Is Suppressive Therapy For Herpes Safe

Switch Medications If Necessary

Acyclovir is another antiviral drug that can be used to treat herpes virus and varicella-zoster virus infections. Neither medication is better than the other, but if someone cant tolerate Valtrex or has an underlying medical condition that prevents them from taking it, acyclovir is another good option. You can compare the medications here.

How Effective Is Suppressive Therapy For Herpes Treatment

Research have proven that nonstop suppressive antiviral therapy can intensely reduce the herpes outbreaks frequency or prevent them completely and lessen the risk of spreading the disease by 50%.

For instance, an important study reveals that individuals who have more than 12 occurrences per year on average could lessen their outbreaks frequency to less than two a year following one year of nonstop suppressive therapy. The research also stated that if recurrences do happen during suppressive therapy, theyre usually shorter in duration and less severe.

Who is Suppressive Therapy Appropriate For?

Your physician may approve that suppressive antiviral therapy is good for you if:

While there is still no cure of herpes, there are certainly treatment for herpes simplex such as taking anti-viral drugs and suppressive therapy that you can opt for to get rid of your herpes outbreaks.

Usual Adult Dose For Herpes Simplex Labialis

2 g orally every 12 hours for a total of 2 dosesHIV-infected adult :1 g orally twice a day for 5 to 10 daysComments:-Therapy should be started at the earliest sign of a cold sore, e.g. tingling, burning, or itching.-Efficacy of treatment when initiated after the development of clinical signs of a cold sore have not been established.-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.Use: For the treatment of cold sores .

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Genital Herpes: A Review

Am Fam Physician. 2016 Jun 1 93:928-934.

Patient information: See related handout on genital herpes, written by the author of this article.

Genital herpes is a common sexually transmitted disease caused by herpes simplex virus and characterized by lifelong infection and periodic reactivation. HSV, a DNA virus, is named from its protein coat as HSV-1 or HSV-2. HSV-1 is the chief cause of orolabial herpes. Until recently, genital herpes was more likely to be caused by HSV-2. However, the incidence of primary genital infection with HSV-1 is now as common or more common than HSV-2 in the United States.1

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Type-specific laboratory confirmation of HSV is recommended in patients with clinical disease to guide counseling and management.

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Interactions With Other Drugs

Drug interactions happen when two or more drugs combine in the body and to create unintended effects or symptoms. Interactions can range from mild to severe and dangerous. See the chart below for some examples.

Valacyclovir can interact with over 60 different drugs, which is why it’s important to let your physician know about any medications you’re taking. For example, valacyclovir can cause serious negative interactions with several medications used to treat HIV, including:

Be sure to tell your physician if you have HIV and if you’re taking medications or taking treatment to control it.

Valacyclovir can also be dangerous when taken in combination with a class of drugs called aminoglycoside antibiotics. This includes drugs such as:

Aminoglycosides along with certain other antibiotics, like bacitracin and valacyclovir can potentially cause kidney damage, and this risk increases when the drugs are taken together.

This is not a full list of possible drug interactions. If you’re using any other medications, consult a more complete list of possible interactions and speak with your doctor and pharmacist for more information.

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Suppressive Treatment Drugs In Pregnancy

Your doctor may recommend suppressive therapy during pregnancy to help reduce your number of herpes outbreaks, especially if you have six or more episodes per year. Long-term suppressive therapy can significantly reduce these outbreaks and is likely safe during pregnancy.

Acyclovir and valacyclovir are the drugs most commonly used for herpes outbreak suppression and treatment during pregnancy. These drugs help reduce how active the virus is. They also help speed up lesion healing. They may also decrease the chance of active lesions at the time of labor. In turn, this decreases the likelihood of needing a cesarean delivery to avoid virus transmission.

No evidence links acyclovir or valacyclovir to serious side effects in infants born to mothers who took these drugs during pregnancy.

Treatment with these drugs usually starts around the 36th week of pregnancy. It continues through delivery. Both the American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention recommend the following dosages during pregnancy:

• acyclovir: 400-mg doses three times per day
• valacyclovir: 500-mg doses twice per day

Famciclovir has also been approved for treatment of recurrent genital herpes. Famciclovir is as effective as acyclovir or valacyclovir, but its also more expensive. However, there is no data on the use of famciclovir during pregnancy, so this drug is used less often.

Who Might Get Herpes Simplex

People of any age can contract herpes simplex. You are more likely to get the virus if you:

• Were assigned female at birth.
• Have had multiple sex partners.
• Started having sex at a young age.
• Have a history of any sexually transmitted infection .
• Have a weakened immune system.
• Dont use condoms for intercourse and dental dams for oral sex.

Who gets HSV-1, commonly known as oral herpes?

Anyone can get HSV-1. Most people contract HSV-1 during childhood. It spreads when an adult who has the virus has close contact with a child, such as when a family member kisses a child.

Who gets HSV-2, commonly known as genital herpes?

Genital herpes affects sexually active teens and adults of all genders and races. It can spread if you have multiple sexual partners and dont use condoms or dental dams.

People assigned female at birth are more at risk. Delicate vaginal tissue can tear, making it easier for the infection to get in. Black people who were AFAB are especially vulnerable, with an estimated 1 in 2 people AFAB between the ages of 14 and 49 infected with HSV-2.

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Genital Herpes During Pregnancy

Prevention of neonatal herpes depends both on preventing acquisition of genital herpes during late pregnancy and avoiding exposure of the neonate to herpetic lesions and viral shedding during delivery. Mothers of newborns who acquire neonatal herpes often lack histories of clinically evident genital herpes . The risk for transmission to the neonate from an infected mother is high among women who acquire genital herpes near the time of delivery and low among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy . Women who acquire HSV in the second half of pregnancy should be managed in consultation with maternal-fetal medicine and infectious disease specialists.

All pregnant women should be asked whether they have a history of genital herpes or genital symptoms concerning for HSV infection. At the onset of labor, all women should be questioned thoroughly about symptoms of genital herpes, including prodromal symptoms , and all women should be examined thoroughly for herpetic lesions. Women without symptoms or signs of genital herpes or its prodrome can deliver vaginally. Although cesarean delivery does not eliminate the risk for HSV transmission to the neonate , women with recurrent genital herpetic lesions at the onset of labor should have a cesarean delivery to reduce the risk for neonatal HSV infection.

Acyclovir 400 mg orally 3 times/dayORValacyclovir 500 mg orally 2 times/day

Other Cutaneous Hsv Infections

Localized cutaneous HSV infections may result from mucocutaneous or cutaneous contact with infectious sources. Herpes gladiatorum, herpetic whitlow, and other localized cutaneous herpetic infections can typically be managed with similar treatment strategies for primary and recurrent herpes labialis or genitalis.

Eczema herpeticum

Eczema herpeticum is an acute HSV infection that occurs in patients with chronic severe atopic dermatitis. It is characterized by erythematous vesicles, erosions, and crusting that occur in areas affected by atopic dermatitis. Dissemination can occur and may be associated with fever, pain, and lymphadenopathy. Prompt initiation of systemic antivirals is indicated.

Erythema multiforme

HSV is the most common cause of erythema multiforme, and recurrences of erythema multiforme parallel recurrences of herpes simplex. Long-term suppressive therapy can be used for patients with six or more episodes per year or for those with severe recurrences. Long-term suppressive therapy with acyclovir has been shown to suppress recurrences of erythema multiforme in approximately 60% of patients. Dosing of systemic antivirals for recurrent herpes labialis or genitalis can be used, as the majority of evidence is derived from small studies and case reports.

References

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How To Get Rid Of Genital Herpes Outbreaks Quickly & Safely

There is no cure for genital herpes, but there are many over-the-counter treatment optionsas well as supplements, herbs, topical treatments, and even dietary changesthat may help clear up outbreaks faster.

In this article, Ill talk about the early warning signs of genital herpes, outline some medicines and at-home treatments for outbreaks, and information on howto heal herpes sores faster.

Ill help you understand what is safe and backed by reliable evidence.

And Ill tell you when to talk to your doctor.

To Medicate Or Not To Medicate For Herpes

Oral herpes medication can improve your quality of life, give you a feeling of control and physical and mental relief from experiencing recurrences of herpes.

Knowing about the treatment options provides you with information to have an open and informed discussion with your Doctor about what is best for you.

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I Sometimes Get Tingles And Pains Around My Buttocks Or Down One Leg What Does This Mean

Occasionally, herpes simplex virus can cause burning skin sensations, deep aches or sudden twinges in the genital area. When they occur in the thighs or buttocks, they are sometimes compared to sciatica. These symptoms are called prodromes or prodromal symptoms. They are a sign that the virus is trying to reactivate and there may be virus on the skin surface. Sometimes sores will follow, but very often your immune response overcomes the virus before visible signs appear. For email version or posted version of more information on treating genital herpes, select tips to prevent recurrences on the subscription form.

How Do Herpes Drugs Work

Herpes medications like valacyclovir, acyclovir and famciclovir belong to a class of medications called antiviral drugs.

Antiviral drugs are designed to inhibit the multiplication of viruses in the body. Unlike antibiotics, which eliminate the bacteria that cause infections, antiviral drugs simply control viral proliferation, rather than completely eliminating the target virus from the body.

None of the antiviral drugs on the market today can cure herpes. However, consistent use of an antiviral drug can make living with herpes much easier by speeding up healing after an outbreak and reducing your risk of transmitting the virus to other people.

Herpes drugs are taken for several reasons. People with active HSV-1 or HSV-2 infections can take them during outbreaks to control and treat their symptoms. Antiviral drugs are also used as part of suppressive therapy for herpes to reduce the severity and frequency of outbreaks.

Even people with asymptomatic herpes can benefit from using antiviral drugs to lower their risk of spreading the virus to other people through sexual or oral contact.

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Side Effects And Follow

Side effects with these herpes drugs are considered mild, and health experts believe these drugs are safe in the long term. Acyclovir is the oldest of the three, and its safety has been documented in people taking suppressive therapy for several years.

People taking suppressive therapy should see their doctor at least once a year to decide if they should continue. You may find taking the pills every day to be inconvenient, the drugs may not work for you, or you may naturally have fewer outbreaks as time goes on. Your doctor can help you make treatment choices to suit your needs.

Dosage And Safety Of Long

• A. MindelAffiliationsAcademic Department of Genitourinary Medicine, University College and Middlesex School of Medicine, Mortimer Street, London W1N 8AA, United Kingdon
• O. CarneyAffiliationsAcademic Department of Genitourinary Medicine, University College and Middlesex School of Medicine, Mortimer Street, London W1N 8AA, United Kingdon
• A. FahertyAffiliationsAcademic Department of Genitourinary Medicine, University College and Middlesex School of Medicine, Mortimer Street, London W1N 8AA, United Kingdon
• P. WilliamsAffiliationsAcademic Department of Genitourinary Medicine, University College and Middlesex School of Medicine, Mortimer Street, London W1N 8AA, United Kingdon

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Acyclovir May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:

• numbness, burning, or tingling in the arms or legs
• temporary inability to move parts of your body
• shaking of a part of your body that you cannot control
• loss of consciousness

Acyclovir may cause other side effects. Call your doctor if you have any unusual problems while you are taking or using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .

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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About Herpes Suppression Treatment

• Taking herpes suppression treatment

  Take 1 tablet 2 times a day for 3 months. We usually recommend that you continue Aciclovir herpes suppression treatment for 1 year.

  If you forget to take a tablet, take it as soon as you remember. However, if it’s nearly time for your next one, skip the missed dose. Do not take 2 tablets to make up for a forgotten dose.

• Side effects of herpes suppression therapy

  A small number of people will experience some side effects when taking Aciclovir, however these are generally mild and should pass quickly. These may include headache, dizziness, nausea, diarrhoea or tiredness.

  For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, contact us via your Patient Record.

• Effectiveness of herpes suppression therapy

  If you have 6 or more outbreaks of genital herpes per year, this treatment should result in fewer, less severe or even no outbreaks.

  Aciclovir suppression treatment is only effective if taken regularly and correctly, as prescribed.

• How herpes suppression tablets work

  Aciclovir is an antiviral that works to prevent the herpes virus from multiplying. Taking it regularly reduces the frequency of genital herpes outbreaks.

What Is Suppressive Treatment For Genital Herpes

Suppressive treatment involves taking medication on a daily basis to reduce the chance of a genital herpes outbreak.

Taking antiviral medicines on a daily basis also reduces the amount of virus that is shed, both when sores are present and in between outbreaks, when the skin looks normal.

Suppressive treatment does not guarantee that you will not get a herpes outbreak, but should reduce the severity and frequency of herpes outbreaks.

Over time, your immune system tends to exert better control over the herpes virus, so your doctor may suggest stopping treatment every 6 months to see whether you have any further outbreaks. Treatment can be re-started if you do have a recurrence.

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Understanding Herpes With H Hunter Handsfield Md

Herpes expert H. Hunter Handsfield, MD, explains the basics about genital herpes, including the difference between genital HSV-1 and HSV-2 infection, testing options and the importance of knowing virus type, and the three-prong strategy for prevention. See more herpes videos at sexualhealthTV.com.

Have a question about herpes youd like Dr. Handsfield or our other experts to answer? Visit our Ask the Experts page to learn how.

Suppressive Valacyclovir Therapy To Reduce Genital Herpes Transmission: Good Public Health Policy

Paul BonnarCopyright

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to

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Home Remedies And Lifestyle

There are some things that you can do at home to lessen the pain of a cold sore or genital herpes, prevent worsening of your condition, and reduce the risk of spreading the infection to others.

• Apply cold compresses: Place a well-insulated ice pack on your lesions for as long as it makes you feel better. The cold will not worsen or improve the lesion, but it can lessen the pain.
• Donât scratch: Avoid touching and scratching lesions caused by herpes, as this can spread the infection to other areas of your own skin.
• Keep the sores clean: Cold sores and genital herpes infections can become infected with bacteria from your hands or, in the latter case, from urine or feces. Keep the sores and blisters, and the areas around them, clean and dry to avoid an additional infection.
• Reduce stress: Stress can affect how well your immune system can keep your herpes infection in check. Reducing your stress may help prevent excessive herpes recurrences.

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