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Antiviral for Herpes

There are three primary prescription antivirals for herpes. They are Zovirax, Famvir, and Valtrex.
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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.

The drugs are Zovirax (acyclovir), Famvir (famciclovir), and Valtrex (valacyclovir).

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.

When are antivirals for herpes prescribed?

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.

Diagnosing herpes

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.”

Taking antivirals for herpes

The following dosages are recommended for oral antivirals for the first outbreak of herpes simplex virus- 2:

Antiviral Dosages for Initial Outbreaks of Genital Herpes
Zovirax (acyclovir)- either 200 mg five times a day for a week to ten days, or 400 mg three times a day for a week to ten days
Famvir (famciclovir)- 250 mg three times a day for a week to ten days
Valtrex (valacyclovir)- one gram twice a day for a week to ten days

 

Suppressive antiviral therapy for herpes

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.

Dosages for Suppressive Therapy with Antivirals
Zovirax 400 mg twice a day
Famvir 250 mg twice a day (less effective for suppressive therapy than the other two antivirals)
Valtrex either 500 mg or 1000 mg once a day, depending on the number of outbreaks the patient is experiencing during the year

 

Comparing antivirals for herpes

Listed below are a list of facts and side effects of each antiviral drug, from Drugs.com:

Zovirax (acyclovir) Facts
Slows the growth of the herpes simplex virus
Used for suppression of genital herpes, shingles, oral herpes (cold sores), and chickenpox outbreaks
Does not cure herpes
Does not protect partners from becoming infected with herpes
FDA approved as safe during pregnancy
Do not take Zovirax while breastfeeding
Do not overdose
Drink plenty of water while taking Zovirax because the drug is hard on the kidneys

 

Greater than 10% of Zovirax users have experienced the following side effects:

Top Side Effects from Using Zovirax (acyclovir)
Vision changes
Dizziness
Nausea
Sensitivity to sunlight


Below are listed some important facts about Famvir:

Facts About Famvir (famciclovir)
Slows the growth of the herpes simplex virus
Used for suppression of genital herpes, shingles, and oral herpes (cold sores) outbreaks
Does not cure herpes
Does not protect partners from becoming infected with herpes
FDA approved as safe during pregnancy
Do not take Famvir while breastfeeding
May be taken with or without food
May impair thinking and reactions. Use caution while driving while taking Famvir

 

Greater than 10% of Famvir users have reported the following side effects:

Top Side Effects from Using Famvir (famciclovir)
Diarrhea
Gas
Headache
Nausea and vomiting
Fatigue


Listed below are several important facts about Valtrex:

Facts About Valtrex (valaciclovir)
Slows the growth of the herpes simplex virus
Used for suppression of genital herpes, shingles, oral herpes (cold sores) and chickenpox outbreaks
Does not cure herpes
Does not protect partners from becoming infected with herpes
FDA approved as safe during pregnancy
Do not take Valtrex while breastfeeding
Drink plenty of water, because Valtrex is hard on the kidneys
The pill is large

 

Here are a few warnings about Valtrex:

Warnings About Valtrex
Valtrex is very hard on the kidneys and can even cause kidney failure in some populations
Elderly populations show a greater risk for serious side effects when they take Valtrex for herpes zoster
Never give Valtrex to children without a doctor's approval and prescription specifically for the child

 

Greater than 10% of Valtrex users have experience the following side effects:

Top Side Effects from Using Valtrex (valaciclovir)
Nausea or stomach cramps
Headaches and dizziness 
Fatigue
Depression
Joint pain
Menstrual cramps
Rash
Stuffy nose and sore throat

Sources


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.

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