Treatment Of Postherpetic Neuralgia
Apply to affected area every 4 to 12 hours as needed.
10 to 25 mg orally at bedtime increase dosage by 25 mg every 2 to 4 weeks until response is adequate, or to maximum dosage of 150 mg per day.
10 to 25 mg orally at bedtime increase dosage by 25 mg every 2 to 4 weeks until response is adequate, or to maximum dosage of 125 mg per day.
25 mg orally at bedtime increase dosage by 25 mg every 2 to 4 weeks until response is adequate, or to maximum dosage of 150 mg per day.
25 mg orally at bedtime increase dosage by 25 mg every 2 to 4 weeks until response is adequate, or to maximum dosage of 150 mg per day.
100 to 300 mg orally at bedtime increase dosage until response is adequate or blood drug level is 10 to 20 g per mL .
100 mg orally at bedtime increase dosage by 100 mg every 3 days until dosage is 200 mg three times daily, response is adequate or blood drug level is 6 to12 g per mL .
100 to 300 mg orally at bedtime increase dosage by 100 to 300 mg every 3 days until dosage is 300 to 900 mg three times daily or response is adequate.
*Additional modalities include transcutaneous electric nerve stimulation , biofeedback and nerve blocks.
How Effective Are Medications For Herpes
Prescription antiviral medications have proven effectiveness in managing HSV symptoms.
A 2017 study comparing the antiviral medications acyclovir, famciclovir, penciclovir and valacyclovir to treat herpes simplex labialis found all antiviral medications were effective to shorten healing time for lesions and reducing pain. The comparison study found valacyclovir had the fastest healing time and pain reduction.
Precautions Before Taking Aciclovir
- Are you pregnant or breast-feeding?
- Do you have any kidneys problems?
- Have you ever had a seizure ?
- Are you taking any other medicines? This includes any medicines you buy without a prescription, such as herbal and complementary medicines.
If you answered yes to any of these questions, its important that you tell your doctor before you start taking aciclovir. Sometimes a medicine isnt suitable for a person with certain conditions or it can only be used with extra care.
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Other Types Of Antivirals
There are several different kinds of antiviral agents that are prescribed to fight viral skin infections. These medications can be divided into systemic antivirals and topical antivirals. Systemic antivirals are usually given orally in pill form. However, they sometimes may be administered intravenously .This is most likely in situations where the patient is suffering from a suppressed immune system , is unable to swallow oral medication, has impaired memory or mental capacity or does not have quick access to a hospital should complications arise during drug therapy.
Topical antivirals are usually available in various forms, including creams, ointments, gels, patches and sprays. In addition, most topical antivirals can be further subdivided into one of three major classes:
- Cytodestructive drugs
- Immunoenhancing drugs
- Viricidal drugs
Management Of Sex Partners
The sex partners of persons who have symptomatic genital herpes can benefit from evaluation and counseling. Symptomatic sex partners should be evaluated and treated in the same manner as patients who have symptomatic genital herpes. Asymptomatic sex partners of patients who have symptomatic genital herpes should be asked about a history of genital symptoms and offered type-specific serologic testing for HSV-2. For partners without genital herpes, no data are available on which to base a recommendation for PEP or PrEP with antiviral medications or that they would prevent acquisition, and this should not be offered to patients as a prevention strategy.
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I Sometimes Get Twinges 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.
Cautions With Other Medicines
Some medicines can affect the way aciclovir tablets or liquid work. They can also make you more likely to get side effects.
If you’re using aciclovir cream on your skin, this is less likely to react with other medicines.
It’s important to tell your doctor if you take any of the following medicines before taking aciclovir:
- cimetidine, a medicine for stomach ulcers
- mycophenolate mofetil, a medicine given after organ transplants
- probenecid, a medicine for gout
- aminophylline or theophylline, medicines for asthma
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How Effective Are Topical Herpes Treatments
Two new topical medications for oral herpes may hold more promise, but they come at a cost.
includes acyclovir 5% cream and 1% hydrocortisone and works better than either ingredient alone. Interestingly, Xerese cream has been shown not only to shorten healing time but also to make it less likely that the lesions will return. Unfortunately, Xerese is expensive and rarely covered by insurance. But it is a combination of 2 cheaper generic creams, so talk to your doctor about making your own combination.
is a different form of acyclovir that can also be used to treat an oral herpes outbreak. It is an adhesive tablet that you place on your gums. Sitavig delivers a high concentration of acyclovir directly to your lip, the site of the cold sore. But again, itll cost you.
Treatment Of Herpes Zoster
The treatment of herpes zoster has three major objectives: treatment of the acute viral infection, treatment of the acute pain associated with herpes zoster and prevention of postherpetic neuralgia. Antiviral agents, oral corticosteroids and adjunctive individualized pain-management modalities are used to achieve these objectives.
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How Is Herpes Diagnosed
The herpes virus is almost always spread through sexual intercourse, oral sex, or kissing. Although sometimes HSV-1 can spread via shared lip balm, utensils, or other items that come in contact with saliva.
In most cases, healthcare providers can diagnose herpes with a visual examination and by discussing various symptoms. If there’s any doubt, they can take a viral culture to confirm, which involves lab analysis of a swab or scraping.
“If the patient has no history of herpes simplex and is a new patient, I always do a viral culture,” says , MD, a board-certified dermatologist and founder of 5th Avenue Aesthetics. “Also, if I am suspicious of HSV-2 or if it is an immunocompromised patient, I will order a viral culture. I start treatment right away before results come back. These results can take one week and it is best to start treatment early.”
But again, symptoms aren’t always present. Fortunately, it’s also possible to diagnose HSV with a blood test. Your body produces antibodies to combat viruses, and doctors can use a blood sample to detect the specific antibodies that fight the herpes simplex virus.
A primary care physician can perform the examinations and tests necessary for an accurate diagnosis. However, sexual health clinics offer similar, reliable services.
Other Antiviral Agents Used In Herpes Infections
Valaciclovir is a prodrug of aciclovir and has better bioavailability. It can also be used to treat HSV and HZV. It is used to prevent CMV infection following an organ transplant. Usual doses are:
- HZV: 1 g three times daily for 7 days
- HSV: 500 mg twice daily for 5 days.
Famciclovir is used for HSV and HZV. The usual doses are:
- HZV: 500 mg three times daily for 10 days
- HSV: 125250 mg three times daily for 5 days
- Suppression longterm: 250 mg twice daily
- Recurrent HSV of lips: a single dose of 500 mg at first signs of blistering
- Recurrent genital HSV: 100 mg twice daily for 1 day at first signs of blistering.
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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.
Aciclovir Tablets And Liquid
Doses will vary, depending on why you’re 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.
You’ll 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 it’s all finished or until your doctor or pharmacist tells you to stop taking it.
For treating a viral infection, you’ll 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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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.
How Can I Treat Herpes At Home
Certain dietary supplementsâlike lysine, vitamin C, zinc, and probioticsâcan help support your immune system and prevent or shorten outbreaks. Once an outbreak has begun, applying cold compresses, licorice root extract, lemon balm oil, manuka honey, or garlic can reduce its severity and provide symptom relief.
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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. It’s important to drink plenty of water so you don’t 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.
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.
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Suppressive Therapy For Recurrent Hsv
Suppressive therapy reduces frequency of genital herpes recurrences by 70%80% among patients who have frequent recurrences . Persons receiving such therapy often report having experienced no symptomatic outbreaks. Suppressive therapy also is effective for patients with less frequent recurrences. Long-term safety and efficacy have been documented among patients receiving daily acyclovir, valacyclovir, and famciclovir . Quality of life is improved for many patients with frequent recurrences who receive suppressive therapy rather than episodic treatment . Providers should discuss with patients on an annual basis whether they want to continue suppressive therapy because frequency of genital HSV-2 recurrence diminishes over time for many persons. However, neither treatment discontinuation nor laboratory monitoring is necessary because adverse events and development of HSV antiviral resistance related to long-term antiviral use are uncommon.
Valacyclovir 500 mg orally 2 times/day for 3 daysOR
Valacyclovir 1 gm orally once daily for 5 days
*Acyclovir 400 mg orally 3 times/day is also effective, but are not recommended because of frequency of dosing.
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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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.