The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2026
Inappropriate Valacyclovir Dosing by Renal Function in Japan.
СтатьяНазвание и аннотация: Перевод в очереди
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Suzuki Sumire, Kondo Yuki, Sato Kaho, Sakazaki Yuka, Tominaga Yoshiko, Sato Koji, Ishitsuka Yoichi
Аннотация
BACKGROUND: Valacyclovir requires dose adjustment according to renal function to prevent serious adverse events. However, real-world data on renal function-based dosing practices are limited.
OBJECTIVE: To evaluate the frequency of valacyclovir overdosing according to renal function and to identify the characteristics associated with overdosing in Japan.
METHODS: We conducted a retrospective cohort study using a nationwide database of administrative claims and laboratory results from acute care hospitals in Japan. We included adults aged ≥18 years who received at least 1 valacyclovir prescription between October 1, 2022, and September 30, 2024, and who had a serum creatinine measurement within the preceding year. The primary outcome was overdosing, defined as a prescribed dose that exceeded the maximum recommended dose for the patient's renal function level per the Japanese package insert. Renal function was estimated using creatinine clearance calculated with the Cockcroft-Gault equation.
RESULTS: A total of 6764 patients with 7901 valacyclovir prescriptions were included; 1649 prescriptions (20.9%) were for patients with impaired renal function. Overdosing was rare among patients with normal renal function. Among patients with impaired renal function, overdosing occurred in 25.1% of prescriptions for varicella or herpes zoster and in 6.4% for other indications. Overdosing was more frequent among women and most common for prescriptions dispensed at community pharmacies.
CONCLUSIONS: In this nationwide study, valacyclovir overdosing was common among patients with impaired renal function, particularly for high-dose indications, and occurred more frequently among women and for prescriptions dispensed at community pharmacies. Strengthening renal function-based prescription review may help reduce preventable overdosing.
OBJECTIVE: To evaluate the frequency of valacyclovir overdosing according to renal function and to identify the characteristics associated with overdosing in Japan.
METHODS: We conducted a retrospective cohort study using a nationwide database of administrative claims and laboratory results from acute care hospitals in Japan. We included adults aged ≥18 years who received at least 1 valacyclovir prescription between October 1, 2022, and September 30, 2024, and who had a serum creatinine measurement within the preceding year. The primary outcome was overdosing, defined as a prescribed dose that exceeded the maximum recommended dose for the patient's renal function level per the Japanese package insert. Renal function was estimated using creatinine clearance calculated with the Cockcroft-Gault equation.
RESULTS: A total of 6764 patients with 7901 valacyclovir prescriptions were included; 1649 prescriptions (20.9%) were for patients with impaired renal function. Overdosing was rare among patients with normal renal function. Among patients with impaired renal function, overdosing occurred in 25.1% of prescriptions for varicella or herpes zoster and in 6.4% for other indications. Overdosing was more frequent among women and most common for prescriptions dispensed at community pharmacies.
CONCLUSIONS: In this nationwide study, valacyclovir overdosing was common among patients with impaired renal function, particularly for high-dose indications, and occurred more frequently among women and for prescriptions dispensed at community pharmacies. Strengthening renal function-based prescription review may help reduce preventable overdosing.