Treatment For Oral Herpes
The antiviral medications available in pill form have been specifically developed for the treatment of genital herpes. However, it is not uncommon for healthcare providers to prescribe the antiviral drugs to those who have frequent or severe outbreaks of oral herpes.
A recent study found valacyclovir to be effective for treating oral herpes in a one-day treatment of 2 grams taken at the first sign of a cold sore, and then again about 12 hours later.
There are two topical antiviral medications prescribed for the treatment of oral HSV symptoms: acyclovir ointment and penciclovir cream. Both work to speed up the healing process and reduce the viral activity. These topical drugs are put directly on the lesions themselves, but can also be used at the onset of prodrome.
Other topical treatments for oral herpes are available over-the-counter , but are not antiviral compounds like acyclovir and penciclovir. Some also contain ingredients that numb the area and induce temporary relief from the discomfort of an outbreak. Unfortunately, some OTC treatments may actually delay the healing time of symptoms because they can further irritate the area with repeated applications. There is only one OTC FDA-approved cream, called Abreva®, which has been clinically proven to help speed the healing process.
Dosage For Shingles Genital Herpes Or Chickenpox
- Shingles typical dosage: 800 mg every 4 hours, five times per day for 710 days.
- Genital herpes:
- Typical initial dosage: 200 mg every 4 hours, five times per day, for 10 days.
- Typical dosage for prevention of recurrent herpes: 400 mg twice per day, every day for up to 12 months. Other dosing plans may include doses ranging from 200 mg three times daily to 200 mg five times daily. Your doctor will decide how long you should take this drug to avoid a flare-up of the infection.
- Typical dosage for reinfection : 200 mg every 4 hours, five times per day, for 5 days. You should take this drug as soon as the first signs of a flare-up appear.
- Chickenpox typical dosage:
- Children who weigh 40 kg or less: 20 mg/kg of body weight, given four times per day for 5 days
- Children who weigh more than 40 kg: 800 mg four times per day for 5 days
Start this drug as soon as the first symptom of chickenpox appears. It isnt known if this drug is effective if your child starts it more than 24 hours after the first sign of chickenpox.
It hasnt been confirmed that acyclovir is safe and effective for children younger than 2 years.
The Elegance Of Virology: How Acyclovir Slows Down Herpes
Earlier this month I wrote about an experimental antiviral vaginal gel that achieved modest success in preventing outbreaks of genital herpes in women Quite a few people read the article, so I’ve followed it up with a more detailed look at how herpes medications help control infections. The biochemistry of how these drugs work is fascinating.
Of the two prescription drugs approved by the FDA to treat or prevent herpes simplex outbreaks , acyclovir is more commonly used . Although many people take the drug, few understand why it works. The details of acyclovir’s mechanism of action give us a wonderful example of the interaction of chemical and biological science as it pertains to drugs. It’s also pretty cool.
The entry of HSV into its host cell triggers a series of events in which the virus “reprograms” the DNA of the cell, forcing it to make viral DNA instead of cellular DNA. This is one of several essential steps required for viral replication without the production of viral DNA new virus particles cannot be made.
One of the enzymes that HSV carries into the host cell is called DNA polymerase. Its function is assembling an enormous number of simple nitrogenous bases – the four building blocks of DNA – into long strands, which will become new DNA. DNA polymerase is essential for the replication of herpes viruses. If DNA polymerase is not functioning the virus cannot grow.
Figure 1. Double-stranded DNA biosynthesis. Images: Wikipedia.
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Warnings For Certain Groups
For people with kidney problems: If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body and cause more side effects.
This medication may also decrease your kidney function. This means your kidney disease may get worse. Your doctor will adjust your dose depending on how well your kidneys are working.
For pregnant women: Acyclovir is a category B pregnancy drug. That means two things:
Talk to your doctor if youre pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.
For women who are breastfeeding: Acyclovir may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your baby. You may need to decide whether to stop breastfeeding or stop taking this medication.
For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.
For children: This drug hasnt been studied in children younger than 2 years.
Cream For Genital Herpes
Wash your hands before and after using the cream.
Put a thin layer of cream on the affected area 5 times a day. Do this every 4 hours for example, at 7am, 11am, 3pm, 7pm and 11pm.
Use the cream for at least 5 days. If the genital herpes sore has not healed by then, you can carry on using the cream for another 5 days.
If the affected area has still not healed after a total of 10 days, stop using the cream and tell your doctor.
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How Can You Catch Herpes
Like most sexual transmitted infections , herpes is passed on when someone with an active outbreak of the virus has sexual intercourse with a partner. It may also be spread by contact with bodily fluids from an infected person, including blood, saliva, vaginal fluid, semen or any fluid expelled from a weeping herpes blister.
The virus is passed onto the other person through tiny breaks in the mucous membranes or skin. Because viruses are very small, herpes can easily spread even if the breaks are only microscopic. This means you cannot conduct a visual inspection of a partner and guarantee that they will not catch the disease.
It is also worth noting that while the virus is generally passed on during the phase when the blisters are visible on the skin, there is also the possibility of infection spreading even when blisters are not showing.
This is due to something called asymptomatic shedding. This is where the virus continues to shed into bodily fluids even when dormant. This kind of shedding is most common during the first 12 months of herpes infections. However, it may continue throughout the life of the infection and you cannot guarantee that because you have no visible sores that your partner will not be infected.
In a monogamous relationship, a female partner carries a substantially higher risk of contracting herpes from an infected male partner than vice-versa.
Does Valacyclovir Each Day Keep Hsv
Am Fam Physician. 2004 Oct 1 70:1363-1364.
Sexual transmission of herpes simplex virus type 2 has been demonstrated from both symptomatic and asymptomatic reactivations in the infected partner. Daily antiviral therapy has been shown to decrease the frequency and amount of genital HSV shedding. Corey and colleagues tested daily valacyclovir for efficacy in preventing sexual transmission of HSV-2 from infected persons to their uninfected partners.
The study enrolled monogamous, immunocompetent, heterosexual couples in which only one partner was infected with HSV-2, as demonstrated by Western blot analysis of antiHSV-2 serum antibodies. Of the initial 4,034 couples screened, 1,385 asymptomatic partners already had serologic evidence of HSV-2 infection and were ineligible, and 799 of the source partners were symptomatic but had negative HSV-2 serology. After informed consent, 352 couples declined to participate, and 14 persons declined to take the study medicines, leaving 1,484 couples available for randomization.
The authors conclude that daily valacyclovir halves the transmission rate of HSV-2 to an uninfected partner over an eight-month period.
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Patients Materials And Methods
Subjects and setting. Healthy men and women who were seropositive for HSV-2 were considered for enrollment. Patients were eligible if they had a diagnosis of a first episode of genital HSV-2 infection 6 months before enrollment. Alternatively, patients were eligible if they had longstanding genital herpes infection and a recurrence rate of 6 episodes during the preceding year. Patients who had been receiving recent suppressive therapy were eligible if they reported 6 recurrences/year before initiating suppressive therapy. Suppressive therapy was stopped for at least 1 month before enrollment, and at least 1 recurrence was required during that time. Subjects were excluded if they were immunocompromised, HIV positive, had abnormal renal or hepatic function, or had a history of malabsorption or of ocular HSV. Women of childbearing potential had to use an effective method of contraception throughout the study. Study participants were recruited by newspaper advertisements, flyers, and local health clinics at 2 centers: the University of Washington Virology Research Clinic in Seattle and the Westover Heights Clinic in Portland, Oregon. Enrollment took place between August 1995 and July 1996. The protocol was approved by human subjects review committees, and all subjects gave written, informed consent.
Who Can And Cannot Take Aciclovir
Aciclovir can be taken by most adults and children.
Aciclovir is not suitable for some people.
To make sure aciclovir is safe for you, tell your doctor if you:
- have had an allergic reaction to aciclovir or any other medicine in the past
- have kidney problems
- are over 65 years old
- are pregnant, trying to get pregnant or breastfeeding
If your immune system is weakened , talk to your doctor about the best type of aciclovir for you.
They may recommend tablets rather than the cream.
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How To Cope With Side Effects
What to do about:
- headaches make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Paracetamol is safe to take with aciclovir if you need a painkiller. Speak to your doctor if this does not help or your headaches are severe.
- feeling dizzy if aciclovir makes you feel dizzy, stop what you’re doing and sit or lie down until you feel better. Do not drive, ride a bike, or use tools or machinery if you feel dizzy.
- feeling or being sick stick to simple meals and do not eat rich or spicy food. It might help to take your medicine after you have eaten. If you’re being sick, try small, frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.
- diarrhoea drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
- skin being sensitive to sunlight stay out of bright sun and use a high factor sun cream even on cloudy days. Do not use a sun lamp or sun beds.
- burning or stinging feeling after applying the cream this usually goes away after a short time. Ask a pharmacist or your doctor for advice if it continues to be a problem.
- itchy, dry or flaking skin try using an unscented moisturiser. Do not apply the moisturiser at the same time as your aciclovir cream.
What Valtrex Tablets Are Used For
Valtrex tablets belong to a group of medicines called antivirals. Valtrex tablets are used for the treatment of genital herpes infection.
Valtrex tablets work by stopping the multiplication of the virus which causes herpes. They can reduce the length and severity of an outbreak of herpes, the duration of pain and shorten the time to healing of crusts associated with herpes. They do not eliminate the herpes virus from the body. The herpes virus is also known as the Herpes Simplex Virus, or HSV.
Valtrex tablets help the blisters to heal more quickly. If you start taking them as soon as you feel an outbreak starting, you may actually prevent the blisters from developing.
Valtrex tablets can also be taken long term to help prevent the HSV infection coming back.
Valtrex is more effective in patients 50 years of age and older.
Valtrex tablets can also reduce the risk of transmitting the virus that causes genital herpes in patients who are taking it continuously to prevent or reduce recurrent outbreaks. It does not cure genital herpes or completely eliminate the risk of transmission. Therefore, in addition to therapy with Valtrex, it is recommended that patients avoid contact when symptoms are present and always use condoms.
Valtrex is not a cure for genital herpes. Because genital herpes is a sexually transmitted disease, you should minimise having intercourse when you have an outbreak of herpes or show any symptoms. This will avoid the risk of spreading herpes to your partner.
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What Drugs And Food Should I Avoid While Taking Acyclovir
Avoid brushing your teeth, chewing gum, or wearing an upper denture while you have a buccal tablet in your mouth. You may rinse your mouth gently. Drink plenty of liquids to prevent dry mouth.
Herpes infections are contagious and you can infect other people, even while you are being treated with acyclovir. Avoid letting infected areas come into contact with other people. Avoid touching an infected area and then touching your eyes. Wash your hands frequently to prevent passing the infection to others.
Taking this medicine will not prevent you from passing genital herpes to your sexual partner. Avoid sexual intercourse while you have active lesions or the first symptoms of an outbreak. Genital herpes may still be contagious through “viral shedding” from your skin, even if you have no symptoms.
How Long To Take Them
For the treatment of herpes infections, the usual course of treatment is five days. However in some instances your doctor may want you to take your tablets for ten days.
For prevention of herpes infections, you should continue to take this medicine every day as prescribed by your doctor.
Do not stop taking Valtrex tablets just because you feel better. The herpes outbreak may not be completely over.
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What Is In This Leaflet
This leaflet answers some common questions about Valtrex tablets. It does not contain all of the available information.
It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking Valtrex tablets against the benefits this medicine is expected to have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
Risks And Side Effects
The three main treatments for herpes acyclovir, famciclovir, and valacyclovir are all FDA-approved drugs, though there are side effects and interactions to be aware of.
Common side effects of these antiviral drugs include headaches and nausea. Famciclovir can cause dizziness, confusion, or sleepiness.
Acyclovir and valacyclovir, which are very similar to each other, can cause your kidneys to stop working. If you have kidney problems, your doctor may prescribe a lower dose. These medications may interact with other drugs such as nonsteroidal anti-inflammatory drugs like ibuprofen, which may weaken kidney function.
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Common Side Effects Of Valtrex
Taking Valtrex may cause side effects, such as:
- Joint pain
Its unknown whether Valtrex causes other adverse effects like hair loss, weight gain, dry mouth, or any other symptoms not listed by the United States Food and Drug Administration . This is not a complete list of side effects. Other side effects may occur. Consult your healthcare provider if you have questions about side effects of Valtrex.
A frequently asked question about Valtrex is whether it will make you urinate more often. It wont necessarily make you pee more, but you should drink plenty of water while taking Valtrex to help the kidneys process it as best they can. Therefore, this extra hydration can result in frequent urination.
Why Is This Medication Prescribed
Acyclovir is used to decrease pain and speed the healing of sores or blisters in people who have varicella , herpes zoster , and first-time or repeat outbreaks of genital herpes . Acyclovir is also sometimes used to prevent outbreaks of genital herpes in people who are infected with the virus. Acyclovir is in a class of antiviral medications called synthetic nucleoside analogues. It works by stopping the spread of the herpes virus in the body. Acyclovir will not cure genital herpes and may not stop the spread of genital herpes to other people.
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