Antiviral for Herpes
There are three primary prescription antivirals for herpes. They are Zovirax, Famvir, and Valtrex.
There are three pharmaceutical drugs that are routinely prescribed for genital herpes, the herpes simplex- 2 (HSV- 2) virus. All three of the drugs work as antivirals, meaning, they kill the herpes virus.
All three of these antivirals are taken by mouth, and are proven to be effective against herpes. According to WebMD.com, Famvir and Valtrex are easier to absorb in the stomach, so they do not have to be taken as often as Zorifax must be taken.
Any of the three prescription antivirals for genital herpes can be recommended when a patient is experiencing an outbreak of the herpes simplex- 2 virus for the first time.
The drugs are also prescribed when patients are experiencing multiple outbreaks per year, and they wish to reduce both the symptoms of the disease and the frequency of the outbreaks.
Pregnant women who have had genital herpes may want to use the antivirals to prevent possible outbreaks during pregnancy.
People who either have an auto-immune disease or have compromised immune systems for any reason may want to use one of these antivirals for herpes as a precautionary measure.
Finally, people who have had genital herpes outbreaks in the past and want to prevent possibly spreading the disease to a new sexual partner may elect to use an antiviral for extra protection.
Genital herpes, whether caused by HSV- 1 or HSV- 2, has to be considered a chronic, life-long condition. The Centers for Disease Control and Prevention states that at least fifty million people in the United States alone are infected with the herpes simplex- 2 virus.
The symptoms for genital herpes can be so mild that they can go completely missed. An infected person may not know they are carrying the virus until his or her partner becomes infected and is diagnosed.
Because of this, patients should realize treatment will be ongoing.
In the doctor’s office, a lab test is performed to determine whether the patient has HSV-1 or HSV- 2, because there has been a sharp increase in HSV-1 genital herpes in younger populations. A lab test for syphilis is usually performed as well.
Patients who test “negative” for genital herpes must understand that these lab results may be a “false negative.” This is because the herpes simplex virus is intermittent- it flares up and goes dormant.
Anyone who suspects herpes should be retested if the results come back “negative.”
The following dosages are recommended for oral antivirals for the first outbreak of herpes simplex virus- 2:
Since the first outbreak of herpes is usually the worst, subsequent outbreaks are usually more mild and less frequent.
However, even if the virus seems to go completely “silent,” the herpes virus is still in the body and can possibly erupt in periods of stress and under other conditions.
Because of this, doctors often recommend that herpes patients undergo what is called suppressive antiviral therapy.
This type of drug therapy reduces the intensity and recurrence of genital herpes by 70- 80% in people who have frequent episodes of the disease. Some patients report not ever having another symptom of genital herpes again.
Zovirax (acyclovir) has been proven to be safe and effective for up to six years of use, while Famvir (famciclovir) and Valtrex (valacyclovir) have been proven to be safe and effective for up to one year.
Quality of life is reported to be better with suppressive therapy rather than with using the antiviral drugs only during outbreaks, according to the Centers for Disease Control and Prevention.
Suppressive therapy should be considered to be a part of an overall protocol to treat genital herpes. Couples should still use condoms during all sexual activity and should refrain from sex during outbreaks.
People with multiple partners should also consider suppressive therapy.
Listed below are a list of facts and side effects of each antiviral drug, from Drugs.com:
Greater than 10% of Zovirax users have experienced the following side effects:
Greater than 10% of Famvir users have reported the following side effects:
Here are a few warnings about Valtrex:
Greater than 10% of Valtrex users have experience the following side effects:
WebMD.com, “Antiviral Medications for Genital Herpes”
HIV Insite. University of California, San Francisco.edu, Xu F, Sternberg MR, Kottiri BJ, et al. "Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States." Journal of the American Medical Association 2006;296:964–73.
Sexually Transmitted Infections. British Medical Journal.com, Scoular A. "Using the evidence base on genital herpes: optimizing the use of diagnostic tests and information provision." Sexually Transmitted Infections 2002;78:160–5.
Sexually Transmitted Infections. British Medical Journal.com, Ryder N, Jin F, McNulty AM, et al. "Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992–2006." Sexually Transmitted Infections 2009;85:416–9.
Centers for Disease Control and Prevention.gov, Leone PA, Trottier S, Miller JM. "Valacyclovir for episodic treatment of genital herpes: a shorter 3-day treatment course compared with 5-day treatment." Clinical Infectious Diseases 2002;34:958–62.
Centers for Disease Control and Prevention.gov, Wald A, Carrell D, Remington M, et al. "Two-day regimen of acyclovir for treatment of recurrent genital herpes simplex virus type 2 infection." Clinical Infectious Diseases 2002;34:944–8.
Clinical Infectious Diseases. Oxford Journals.org, Aoki FY, Tyring S, az-Mitoma F, et al. "Single-day, patient-initiated famciclovir therapy for recurrent genital herpes: a randomized, double-blind, placebo-controlled trial." Clinical Infectious Diseases 2006;42:8–13.
Clinical Infectious Diseases. Oxford Journals.org, Chosidow O, Drouault Y, Leconte-Veyriac F, et al. "Famciclovir vs. acyclovir in immunocompetent patients with recurrent genital herpes infections: a parallel-groups, randomized, double-blind clinical trial." British Journal of Dermatology 2001;144:818–24.
Clinical Infectious Diseases. Oxford Journals. org, Bodsworth NJ, Crooks RJ, Borelli S, et al. "Valaciclovir versus acyclovir in patient initiated treatment of recurrent genital herpes: a randomized, double blind clinical trial." International Valaciclovir HSV Study Group. Genitourinary Medicine 1997;73:110–6.
Pubmed.gov, Fife KH, Barbarash RA, Rudolph T, et al. "Valaciclovir versus acyclovir in the treatment of first-episode genital herpes infection. Results of an international, multicenter, double-blind, randomized clinical trial." The Valaciclovir International Herpes Simplex Virus Study Group. Sexually Transmitted Diseases 1997;24:481–6.
Pubmed.gov, Diaz-Mitoma F, Sibbald RG, Shafran SD, et al. "Oral famciclovir for the suppression of recurrent genital herpes: a randomized controlled trial." Collaborative Famciclovir Genital Herpes Research Group. Journal of the American Medical Association 1998;280:887–92.
Pubmed.gov, Mertz GJ, Loveless MO, Levin MJ, et al; Collaborative Famciclovir Genital Herpes Research Group. "Oral famciclovir for suppression of recurrent genital herpes simplex virus infection in women: a multicenter, double-blind, placebo-controlled trial." Archives of Internal Medicine 1997;157:343–49.
Centers for Disease Control and Prevention.gov, Reitano M, Tyring S, Lang W, et al; International Valaciclovir HSV Study Group. "Valaciclovir for the suppression of recurrent genital herpes simplex virus infection: a large-scale dose range-finding study." Journal of Infectious Diseases 1998;178:603–10.
Centers for Disease Control and Prevention.gov, Romanowski B, Marina RB, Roberts JN. "Patients‘ preference of valacyclovir once-daily suppressive therapy versus twice-daily episodic therapy for recurrent genital herpes: a randomized study." Sexually Transmitted Diseases 2003;30:226–231.
New England Journal of Medicine.org, Corey L, Wald A, Patel R, et al. "Once-daily valacyclovir to reduce the risk of transmission of genital herpes." New England Journal of Medicine 2004;350:11–20.
Centers for Disease Control and Prevention, Goldberg LH, Kaufman R, Kurtz TO, et al; "Acyclovir Study Group. Long-term suppression of recurrent genital herpes with acyclovir: a 5-year benchmark." Archives of Dermatology 1993;129:582–7.
Pubmed.gov, Wald A, Selke S, Warren T, et al. "Comparative efficacy of famciclovir and valacyclovir for suppression of recurrent genital herpes and viral shedding." Sexually Transmitted Diseases 2006;33:529–33.
American Social Health Association.org, “Frequently Asked Questions About Genital Herpes”
Drugs.com, “Acyclovir Side Effects”
Drugs.com, “Famvir Side Effects”
Drugs.com, “Valtrex Side Effects”
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