Drug Treatment For Genital Herpes
If you are infected with genital herpes, your doctor may prescribe oral antiviral drugs to help ease your symptoms during both a first episode and recurrent episodes. Your doctor may also suggest taking antiviral drugs daily as a suppressive therapy to reduce symptoms and protect partners.
Remember, though, that antiviral drugs do not wipe out the virus completely. It continues to live in your body, so if you stop taking the drugs that suppress it, you may have more frequent or more intense symptom outbreaks, and the risk of your transmitting the virus to others rises.
Three antiviral drugs, all taken by mouth, are used to treat genital herpes:
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How Is Genital Herpes Diagnosed
If you have a herpes sore, your dermatologist can often diagnose you by looking at the sore and taking a swab from the sore. A lab test can tell whether the sore contains the herpes simplex virus , which is what causes genital herpes.
If you dont have a sore or any symptoms, the Centers for Disease Control doesnt recommend testing for most people. You can learn whether you should be tested if you dont have symptoms at:
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Homeopathic Medicines For Shingles
Homeopathic treatment for shingles works in a gentle, yet effective manner to reduce the severity of the symptoms and also help clear up the infection rather than suppressing it. These medicines have no side effects and work very well for post-herpetic neuralgia.
There is no cure for shingles in the conventional system of Medicine medications are aimed to reduce the duration of shingles episode and to minimize the intensity of pain. Some commonly used medicines include
Antivirals: These do not treat shingles but are meant to reduce the severity and duration of the disease. They are not effective for postherpetic neuralgia. Side effects of antiviral medicines include nausea, dizziness, pain in stomach, mild skin rashes, joint pains, and they can also cause a sore throat.
Analgesics: Pain medications are used to treat mild to moderate pains in shingles. When the pain is severe, excessive intake of painkillers can cause side effects and trigger anxiety in a person.
Corticosteroids: Corticosteroids are indicated along with antivirals to reduce the pain and for postherpetic neuralgia. Prolonged usage of corticosteroids can cause immunosuppression.
Treatment For Genital 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.
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Antiviral Medicine Can Be Taken Daily
For some people, taking an antiviral medicine every day works best because they have:
A partner who doesnt have the virus
Even if you treat an outbreak, you can have new outbreaks. Some people have several outbreaks a year. If you have six or more outbreaks a year, your dermatologist may recommend taking an antiviral medicine every day.
Taken daily, this medicine can reduce how often you have an outbreak. Studies show its safe to take daily and can reduce outbreaks by 70% to 80%.
A partner who doesnt have the virus
If your partner doesnt have the virus that causes genital herpes, taking an antiviral medicine every day can decrease the risk of passing the virus to your sexual partner.
Even when taking medicine, you can still give your partner the virus. You can reduce this risk by skipping sex when you have sores and wearing a condom when you dont.
If you decide to take medicine daily, youll likely take it every day for at least one year. At the end of one year, your dermatologist should re-evaluate you to see if you still need to take an antiviral every day.
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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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.
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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.
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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Ranunculus Bulbosus: For Bluish Vesicles And Intense Itching
Ranunculus bulbosus for shingles is derived from the plant bulbous buttercup or St Anthonys Turnip. This is a perennially growing plant and belongs to the Buttercup family. Ranunculus bulbosus is prepared from the bulb of this plant. This plant is native of Western Europe and the northern Mediterranean coast. As an introduced weed it grows in eastern and western parts of North America.It is the principle medicine for treating Herpes zoster. It is indicated for herpetic eruptions with itching where the eruptions are vesicular and pustular. It is highly recommended for shingles with blue blisters that are filled with serum. There is an intense burning and itching that gets worse with contact.
What If I Forget A Dose Of Aciclovir
If you forget a dose of aciclovir, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, just skip the missed dose and continue with your next one as normal.
Never have 2 doses at the same time. Never have an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you.
You could also ask your pharmacist for advice on other ways to remember your medicines.
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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.
Risks And Side Effects
The three main treatments for herpes acyclovir, famciclovir, and valacyclovir are all FDA-approved drugs, though there are side effects and interactions to be aware of.
Common side effects of these antiviral drugs include headaches and nausea. Famciclovir can cause dizziness, confusion, or sleepiness.
Acyclovir and valacyclovir, which are very similar to each other, can cause your kidneys to stop working. If you have kidney problems, your doctor may prescribe a lower dose. These medications may interact with other drugs such as nonsteroidal anti-inflammatory drugs like ibuprofen, which may weaken kidney function.
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What Helps Herpes Sores Heal Faster
Keeping the sores clean, cool, and dry is beneficial to the healing process. Bandaging, heating, or picking at sores will irritate them and can extend their duration. The most effective method for shortening herpes outbreaks is a prescription antiviral medication like valacyclovir, famciclovir, or acyclovir.
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.
The frequency of genital herpes outbreaks slows down over time in many people.
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What Are The Treatment Options For Genital Herpes
Treatment with antiviral medication is a good idea the very first time people have an outbreak of genital herpes. Later outbreaks are often milder, and then medication isn’t always needed. Preventive treatment may be considered if the outbreaks are frequent.
Genital herpes may clear up on its own. But the symptoms are often more severe the first time you have an outbreak. Most people then use antiviral medication to relieve the symptoms and prevent complications. These medications include aciclovir, famciclovir and valaciclovir.
The Virus And Pathogenesis
HSV is a double-stranded DNA virus that may enter the host through abraded skin or intact mucous membranes.1 Epithelial cells are the initial targets. Once infected, these cells die, releasing clear fluid intradermally to form vesicles and merging with other cells to create multinucleated giant cells.
Retrograde transport through adjacent neural tissue to sensory ganglia leads to lifelong latent infection.1 Reactivation of the virus is triggered by local or systemic stimuli such as immunodeficiency, trauma, fever, menstruation, ultraviolet light and sexual intercourse.1–3 Although emotional stress is assumed to trigger HSV recurrence, recent research fails to show a definite causative role.4 Once reactivated, the virus is transported by the neuron back to the epithelium, where more replication occurs, and another outbreak ensues.
HSV exists as two separate types, labeled 1 and 2, which have affinities for different body sites.2 Ninety percent of infections caused by HSV-2 are genital, and 90 percent of those caused by HSV-1 are oral the reason for this division is unknown.5 In addition, oral HSV-1 infection recurs more frequently than oral HSV-2, and genital HSV-2 recurs more often than genital HSV-1.
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How Is Genital Herpes Treated
There is no cure for genital herpes, but treatment can help. Self-care can relieve symptoms and help sores heal. Medicine can shorten an outbreak and also relieve symptoms.
Self-care for genital herpes
Dermatologists recommend the following self-care tips for their patients who have an outbreak:
Keep sores clean and dry.
Wear loose-fitting cotton underwear.
If an area feels painful, place a cold compress on it.
To cleanse and sooth painful sores, reduce itchiness, or decrease tenderness, take an Epsom salts bath. You want to soak for 10 to 20 minutes.
Medicine for genital herpes
To treat genital herpes, your dermatologist may prescribe one of these antiviral medicines:
Taking medicine is recommended for anyone who has a weakened immune system. With a weakened immune system, your body will likely need help to get rid of sores and symptoms. Without medicine, sores may not clear and symptoms can linger. You should continue taking the medicine until all sores have completely healed.
Medicine works best when started within 24 hours of getting a herpes sore.
If one of the medicines listed above fails to bring relief, you may need another medicine. For a severe infection, getting acyclovir through an IV may be necessary. Other antiviral medicines may also be an option.
Management Of Herpes Zoster And Postherpetic Neuralgia
SETH JOHN STANKUS, MAJ, MC, USA, MICHAEL DLUGOPOLSKI, MAJ, MC, USA, and DEBORAH PACKER, MAJ, MC, USA, Eisenhower Army Medical Center, Fort Gordon, Georgia
Am Fam Physician. 2000 Apr 15 61:2437-2444.
Patient information: See related handout on shingles, written by the authors of this article.
Herpes zoster results from reactivation of the varicella-zoster virus. Unlike varicella , herpes zoster is a sporadic disease with an estimated lifetime incidence of 10 to 20 percent. The incidence of herpes zoster increases sharply with advancing age, roughly doubling in each decade past the age of 50 years. Herpes zoster is uncommon in persons less than 15 years old. In a recent study,1 patients more than 55 years of age accounted for more than 30 percent of herpes zoster cases despite representing only 8 percent of the study population. In this same study, children less than 14 years old represented only 5 percent of herpes zoster cases.
The normal age-related decrease in cell-mediated immunity is thought to account for the increased incidence of varicella-zoster virus reactivation. Patients with disease states that affect cell-mediated immunity, such as human immunodeficiency virus infection and certain malignancies, are also at increased risk. Chronic corticosteroid use, chemotherapy and radiation therapy may increase the risk of developing herpes zoster.
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