Sunday, February 5, 2023

Should I Take Antivirals Daily For Herpes

Side Effects And Follow

Pharmacology – ANTIVIRAL DRUGS (MADE EASY)

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.

Do Natural Remedies Help

There are several options that can be tried to ease the pain. A73612 and Donnor52059 suggest dabbing cornstarch directly on the sores. I canât find any scientific studies that have researched this, but I canât see that it would do any harm.

A73612 also recommends squirting water from a bottle over the sores when you pee. This is a time-honoured method that will help to ease the pain.

Yolandayw mentioned taking a simple painkiller such as paracetamol during an outbreak. Feelbroken advised putting Vaseline on the sores. Lidocaine 5%, a local anaesthetic gel that numbs the area, is another option. Some people find it helpful to put on five minutes before passing urine. You need to get it on prescription and it doesnât suit everyone. Some people develop sensitivity to it which makes the symptoms worse.

Yolandayw also advised using ice as a home remedy. Simply wrap the ice in a tea towel and apply for 5-10 minutes. Never put ice directly on the skin as this can cause âice burnâ. Drinking plenty of water can also be helpful as it reduces the concentration of urine, making it less painful when you have to pee.

D91907 mentioned putting aloe vera gel on the sores. There is some scientific evidence that aloe vera is useful for both genital and oral herpes.

How Do I Treat Genital Herpes

For most people antiviral medicine is not necessary either because their body prevents recurrent symptoms or because they find that adopting a healthier life style makes a difference. See What can I do to prevent frequent recurrences?For people who are unlucky and get frequent recurrences, there are two ways that antiviral tablets can be used.

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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.

How Can I Best Learn To Cope With Herpes Simplex

How to Have a Happy Sex Life with Herpes

Some people feel distressed or embarrassed about their herpes simplex infection. Its important to understand that the herpes virus is common. For most people, herpes doesnt significantly interfere with daily life.

To cope with negative feelings, you may consider:

  • Connecting with others through support groups or online forums.
  • Sharing your feelings with a trusted friend or loved one.
  • Speaking with a therapist.

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Coping With The Herpes Diagnosis

Anger, violation, and shame are typically the first on-set of feelings that are felt after being told youre going to have to deal with herpes for the rest of your life. You may also feel like youre the only one your friends and family will know that have it.

Wait, do you even want them to know? Who gave it to you? How do you even approach living your life with herpes now? These are some of the initial thoughts thatll probably race through your mind in the same doctors office where you just found out a few seconds ago.

Although diagnoses are overwhelming and can be traumatic by nature, theres also a positive in it. You can take power and control of your life by knowing whats going on with your body. In fact of the 20 percent of people who have HSV-2, only 10 to 15 percent of them know that they have it. Thats because at least 10 percent of herpes sufferers have mild to no symptoms at all. Herpes can produce quite mild symptoms to where you can mistakenly attribute it to various other problems without even thinking it could be a sexually transmitted disease. This then encourages the unintentional cycle of passing herpes on. With having an official diagnosis, you can

How To Take Aciclovir

  • Swallow your aciclovir tablets with a glass of water. If you have difficulty swallowing the tablet, the tablet can be dissolved in a small glass of water. Stir until dissolved. Drink all the water to make sure you get the full dose.
  • Timing: Separate your doses out evenly during the day. For example, if your dose is to be taken 5 times a day, take a dose about every 4 hours such as 7am, 11am, 3pm, 7pm and 11pm. You can take aciclovir with or without food.
  • Drink plenty of water while taking aciclovir. Itâs important todrink plenty of water so you donât get dehydrated while taking aciclovir.This could affect your kidneys.This is especially important for older adults.
  • Missed dose: If you forget to take your dose, take it as soon as you remember but, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Keep taking aciclovir until the course is finished. Do not stop taking it, even if you feel better after a few days. Your doctor will advise you on how long to take aciclovir for .
  • Wear sunscreen when outside. Protect yourself from too much sunlight while being treated with aciclovir. Always cover up and apply a thick layer of broad spectrum sunscreen when outside. Do not use sunbeds.

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Binding And Entry Inhibition

Other antiviral drugs act on the host cell to inhibit the virus . The advantage to this approach is that resistance to the drug is less likely to appear, especially because these drugs are not subject to TK activation and ACV resistance mutations in that locus while random mutations occur in both viruses and hosts, the mutation rate in viruses is much higher than it is in host cells . On the other hand, targeting a host cell function may lead to higher toxicity, potentially limiting therapeutic use to only viral strains that are resistant to safer therapies.

n-Docosanol.

Antiviral Tablets To Stop The Herpes Virus Multiplying

Anti-Herpetic Drugs – How They Work

Antiviral medicines taken by mouth, such as valaciclovir or acyclovir, are the most effective in controlling symptoms, although they cant cure genital herpes. They stop the virus from multiplying in body cells where the virus is present. The medicine only works while you are taking it. The infection can come back when you stop taking it.

Antiviral tablets are used in the following two ways:

  • To treat outbreaks as they happen : The aim is to shorten the time each outbreak lasts and to relieve symptoms. This works best when taken as soon as you get symptoms and before the blisters appear.
  • To prevent or reduce recurrences : If you get frequent or severe recurrent outbreaks, your doctor may recommend you take antiviral tablets every day to help prevent recurrences. Suppressive therapy is taken continuously, every day, for months or years. Suppressive antiviral therapy may help reduce the risk of transmitting the virus to sexual partners.

Antiviral creams bought over the counter from the pharmacy are not recommended as a treatment for a first episode or recurrent genital herpes as they are of little benefit. Antiviral tablets are the preferred treatment.

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Are Antiviral Medications Safe

Antiviral medications are considered to be very safe. They are nearly always well tolerated because the active ingredients only have an effect in cells that have been infected by the virus.

People who have kidney failure may need to take a lower dose because the medication is removed from the body through the kidneys.

What Are The Symptoms Of Genital Herpes

The symptoms of genital herpes vary a lot. Most people have very mild symptoms or none at all.

Symptoms can vary from a mild area of irritation to more painful blisters or sores and generally feeling unwell. Common symptoms may include:

  • sometimes sores on the cervix

If you are having a first episode of genital herpes, you are more likely to also feel generally unwell and have fever, headache and general bone and muscle aches.

This may last for several days, during or after which reddened areas may appear on your genitals. These may develop into painful blisters. The blisters then burst, generally to leave sores that gradually heal, usually without scarring.

The severity of this first episode varies between people, but for some it may be severe and last for up to 3 weeks if not treated. These symptoms should quickly resolve with treatment. There is effective treatment available if symptoms are problematic.

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What Else Can I Do To Help With A Genital Herpes Outbreak

As well as taking medication to help with symptoms, you can also try:

  • using an anaesthetic gel to numb your skin and ease any pain
  • soaking the affected area with plain or salt water
  • applying Vaseline to the affected area
  • drinking plenty of fluids
  • wearing loose clothing
  • taking pain relief medications, like paracetamol or ibuprofen

The symptoms of herpes outbreaks will usually go away by themselves within 10 days as your immune system fights the infection on its own. You might find the sores painful during that time, so medication can help you by clearing up the infection more quickly.

If youd like to speak to one of our doctors about your symptoms, you can book a telephone consultation. Theyll be able to provide personalised advice on how to cope with genital herpes.

Treatment Of Recurrent Genital Herpes

Is It Herpes or Something Else?

Most herpes recurrences are so mild and infrequent that taking treatment isnt considered necessary or helpful.

For some people herpes recurrences, while infrequent, can be more prolonged and you may find taking a short course of medication when you recognise the signs of a recurrence lessens the length and severity of the symptoms and reduces the risk of transmission if you are sexually active. This is called EPISODIC TREATMENT as it is not taken all the time.

Because this therapy is most effective before you develop skin rashes or lesions , it is important you have a readily available supply of medication to start as soon as you experience signs that you are having a recurrence.

Episodic treatment is 500mg of valaciclovir twice daily for 3 days taken 3 times daily for 2 days).

Ask your Doctor to prescribe 50 x 500mg tablets of valaciclovir and self-initiate treatment at the first sign of a recurrence starting.

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Treatment Of Primary Infection

Antiviral therapy is recommended for an initial genital herpes outbreak, especially if the patient has systemic symptoms or is immunocompromised.2 Oral acyclovir is effective in reducing symptoms1 . Intravenous administration may be required in immunocompromised patients and those with severe disseminated infection.1 Topical acyclovir reduces the duration of viral shedding and the length of time before all lesions become crusted, but this treatment is much less effective than oral or intravenous acyclovir.1

Effect of Acyclovir Treatment on Primary Genital Herpes

Symptom/sign

Time until all lesions are crusted

Time until all lesions are healed

*Dosage = 200 mg five times daily for 10 days, given within six days of lesion onset.

Information from Mertz GJ, Critchlow CW, Benedetti J, Reichman RC, Dolin R, Connor J. Double-blind placebo-controlled trial of oral acyclovir in first-episode genital herpes simplex virus infection. JAMA 1984 252:114751.

Effect of Acyclovir Treatment on Primary Genital Herpes

Symptom/sign

Time until all lesions are crusted

Time until all lesions are healed

*Dosage = 200 mg five times daily for 10 days, given within six days of lesion onset.

Information from Mertz GJ, Critchlow CW, Benedetti J, Reichman RC, Dolin R, Connor J. Double-blind placebo-controlled trial of oral acyclovir in first-episode genital herpes simplex virus infection. JAMA 1984 252:114751.

Famciclovir is not FDA-labeled for this indication.

Foods To Avoid During Herpes

Here are some foods that you might not eat if you have herpes:

Arginine and Acidity

Arginine is an amino acid that is plentiful in specific foods and can increase the potential that you will experience a herpes blister, either genital or oral. L-lysine is another amino acid that has anti-viral properties and can help reduce the effect of arginine and your potential for an outbreak. However, lysine has acidic properties, and when taken with acid-rich foods like dairy products or sweets, it can lead to hyperacidity in the body. This imbalance can also trigger an outbreak.

Sweets

Foods that are sweet or have sugar are high in the amino acid arginine. This includes chocolate and raisins. Other foods that are high in sugar include soft drinks and foods made with high fructose corn syrup, such as popsicles, fruit juices, some breakfast cereals, candy bars, cough syrups, drink mixes, ketchup and jams and jellies. Each of these products contains sugars and syrups that will increase your risk of developing new herpes lesions.

Nuts

Nuts are high in arginine and low in lysine, increasing your potential for an outbreak so avoid peanuts and peanut butter because of the high amount of arginine in the products. Other nuts are also high in arginine, such as almonds, Brazil nuts, cashews, filberts, pecans and walnuts.

Caffeine

Herbal Remedies to Cure Genital Herpes Outbreaks

Vitamins to Prevent Genital Herpes Outbreaks

Vitamin A

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What Are Antiviral Medications For Herpes

There are three antiviral medications that are FDA-approved for the treatment of genital herpes:

  • Acyclovir: The oldest antiviral medication for herpes is acyclovir. It has been available since 1982 in a topical form and sold since 1985 in pill form. Acyclovir has been shown to be safe in persons who have used it continuously for as long as 10 years.
  • Valacyclovir: A newer drug, valacyclovir, actually uses acyclovir as its active ingredient. This medication delivers acyclovir more efficiently so that the body absorbs much of the drug, which has the advantage of taking the medication fewer times during the day.
  • Famciclovir: Famciclovir uses penciclovir as its active ingredient to stop HSV from replicating. Like valacyclovir, it is well absorbed, persists for a longer time in the body, and can be taken less frequently than acyclovir.

Antiviral medication is commonly prescribed for patients having a first episode of genital herpes, but they can be used for recurrent episodes as well. There are two kinds of treatment regimens: episodic therapy and suppressive therapy.

Ganciclovir Cidofovir And Foscarnet

Antivirals | HIV, Hepatitis, Influenza, Herpes Treatment

In the last decade, alternatives to ACV for herpesvirus treatment have emerged and become commercially available as therapeutic drugs. Ganciclovir is a nucleic acid analog that does not require viral proteins for its activation in the cell . These compounds differ from each other either, in their molecular processing into an active form of an acyclic guanosine analog, or bioavailability which significantly determines the frequency of administration .

Ganciclovir is indicated for the treatment of CMV, particularly for systemic and ocular infections in immunosuppressed patients . However, ganciclovir has also been reported to have antiviral activity against HSV-1 and HSV-2 and may be used for the treatment of herpetic keratitis . At present, there is an ongoing clinical study that is recruiting patients for assessing the effects of oral ganciclovir, together with femtosecond laser-assisted corneal debridement in the treatment of herpes simplex virus epithelial keratitis . Of note, ganciclovir has been reported to produce considerable adverse side effects in a high percentage of individuals , such as nephrotoxicity, neutropenia, myelosuppression, confusion, altered mental status, anxiety, ataxia, tremors, convulsions, fever, abnormal levels of liver enzymes in serum, diarrhea, and nausea, among others .

Table 1. Approved and experimental antiviral drugs against HSV-1 and HSV-2 .

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To Use Buccal Acyclovir Follow These Steps:

  • Find the area on the upper gum above your left and right incisor teeth .
  • With dry hands, remove one delayed-release tablet from the container.
  • Gently apply the tablet to the upper gum area as high as it will go on your gum above one of your incisor teeth on the side of your mouth with the cold sore. Do not apply it to the inside of the lip or cheek.
  • Hold the tablet in place for 30 seconds.
  • If the tablet does not stick to your gum or if it sticks to your cheek or the inside of your lip, reposition it to stick to your gum. Leave the tablet in place until it dissolves.
  • Do not interfere with the placement of the tablet. Check to see if the tablet is still in place after eating, drinking, or rinsing your mouth.
  • If the delayed-release buccal tablet comes off within the first 6 hours of application, reapply the same tablet. If it still will not stick, then apply a new tablet. If you accidentally swallow the tablet within the first 6 hours of application, drink a glass of water and place a new tablet on your gum. If the tablet falls off or is swallowed 6 or more hours after application, do not apply a new tablet until your next regular time.

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