When Is Preventive Treatment Considered
Some people have outbreaks of genital herpes very often or experience especially severe symptoms. Then it may be a good idea to take antiviral medication for a longer time including during symptom-free phases. The goal is to prevent further outbreaks and to keep the symptoms from becoming so severe. Also, the antiviral medication reduces the likelihood of infecting others. As preventive treatment, the WHO recommends the following:
- aciclovir: 400 mg two times per day,
- famciclovir: 250 mg two times per day or
- valaciclovir: 500 mg once per day.
Research shows that preventive treatment can considerably lower the risk of further outbreaks. The people participating had four or more herpes outbreaks per year before the start of the studies, and then took an antiviral medication or a fake treatment for up to one year. A comprehensive analysis of the study results shows that
- 96 out of 100 people who took a placebo had at least one further outbreak of genital herpes.
- 46 out of 100 people who were given antiviral medication had at least one further outbreak of genital herpes.
In other words, the medication prevented further outbreaks in 50 out of 100 people within one year.
People with very frequent herpes outbreaks also benefited from preventive treatment: In one study involving people with very frequent outbreaks, the medication lowered the number of episodes in one year from 11 to 2.
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.
What Happens If You Leave Herpes Untreated
According to the CDC , genital herpes can lead to painful sores, which can be worse in people with weaker immune systems. A person may also spread the virus to other parts of their body.
In pregnant people, herpes may lead to miscarriage or make early delivery more likely. A person can also pass herpes on to their baby before or during birth. This can cause neonatal herpes, which can be fatal.
Pregnant people with herpes may need to receive herpes treatment toward the end of their pregnancy and have a cesarean delivery if they have herpes symptoms when they give birth.
It is important that people speak with a doctor about treating herpes.
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What Is The Best Medication For Herpes
The effectiveness of a particular medication varies depending on the person, so thereâs no single âbestâ herpes treatment. Doctors prescribe the most suitable drug for each patientâs condition, medical history, and current medications. That said, here are a few of the drugs most commonly used to treat HSV:
|Best medication for herpes|
This doesnât encompass the full scope of potential side effects, just the most common ones. Anyone considering treatment with one of these medications should speak with a healthcare professional for a more comprehensive list.
How Can I Prevent Herpes Outbreaks
If you have lots of herpes outbreaks, your doctor may tell you to take medicine every day this is called suppressive therapy. It can help prevent future herpes outbreaks, and lower your chances of giving herpes to your partners.
Whether or not you take medicine to treat herpes, taking care of yourself by eating healthy foods, getting enough sleep, and avoiding stress might help keep future outbreaks from popping up.
No one knows for sure what triggers genital herpes outbreaks. Other infections, surgery, sex, your period, skin irritations, and stress may cause outbreaks. Sunburns, injuries to your lips, or other infections can cause oral herpes flare-ups. Try to avoid getting sunburned if you have oral herpes.
Genital herpes outbreaks usually happen less often and become shorter and weaker after a few years whether or not you get treated.
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Treating A First Outbreak Of Herpes
A first outbreak of genital herpes can cause a long illness with severe genital sores and can also affect the nervous system. Even if your first episode of herpes is mild, you may have severe or prolonged symptoms later. For this reason, the Centers for Disease Control and Prevention recommends that everyone who has a first episode of genital herpes take antiviral drugs.
Almost everyone who has one episode of genital herpes caused by HSV-2 also has later breakouts of sores. Later episodes are less common if your case of genital herpes is due to an HSV-1 infection.
The frequency of genital herpes outbreaks slows down over time in many people.
Is There A Cure Or Treatment For Genital Herpes
There is no cure for genital herpes. However, daily use of antiviral medicines can prevent or shorten outbreaks. Antiviral medicines also can reduce the chance of spreading it to others.
Though several clinical trials have tested vaccines against genital herpes, there is no vaccine currently available to prevent infection. One vaccine trial showed efficacy among women whose partners had HSV-2, but only among women not infected with HSV-1. Efficacy was not observed among men whose partners had HSV-2. Another trial testing the same vaccine showed some protection from genital HSV-1 infection, but none from HSV-2.
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When And How Are Later Outbreaks Treated
Later outbreaks with only mild symptoms dont necessarily need to be treated. The blisters can then simply heal on their own.
But antiviral medication can also shorten the duration of later outbreaks by an average of about two days. If you decide to have treatment, its important to start it within the first 24 hours of the outbreak ideally, as soon as you notice the first symptoms. So its a good idea to always have a few tablets at home or to take them with you when you travel so they are ready to use. You can get a prescription from your doctor.
In later outbreaks you can take them for a shorter time. The WHO recommends the following:
- aciclovir: 400 mg three times per day or 800 mg two times per day for five days, or 800 mg three times per day for two days,
- famciclovir: 250 mg two times per day for five days, or
- valaciclovir: 500 mg two times per day for three days.
A different dose and treatment duration may be a good idea for people who have immune system disorders, such as an HIV infection.
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.
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Does Valacyclovir Cause Hair Loss
In very rare cases people taking valacyclovir have experienced some hair thinning and hair loss. In clinical trials it happened so rarely it wasnt possible to estimate the percentage of people that will likely experience hair loss as a side effect. Talk to your doctor if youre concerned about valacyclovir and hair loss.
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Aciclovir Tablets And Liquid
Doses will vary, depending on why youre taking aciclovir. Your doctor will tell you how much to take and how often.
A single dose is generally between 200mg and 800mg, and may be lower for children.
Youll usually take aciclovir 2 to 5 times a day. Try to space the doses evenly throughout the day.
If you take aciclovir:
- 4 times a day you could take it first thing in the morning, at midday, in the late afternoon and at bedtime
- 5 times a day for example, you could take it at 7am, 11am, 3pm, 7pm and 11pm
You can take aciclovir with or without food. Drink plenty of water while taking this medicine to help keep your kidneys working well.
Keep taking the medicine until its all finished or until your doctor or pharmacist tells you to stop taking it.
For treating a viral infection, youll usually take aciclovir for 5 to 10 days. For prevention, you may need to take it for a long time.
Tablets: swallow the tablets whole with some water. If you find tablets difficult to swallow, you can dissolve them in water. Add a tablet to a small glass of water and stir. Drink all the liquid to make sure you get the full dose.
Liquid: use the measuring spoon or plastic syringe that came with your medicine. If you do not have a measuring spoon or syringe, ask your pharmacist for one. Do not use a kitchen teaspoon as you will not get the right amount of medicine.
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What Form Does This Medication Come In
500 mg Each blue, film-coated, capsule-shaped tablet printed with edible white ink with âVALTREX 500 mgâ contains valacyclovir HCl equivalent to 500 mg valacyclovir. Nonmedicinal ingredients: carnauba wax, cellulose, crospovidone, hydroxypropyl methylcellulose, Indigotine Aluminum Lake, magnesium stearate, polyethylene glycol, polysorbate 80, povidone, silicon dioxide, and titanium dioxide.
1,000 mg Each white, film-coated, capsule-shaped tablet printed with edible blue ink with âGX CF2â contains valacyclovir HCl equivalent to 1,000 mg valacyclovir. Nonmedicinal ingredients: carnauba wax, cellulose, crospovidone, hydroxypropyl methylcellulose, magnesium stearate, polyethylene glycol, polysorbate 80, povidone, silicon dioxide, and titanium dioxide.
Avoid The Following While You Are Using Acyclovir Buccal Delayed
- Do not chew gum, touch, or press the buccal tablet after it has been applied.
- Do not wear upper dentures.
- Do not brush your teeth until it dissolves. If your teeth need to be cleaned while the tablet is in place, rinse the mouth gently.
Shake the suspension well before each use to mix the medication evenly.
Your symptoms should improve during your treatment with acyclovir. Call your doctor if your symptoms do not improve or if they get worse.
Take or use acyclovir until you finish the prescription, even if you feel better. If you stop taking acyclovir too soon or skip doses, your infection may not be completely treated or may become more difficult to treat. The delayed-release buccal tablet is applied as a one-time dose.
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Protecting Your Partner And Preventing Herpes Transmission
Research shows that the single greatest fear is the fear of transmission to partners, says Dr. Handsfield.
The main ways to avoid transmitting herpes are:
- Learn to recognize how you feel when an outbreak is on the way, and stop having sex immediately.
- Dont have sex during active outbreaks.
- Always use condoms but dont rely on them during outbreaks. They dont completely cover infectious areas.
- Only after all sores have scabbed over and healed should you have sex again.
- Avoid touching your herpes sores, because you can spread them to other places on your body that way. Whenever you touch a sore, wash your hands immediately.
- Dont kiss people or have sex if you have a cold sore.
- Tell potential partners about having herpes before having sex with them, even though it may be hard.
- Ask your doctor about taking antiviral drugs regularly.
Other Uses For This Medicine
Acyclovir is also sometimes used to treat eczema herpeticum to treat and prevent herpes infections of the skin, eyes, nose, and mouth in patients with human immunodeficiency virus , and to treat oral hairy leukoplakia .
This medication may be prescribed for other uses ask your doctor or pharmacist for more information.
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How Are Initial Outbreaks Treated
Antiviral medications can help to control the symptoms and shorten the duration of initial herpes outbreaks by 2 to 4 days. The treatment of an initial outbreak should be started within the first three days the earlier, the better.
The medications are taken as tablets. The number of tablets per day depends on the active ingredient and the dose. The World Health Organization recommends the following doses and amounts for treating an initial outbreak:
- aciclovir: 200 mg five times per day or 400 mg three times per day,
- famciclovir: 250 mg three times per day, or
- valaciclovir: 500 mg two times per day.
The WHO recommends that the treatment last ten days.
These three medications are about as effective as each other. Aciclovir is the most commonly used because doctors and patients have the most experience with this medication.
What Side Effects Are Possible With This Medication
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- increased sensitivity to UV light
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- behaviour changes
- pain in the side between the ribs and hip or kidney area of the back
- signs of anemia caused by red blood cell destruction
- signs of bleeding
- signs of decreased kidney function
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of a serious allergic reaction
- signs of a severe skin reaction
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Is There An Antiviral Treatment For Covid
Historically, antiviral therapy has been available only for a limited number of infections, including those caused by HIV, herpes, hepatitis B and C, and influenza A and B. Drug companies and researchers investigated new and existing antivirals for potential use in treating COVID-19, and some candidates have proven effective in clinical trials.
Several countries have approved the use of the drug Veklury for certain patients. For example, in October, 2020, the U.S. Food and Drug Administration approved it for qualified patients who have been hospitalized as a result of COVID-19. Veklury is administered via injection and is limited to hospital or comparable healthcare settings.
In December, 2021, the FDA granted emergency use authorization for Paxlovid and molnupiravir, orally administered drugs that can be taken at home.
Valtrex Vs Acyclovir: Which Is Better For Cold Sores
Cold sores, also called fever blisters, are small painful blisters that appear on the lips or around the mouth. They are caused by type one herpes simplex virus .
Herpes is highly contagious and spreads through close contact such as kissing or sexual contact.
It can also spread by sharing an infected persons utensils, razors, or towels.
Cold sores cant be cured, but you can manage outbreaks with herpes medications like valacyclovir and acyclovir .
In this article, Ill discuss how antivirals help cold sores and how valacylovir compares with acyclovir.
Ill explain the effectiveness of valacyclovir and acyclovir as well as the side effects and costs of both medications.
Finally, Ill discuss which is better for cold sores.
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How Long Does Valacyclovir Take To Work
The amount of time required for valacyclovir to control a herpes or chickenpox outbreak varies based on the severity of the outbreak and how soon you take valacyclovir after noticing herpes symptoms.
For most initial herpes outbreaks and cases of recurring herpes, valacyclovir takes effect very quickly and provides some level of relief in as little as two to three days. Generally, the sooner you take valacyclovir after noticing symptoms, the faster it will be to provide relief.
Its important to remember that every outbreak is different, meaning valacyclovir can potentially take less or more time than the figures listed above to provide relief and control over a shingles infection or herpes outbreak.
Our guide to how long valacyclovir takes to become effective covers more about valacyclovirs onset of action and average time to start working for different viral injections.
Fighting Viruses: How Do Antivirals Work
This article was reviewed by a member of Caltech’s Faculty.
Antivirals are medications used specifically to treat viral infections. They aim to minimize the symptoms of an infection and shorten its duration. They also can help reduce transmission of a virus.
Rather than killing a virus directly, antivirals usually suppress the virus’s ability to infect and multiply in your cells. These drugs often work by inhibiting molecular interactions and functions needed by the virus to produce new copies of itself.
The way a drug produces its therapeutic effect is called its mechanism of action. Antivirals are often delivered in combinations that have different mechanisms of action. This helps to prevent the emergence of mutated drug-resistant viral strains that can bypass the effects of a single drug. For example, combination antiviral therapy is now the standard of care in HIV and hepatitis C virus infections. It is highly desirable to develop multiple antivirals whenever possible.
The development of antivirals can be challenging. Because viruses are parasites that hijack host cell machinery, care must be taken to select drug targets that interfere with viral replication while causing as little harm to healthy host cells as possible. Like vaccines, antivirals must go through a multistep approval process by the U.S. Food and Drug Administration .
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