How Do Other Antivirals Work
Antivirals are medications used in the treatment and prevention of various types of viral infections. Other antivirals are medications that are not categorized into any specific classes of antivirals. Most of the other antivirals block viral replication by interfering with DNA polymerase, an enzymevital for DNA synthesis and viral replication.
Some of the other antivirals are active drugs that directly take effect, while some are prodrugs, which release the active form of the drug after being metabolized. Other antivirals include the following:
- Acyclovir: Acyclovir is an active drug effective against herpes simplex virus 1 and 2 that cause genital and oral herpes, and varicella-zoster virus which causes chickenpox and shingles. Acyclovir gets incorporated into the viral DNA, inhibits DNA polymerase, and terminates the DNA chain to prevent viral replication.
- Brincidofovir: Brincidofovir is a prodrug approved for treating human smallpox, a disease caused by the variola virus. Although smallpox has been eradicated with vaccination, concerns that the variola virus can be used as a bioweapon remain.
- Brincidofovir penetrates cells and releases cidofovir which is metabolized to produce cidofovir diphosphate, the active drug that selectively inhibits orthopoxvirus DNA polymerase-mediated viral DNA synthesis and reduces the rate of viral DNA synthesis.
- Herpes zoster infection , which is caused by reactivation of VZV
- Herpetic keratitis – Orphan
Topical Otc Treatments For Genital Herpes
Several over-the-counter topical options are available for genital herpes treatment, but evidence suggests they arent all effective.
Start with a few simple DIY topical compresses. Research shows that topical therapy can effectively alleviate symptoms of genital herpes outbreaks and even contribute to the prevention of outbreaks when used promptly.
Here are a few tried-and-true natural compress ideas to get you started:
- -Dry, warm compress using warmed rice in a sock
- -Cold compress using an ice pack or soft washcloth filled with ice
- -Baking soda paste
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When To See A Medical Provider
Patients should get in contact with their doctors as soon as possible if they suspect they are experiencing an initial outbreak of genital herpes, or are experiencing especially severe and frequent cold sore outbreaks.
In these cases, the sooner your doctor can test you for herpes and prescribe you medication, the better.
Following an initial diagnosis, you should work with your doctor to make sure that you have the right antiviral medications on hand to treat later outbreaks as soon as they happen.
Your doctor can also help set you up with a preventative course of antiviral treatment.
Once on medication, you should talk to your doctor if you are experiencing any serious side effects.
Its especially important to consult your doctor about initial or recurrent genital herpes outbreaks if you are pregnant, or trying to become pregnant.
In these cases, doctors use special medication and treatment strategies to not only support their pregnant patients, but also to safeguard the health of the babies.
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What Are The Symptoms Of Herpes Simplex
Many people with the infection never experience any herpes symptoms. If you do notice symptoms, youll experience them differently depending on whether youre having your first herpes outbreak or a repeat outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms dont last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
People who do have herpes symptoms may experience:
- Cold sores around their lips, mouth or tongue. They may look crusty or like fluid-filled blisters.
- Tingling, itching or burning.
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.
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What Other Drugs Interact With Acyclovir
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of this medicine or any drug before seeking medical advice from your doctor, healthcare provider or pharmacist first. To do so may result in serious consequences or side effects.
Severe Interactions of Acyclovir include:
- There are no severe interactions from the use of acyclovir.
Serious Interactions of Acyclovir include:
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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Valacyclovir Vs Acyclovir Vs Famciclovir: The Facts
Medically reviewed by Patrick Carroll, MD
There are several drugs used to treat herpes, all of which are antiviral medications. Some of the most popular, effective and widely used herpes medications currently available are valacyclovir , acyclovir and famciclovir . All of these drugs work through a similar mechanism, and all have their place in treating cases of HSV-1 and HSV-2.
In this guide, comparing valacyclovir vs. acyclovir vs. famciclovir to explain which one is the best choice for treating and managing the virus.
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.
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Which Herpes Medication Is Best
In the war between valacyclovir vs. acyclovir vs. famciclovir, the truth is, there is no best herpes medication. All three of the drugs are safe and proven to be effective as treatments for HSV-1, HSV-2, shingles and other forms of the herpes virus.
If you think you might have herpes, the best approach is to speak to your doctor about treatment options. Your doctor will be able to provide advice on the most effective drug for treating herpes based on your symptoms, immune system, lifestyle and overall health.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standardshere.
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Where Can I Get Medications For Herpes
The most common antiviral medications used to manage herpes simplex symptoms are available by prescription. If you have symptoms such as a cold sore or genital herpes, call your doctors office. They will first diagnose if you have herpes simplex. Then they will prescribe an appropriate medication to manage your symptoms.
Only docosanol is an antiviral medication available over the counter as a cream to manage oral symptoms such as cold sores or fever blisters.
If you have mild symptoms from a recurring oral herpes infection, you may be able to use nonprescription methods or some home remedies to manage your symptoms.
Examples include:
- pain relievers such ibuprofen or acetaminophen to help with pain
- cold compress or ice to soothe burning or itching
- zinc oxide topical cream, which may help soothe itching or burning
Before trying over the counter medications or supplements, be sure to talk with your doctor or pharmacist about your symptoms.
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How Do Hsv Antivirals Work
Herpes simplex virus antivirals are used to treat herpes simplex virus 1 and 2 . Acyclovir is the antiviral most commonly used to treat HSV infections. It works by inhibiting DNAsynthesis and therefore prevents replication of the virus. HSV-1 is transmitted by oral-to-oral contact, mainly causes oral herpes known as cold sores, and may also cause genital herpes. HSV-2 is a sexually transmitted disease that causes genital herpes. Herpes infections are highly contagious oral and genital herpes is usually asymptomatic, and if symptomatic, painful blisters or ulcers appear at the site of infection. HSV-2 infection increases the risk of acquiring and transmitting human immunodeficiency virus infection.
Acyclovir is converted into acyclovir monophosphate by viral thymidine kinase enzyme, which is then converted into acyclovir triphosphate by the hostcell kinases. The formed ACV-TP competitively inhibits and inactivates HSV DNA polymerase and prevents viral DNA synthesis and replication of the virus.
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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.
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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.
What Are Medications For Genital Herpes
Acyclovir , famciclovir , and valacyclovir are examples of antiviral drugs that have been used to treat genital herpes. Because the first outbreak of herpes is usually the most severe, most doctors recommend treatment for the initial attack. With subsequent attacks, treatment is only useful if it is given prior to the outbreak or within the first 24 hours after the outbreak has started.
Suppressive treatment is also given for people who have more than six genital herpes outbreaks a year. With suppressive therapy, antiviral medications are taken continuously in order to lessen the frequency of recurrences.
Your doctor can help you decide whether antiviral drug treatment is right for you and can guide the choice of drug.
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One Option For Ongoing Therapy: Taking Drugs Regularly
Some people with genital herpes choose to take antiviral medication daily to reduce the number of symptom outbreaks they have. In some cases, daily therapy prevents outbreaks completely.
Numerous studies over the years have demonstrated the safety and effectiveness of all three of the approved antivirals used to treat genital herpes.
Studies have also shown that daily antiviral therapy reduces the rate of transmission from an HSV-2 infected person to an uninfected partner of the opposite sex.
Daily therapy also lowers the odds of infecting other people if you have multiple sex partners or if you are a man who has sex with men.
The drugs work both for people who have had herpes symptoms and for those whose blood tests show they have an HSV-2 infection but who have never had symptoms.
Some people choose to take antiviral drugs only as needed, for outbreaks that occur after the first one. For this to work, you need to start taking the medicine within one day of sores cropping up or during the time period that comes before some outbreaks.
During the prodrome, you may feel
- Burning in the area where the virus first entered your body
- Itching or tingling in that area
- Pain in your back, buttocks, thighs, or knees
Your doctor will probably give you a prescription you can fill and keep handy for timely use, and tell you to start taking the drugs just as soon as symptoms begin.
How Do You Get Herpes
Oral herpes can be spread through saliva, kissing, and skin-to-skin contact. HSV-1 can also cause genital herpes, if the genital areas are exposed to fever blisters or sores on the mouth or face, or through oral sex. Even though HSV-1 also never completely goes away, that strain of the virus causes fewer outbreaks over time in the genital areas than HSV-2.
Genital herpes can be transmitted through skin-to-skin contact and/or sexual intercourse of all types . Most people dont realize that sores from genital herpes can appear on the face as well as the genital area. Because the virus can spread any time contact occurs with a blister or sore, a condom doesnt always provide sufficient protection.
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To Use Buccal Acyclovir Follow These Steps:
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.
Related Resouruces For Herpes
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This article is not medical advice. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
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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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