Is Valacyclovir Safe During Pregnancy
Status
cautionReason
Limited pregnancy data; official labeling says use only if benefit justifies risk. Consult your prescriber.
Drug Information
Safe Amount
Dosage must be determined by your provider based on individual risk/benefit.
Effects
- Pregnancy
- Untreated herpes simplex in pregnancy can increase fetal/newborn risk; neonatal HSV risk is highest with late-pregnancy acquisition.
- Mother
- May help treat herpes infections; untreated herpes can cause maternal complications and transmission risk.
- Baby
- No drug-associated increase in major birth defects has been identified in available human data, but data are limited.
Trimester Notes
- 1st Trimester
- Available human data have not identified a drug-associated increase in major birth defects, but data are limited.
- 2nd Trimester
- Human data are limited; use only when the expected benefit outweighs the risk.
- 3rd Trimester
- Late pregnancy genital HSV can raise neonatal infection risk; provider may consider suppressive therapy near delivery.
Risk-Benefit Note
For antivirals, the benefit of treating herpes and reducing complications may outweigh the limited fetal risk. Do not stop or continue without provider guidance.
Conditions & Warnings
- Consult OB/GYN or prescriber
- Do not stop or start without provider guidance
- Herpes simplex infection
- Genital herpes in pregnancy
- Recurrent herpes suppression near delivery may be considered by the provider
Alternatives
- Acyclovir (provider-directed)
- Supportive care and prompt OB/GYN review
References
- FDA label, Valtrex (valacyclovir)
https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020487s022lbl.pdf - MotherToBaby, Acyclovir/Valacyclovir fact sheet
https://www.ncbi.nlm.nih.gov/books/NBK582557/