How Much Valacyclovir (Valtrex) Should You Take During a Herpes Outbreak?

Michele Emery, DNP

Reviewed by Michele Emery, DNP

Written by Our Editorial Team

Published 07/05/2018

Updated 05/21/2019

Have you noticed the warning signs of a herpes outbreak starting to occur? From cold sores to genital herpes, the key to managing and overcoming a herpes outbreak is acting as quickly as possible to treat the symptoms, stop the virus and speed up recovery.

Valacyclovir is one of the most powerful and effective drugs on the market for this purpose. It’s an oral antiviral drug that works quickly, helping you reduce recovery time, ease symptoms and lower your risk of transmitting HSV-1 or HSV-2 to others during an outbreak.

Also known as Valtrex, valacyclovir comes in a variety of dosage forms. Below, we’ve explained the standard doses of valacyclovir for treating herpes outbreaks, from initial outbreaks of HSV-1 and HSV-2 to recurring outbreaks of oral or genital herpes.

Beyond outbreaks, valacyclovir is also used for a variety of other herpes-related issues. We’ve covered those in our full guide to valacyclovir dosages.

This data is provided for informational purposes only. If you’ve been prescribed a certain amount of valacyclovir by your doctor for treating herpes, following their dosage instructions.

How Much Valacyclovir Should You Take for a Primary Herpes Outbreak?

Most people find out that they have the herpes virus during the primary (or initial) outbreak. The first outbreak of herpes tends to be the most intense, with a person developing both the physical symptoms of herpes (cold sores or genital lesions) as well as a variety of other symptoms.

During a primary outbreak, many people experience muscle aches, chills, fever, swelling of the glands around the neck and pelvic area, headaches and other flu-like symptoms. If you’re going through a primary outbreak, it’s normal to feel fatigued and lacking in energy.

A painful, burning feeling when urinating is a common symptom in both sexes. Women going through initial outbreaks may experience unusual vaginal discharge and pain in the cervix due to the virus.

Our guide to the signs and symptoms of genital herpes goes into more detail about the most common symptoms people experience during initial outbreaks. Outbreaks of oral herpes can include similar physical effects, although the herpes sores are isolated to the lips and mouth.

One of the biggest reasons a primary herpes outbreak is so intense is that the virus is relatively strong during this period. Over time, your body will develop its own immune response to HSV-1 or HSV-2 -- depending on your infection type -- allowing it to suppress the virus.

Both oral and genital herpes primary outbreaks tend to last for two to three weeks, with the most intense symptoms during the first one to two weeks of the outbreak.

herpes treatment

your outbreak is no match against an Rx option.

Using Valacyclovir to Treat a Primary Outbreak of Genital Herpes

Valacyclovir can be extremely helpful for treating an initial herpes outbreak. Used early, it acts to suppress the virus and prevent it from multiplying, providing relief from the physical symptoms of a herpes outbreak and helping you recover faster.

Because primary herpes outbreaks tend to be the most intense experience infected people will have with the virus, treatment involves a relatively high dose of valacyclovir.

The standard dose of valacyclovir for an initial outbreak of genital herpes is 1,000 mg twice a day. This is typically continued over a 10-day period to continually suppress the virus and help the lesions caused by the viral infection to close and heal.

If you believe you may experiencing the first signs of a genital herpes outbreak, it’s important to see your doctor as soon as possible about treatment options. Valacyclovir is most effective if its taken as early as possible during an outbreak.

Your doctor may also recommend the use of pain relief medication to manage the other physical symptoms of a primary herpes outbreak.

Using Valacyclovir to Treat a Primary Outbreak of Cold Sores

Valacyclovir is also used to treat primary outbreaks of cold sores, or oral herpes. The standard dosage of valacyclovir for managing a primary oral herpes outbreak is 2,000 mg every 12 hours for one day (two doses in total).

During a particularly severe or persistent outbreak, your doctor may recommend adjusting your valacyclovir dose or extending the dosage to provide greater relief. Follow your doctor’s advice and instructions for the best results from valacyclovir and other antiviral medication.

How Much Valacyclovir Should You Take for a Recurrent Genital Herpes Outbreak?

After the primary outbreak, genital herpes enters a latent stage. During this period, the virus lays dormant in the body (in its inactive state, it lives in nerves in the base of the spine), with no clear symptoms or signs of an infection.

Over time, many people with genital herpes will experience recurrent outbreaks of the virus that cause herpes sores to develop. Outbreaks affect people with HSV-1 and HSV-2, although they tend to be more common in people with the HSV-2 type of the herpes virus.  

Recurrent outbreaks are usually less intense than the initial outbreak. Most people only notice the development of herpes sores on the genitals, with few or none of the flu-like symptoms that can make a primary outbreak so unpleasant.

During a recurring outbreak, you normally won’t need to take as much as you did for the primary outbreak. A standard valacyclovir dosage for recurrent genital herpes outbreaks is 500 mg twice per day for three days.

If you have particularly severe genital herpes outbreaks or the herpes sores you develop during an outbreak take longer than normal to recover, your doctor may adjust your dosage to provide extra relief from symptoms and faster healing. In any case, follow your doctor’s instructions.

How Much Valacyclovir Should You Take for a Cold Sore Outbreak?

Cold sores also come and go, with many people experiencing recurrent outbreaks every few months after the initial outbreak passes. Like genital herpes, oral herpes outbreaks are often triggered by external factors, such as hormonal changes and illnesses.

The standard valacyclovir dosage for an outbreak of cold sores is the same as the dosage used for a primary oral herpes outbreak -- 2,000 mg of valacyclovir taken every 12 hours, for a total of two doses. Taken early in a cold sore outbreak, this can significantly speed up healing.

For particularly bad outbreaks of cold sores, your doctor may also recommend the use of topical treatments, which can alleviate pain, itching and discomfort. Follow your doctor’s instructions on medication use for the fastest recovery and best results.

herpes treatment

your outbreak is no match against an Rx option.

Learn More About Using Valacyclovir to Treat Herpes

Valacyclovir is a safe, effective and well-researched medication that’s used to treat all forms of herpes, from HSV-1 and HSV-2 to shingles. For most people, it’s completely safe to use on an outbreak-by-outbreak basis for symptomatic relief and faster recovery.

Like all prescription medication, it’s important to follow your doctor’s instructions when you use valacyclovir. The dosage information provided above is for informational purposes only -- follow the instructions provided by your doctor when you are prescribed this medication if they differ.

Interested in learning more about how valacyclovir works? Our Valacyclovir 101 guide goes into more detail about how valacyclovir works to suppress the herpes virus to help you recover faster during outbreaks, reduce your transmission risk and more easily manage life with herpes.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.