, albeit a bit of a side issue, ‘aspirin is nowhere near as strong as Valtrex’ is a) comparing apples and oranges and b) frankly something I disagree with. Aspirin is OTC not because its weak but because its well characterised and long known. Its a pretty messy drug hitting a lot of pathways very strongly (look at its side effects, contraindications and interactions – fair old list).
On to the main event – what Meredith has cited from the FDA does NOT say what she is saying it does. She seems to claim it shows the FDA says Valtrex causes birth defects (from a comment in one post and the post
quoting the FDA). The citation quoted from the FDA says the evidence is currently directly the opposite ie that Valtrex has not been demonstrated to produce birth defects – if the Valtrex was causing defects then you would be seeing an increased amount over the one that happen in the untreated population – that was not seen. The concern from the FDA was that the sample size in the study was not large enough to cover everything in detail. So boiled down its says ‘We haven’t seen anything yet, but we havent looked at weird cases so be careful after all this is kids we are talking about’. The FDA is a regulatory body and protectionist in nature – thats its purpose after all, so it WILL flag up gaps in knowledge…thats NOT the same as saying ‘Drug X causes Y’. This sort of misunderstanding of the precise things being said is where your media scare stories come from.
That said, that boiled down answer may quite sensibly be a fairly dominant aim for any expectant mother.
Incidentally the epidemiologic study is published as primary data and its this paper. http://www.ncbi.nlm.nih.gov/pubmed/15108247?ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
How much beyond the abstract you can get will vary on your access to this sort of thing.
The primary conclusion in that paper was as follows: The observed rates and types of birth defects for pregnancies exposed to acyclovir did not differ significantly from those in the general population.
Moving on a bit more…Another point in the FDA note is this… ‘VALTREX should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.’ Here we get into two way risk assessment. Most people want is this ’safe’ or ‘unsafe’ as an answer. Simply put – thats a rarity. We need to risk assess and thats cost/benefit analysis. The above does not mean there there is a defined risk, nor does it mean that you don’t give Valtrex. It tells you to assess it and go from there.
So its a case of identifying what risks the antiviral drugs can remove and balancing that against a theoretical risk.
One area clinical practice certainly identifies is in third trimester…here are some reviews and primary data from experts in the field. They cover a number of areas from ethics, patient information, danger to child, risks of surgery that can be avoided etc. They explore the hows and whys of antiviral therapy along with the paper above exploring the risks.
http://www.ncbi.nlm.nih.gov/pubmed/18254066?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/16816068?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/17165093?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
I got this information from WebMD.
Treatment during pregnancy
The Centers for Disease Control and Prevention (CDC) has published guidelines about the use of antiviral medicines for genital herpes during pregnancy.1
* Oral acyclovir (Zovirax) may be given to pregnant women for a primary HSV infection or for severe recurrent outbreaks.
* Oral acyclovir may be given to pregnant women at any time during the pregnancy, including the first trimester.
* Acyclovir may be given intravenously (IV) to pregnant women with severe HSV infection.
* Acyclovir may reduce the frequency of recurrent outbreaks in pregnant women close to delivery, thereby reducing the possibility of needing a cesarean section at the time of delivery.
If a genital herpes blister or sore is present at the time of labor and delivery, a cesarean section is usually done. A cesarean section may be recommended if a woman has tingling or pain (prodromal symptoms), suggesting an impending outbreak. Acyclovir (Zovirax) used in the last 4 weeks of pregnancy may reduce the need for delivery by cesarean section by reducing the risk of a recurrent outbreak at the time of delivery.
I don’t know much about Zovirax. Is it similar to Valtrex? Is it for women with more severe outbreaks or what?
The information that you just posted is pretty much what we’ve been saying all along.
Valtrex, Famvir, Acyclovir, Zovirax.. are all clinically proven herpes antivirals that will not hurt a fly.
I hope it was worth it to you to be such an ass to me via e-mail the way that you were.
I think you owe me and the rest of those that come here seeking information and civility an apology for your RUDE behavior.
Hello,
I wanted to update everyone and let you know that I had my third child on Jan. 22. He was my second child since contracting HSV. I was put on suppressive therapy at 34 weeks (acyclovir). He was born happy and healthy with no health problems. He was 7 lbs 8 oz and 19 3/4 inches long. I just wanted to let everyone know that (based upon your doctor’s recommendations of course) suppressive therapy is very safe while pregnant and has presented no complications to either one of my two pregnancies and births. :)
Hi Melanie! Thanks for popping back in and giving us an update on what’s been happening. Thanks so much for sharing your feedback on suppressive therapy while pregnant too. Congratulations!! :-)
I am 19 weeks pregnant and have been prescribed Valtrex to treat SHINGLES! I am concerned about the potential damage to baby. I see nothing out there for women in my situation to read about or for commiseration. SO, seems like were on the same med but for different reasons… Having the virus scares me and treating it scares me! Ahhhhh! Any reference advice?
Aimee, you really have nothing to worry about. The anti-virals are perfectly safe for use during pregnancy. I can tell you that Acyclovir is listed as a “B” medication and that is simply because it hasn’t been tested on pregnant women but I don’t know a woman with herpes NOT using it during pregnancy. Let this be one less thing that you have to stress about :)
Now breathe ;)
Jennifer
I agree w/Jennifer. Valtrex is not going to hurt you OR your baby. Try and relax and enjoy the rest of your pregnancy.
My ultimate advice is to get your advice directly from an actual licensed MEDICAL DOCTOR! Or contact GSK directly they will be able to tell you if they’ve done any studies or the outcome of any direct research. I highly value the experiences and opinions of every person. But I also believe that you should write down ANY AND EVERY question you may have and take them directly to someone that has went through SCHOOL TESTING AND LICENSING in that area preferrably an Infectious Disease Doctor along with your OB… It is not enough to just know medical terminology… as there are an infinite number of areas of medical study. I personally help in the treatment and research of HIV, however just because I’m in the medical profession… I honestly had NO CLUE what to expect during pregnancy. Because that was never my area of interest nor experise. Thank you all very much for sharing your stories maybe your experience would encourage someone to actually ASK THEIR DOCTOR as we all know every body reacts differently and even your third pregnancy may be totally opposite from first. Take care thank u again
Send me your story for publishing today!
Return back to the Inspirational Stories home page.
When you are pregnant and have herpes.
Pregnant or Think You Might Be Pregnant
I am 8 weeks pregnant today, and had a genital herpes breakout three days ago. After much thought, I finally took valtrex that evening, I have taken a total of 3 dosages (12 hours apart) with a large amount of water…This is my first breakout, in a long while…. I got pretty upset/stressed this past weekend, and after that the tingling started, then the one sore appeared…. Is there anyone that has taken it this early in pregnancy….
I took it all through BOTH pregnancies! No worries, okay? *hug* :)
The only reason that it is listed as a “B” medication is because they have never tested it on pregnant women (for obvious reasons) but there are enough of us ‘veterans’ that have taken it all the way through pregnancies that it’s only a matter of time before it becomes an “A” medication.
Thanks for responding!!!… I wish that all the women that have taken it ALL through pregnancy would let the “Valtrex People” know their experiences, because while searching on the internet for an answer for myself, I saw a hundred other women needing the same answer to this question. Thank you again for responding……..
Suppressive therapy during the last six weeks of pregnancy is perfectly safe.
Wow, I never realized that you could get so much back lash for posting something like this. Basically everything that the doctor has told me. But considering this is my first pregnancy and question every step I am taking at this moment, I needed a little more confirmation. I appreciate this post. It sites informative sources. I understand Meredith’s position on presenting both sides. Obviously taking a drug such as Valtrex is a personal choice and you do have a reason to voice your opinion, but I can bet that you have much less creditibility with hostile words.
Now something new that I found out when I first got pregnant was that my doctor advised me to stop taking the Valtrex immedaitely. After three good years of taking it faithfully and new pregnancy hormones storming my body, let’s just say it was not pleasant. My doctor has said there is no proof of any harm to the baby during the first trimester, however wanted to error on the side of caution as the most crucial development of the baby is taking place. I am almost through my 12th week and in almost another I can crack open my bottle of Valtrex!
Then again, everyone is different and some people will react differently to new drugs, hormone changes, pregnancies, but just talk to your doctor(s). There is no proof that one tiny 500mg of Valtrex could have wrecked someone’s immune system so badly during pregnancy. It seems a little far off. There is a possibilty but still, very slight especially in the dead of winter.
Again Angela, thanks for the site! Its good to not be the only one on this boat!
Thanks for your feedback. As you can see I don’t let people walk all over me. Especially on my blogs. Thanks for stopping by and chiming in on this topic.