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Muneeb Ali
Muneeb Ali, Emergency Medicine
Category: Urology
Satisfied Customers: 7354
Experience:  MBBS,MD,ECFMG certified. Have dealt with urological emergencies in the ER on a regular basis
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I am a PD dialysis patient...I got shingles and went to

Customer Question

I am a PD dialysis patient...I got shingles and went to ER..The medicine given to me was
an 800mg of VALTREX...I was also given a prescription for Three (3) 1,000mg VALTREX pills a day, for 7 days...On the second day I started tripping out with hallucinations...Was I given too much VALTREX for a PD Dialysis ?????
Submitted: 1 year ago.
Category: Urology
Expert:  Muneeb Ali replied 1 year ago.

Hi,

Im sorry to hear about your symptoms. Well in cases of peritoneal dialysis there are no set dose recommendations however it is said that the drug removal by PD is less than that of hemodialysis and that is why the dosing guidelines which should be followed are those which are set in patients with end stage renal disease not on dialysis. So according to that recommendation, you were given a higher dose of valtrex and valtrex is known to be neurotoxic in patients with renal problems. If your creatinine clearance was less than 10 at that time then you should have been given 500 mg a day however if it was above 10 and under 30 then you recieved the right dose.

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Expert:  Muneeb Ali replied 1 year ago.

So it all depends on your creatinine clearance, if it was above ten then you recieved the right dose and if not, then you were given a higher dose. Valtrex is known to cause CNS side effects in many patients especially those with renal failure.

Hi,

Im sorry to hear about your symptoms. Well in cases of peritoneal dialysis there are no set dose recommendations however it is said that the drug removal by PD is less than that of hemodialysis and that is why the dosing guidelines which should be followed are those which are set in patients with end stage renal disease not on dialysis. So according to that recommendation, you were given a higher dose of valtrex and valtrex is known to be neurotoxic in patients with renal problems. If your creatinine clearance was less than 10 at that time then you should have been given 500 mg a day however if it was above 10 and under 30 then you recieved the right dose.

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

http://www.justanswer.com/medical/expert-dr-muneeb-ali/

Expert:  Muneeb Ali replied 1 year ago.

Would you to know anything else? If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.

Expert:  Muneeb Ali replied 1 year ago.

One last thing, three pills a day of valtrex would ONLY be indicated if your creatinine clearance was greater than 50,

ill summarize the dosing recommendations below for easy referral

Creatinine clearance will be abbreviated as CrCl

CrCl < 10 ml/min then the dose would be 500 mg a day

CrCl 10-29 then the dose would be 1000 mg a day

CrCl 30-49 then the dose would be 1000 mg twice a day

CrCl >50 then the dose would be 1000 mg thrice a day

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

http://www.justanswer.com/medical/expert-dr-muneeb-ali/