How Should This Medicine Be Used
Acyclovir comes as a tablet, a capsule, and a suspension to take by mouth. It also comes as a delayed-release buccal tablet to apply to the upper gum of the mouth. The tablets, capsules, and suspension are usually taken with or without food two to five times a day for 5 to 10 days, starting as soon as possible after your symptoms begin. When acyclovir is used to prevent outbreaks of genital herpes, it is usually taken two to five times a day for up to 12 months. The delayed-release buccal tablet is usually applied with a dry finger as a one-time dose within 1 hour after itching, redness, burning or tingling cold sore symptoms begin but before the cold sore appears. Take or use acyclovir at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take or use acyclovir exactly as directed. Do not take or use more or less of it or take it more often or for a longer time than prescribed by your doctor.
Do not chew, crush, suck, or swallow the delayed-release buccal tablets. Drink plenty of liquids, if you have a dry mouth while using the delayed-release buccal tablets.
What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to acyclovir.
Do not let anyone else take or use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Implications For Research And Practice
The proportion of patients in the UK receiving antivirals following a diagnosis of zoster in primary care is low. This research highlights the problem of under-prescribing of antivirals for zoster in UK general practice even for groups where clear guidelines recommend treatment.
Further research is required to understand the basis for the low proportions given antivirals. This is particularly pertinent for older and immunocompromised patients. Controlled trials assessing the benefits of antivirals prescribed > 72 hours after rash onset would enable more detailed guidance for physicians and may increase antiviral prescribing if delay in presenting to GPs is a factor contributing to low antiviral use. Treatment guidelines could be reviewed to clarify which patients should be treated with antivirals when it is not possible to initiate treatment within 72 hours of rash onset.
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Lidocaine Cream And Patches
2017 study suggests that its one of the best-tolerated treatments for PHN.
PHN is a complication of shingles characterized by long-term nerve pain after your rash disappears. The CDC says that about 10 to 18 percent of people experience PHN after shingles.
Lidocaine is often administered in patches. The study linked above notes that up to 3 patches can be applied in a 12-hour window.
Questions To Ask Your Doctor
- Ive had chickenpox. Am I at risk of developing shingles?
- What is the best treatment for my shingles?
- The pain from shingles isnt going away. What can I do to make myself more comfortable?
- Im on treatment for shingles. When should I call my doctor if things dont get better?
- I have shingles and my children havent had the chickenpox vaccine. Should I get them vaccinated?
- Is the shingles vaccine right for me?
- Are there any risks associated with the shingles vaccine?
- Will my post-herpetic neuralgia ever go away?
- If Ive never had the chickenpox, should I still get the shingles vaccination?
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Topicals Are Not A Substitute For Medical Treatment
Topical products can help you manage your symptoms. But they arent a substitute for proper medical treatment.
Its important to visit your doctor if youre dealing with shingles. Your doctor can prescribe antiviral drugs and other medications that can shorten the duration of your infection and help you avoid severe complications.
The following creams may be able to help you manage shingles symptoms.
What Drugs Are Prescribed For Shingles
- An injection including corticosteroids and local anesthetics
If postherpetic neuralgia develops, similar medications are used to treat PHN pain.
While it may seem strange for your doctor to prescribe drugs for shingles that are commonly used to treat depression and prevent seizures, shingles is at root a nerve disorder, and these drugs work in different ways to calm overactive nerves.
Antiepileptics in general are thought to reduce the ability of the neurons to fire at high frequency, says Sangeetha Kodoth, MD, an allergist and immunologist with Allergy Specialists of Knoxville in Tennessee.
Its believed that tricyclic antidepressants an older class of antidepressants work by increasing the levels of the neurotransmitters serotonin and norepinephrine, which then modify pain response.
Antibacterial agents may also be prescribed if a bacterial infection occurs with the shingles rash.
Before taking any medication for shingles, be sure to talk to your doctor about possible side effects.
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Valacyclovir For Shingles: How Effective Is It
Shingles, like other herpes viruses, is a lifelong infection and there is no cure. However, treatments like antivirals can decrease both the length and severity of your outbreak. Antivirals are most effective if started as soon as possible and include medications such as acyclovir, valacyclovir, and famciclovir.
Can I Give Shingles To Others
No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:
- Anyone who has never had chickenpox
- Babies under 12 months old
- Very sick people
Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.
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What Are The Symptoms Of Shingles
The initial symptoms of shingles include:
- a burning, tingling or itching sensation
- a stabbing sensation
- numbness in the affected area of the body
- sensitivity to light
- fever and/or headache
Two to 3 days after these symptoms appear, a painful rash will appear on the sensitive area of skin, usually on one side of the body in the area of one skin nerve .
At first this rash consists of painful red bumps that quickly develop into fluid-filled blisters, which will eventually have a crusty surface. The rash can last for 10 to 15 days.
How Long Do You Need To Take Antiviral Drugs
Treatment length varies depending on the antiviral drug and viral infection. You may need one dose of an IV drug or a week of oral medicine.
People who have chronic ailments like HIV may take daily antivirals for life. This drug regimen keeps the virus from becoming active. It can prevent the virus from infecting others.
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How Should I Take Zovirax
Take Zovirax exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Start taking Zovirax as soon as possible after the first appearance of symptoms .
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Shake the oral suspension before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device .
Acyclovir doses are based on weight . Your dose needs may change if you gain or lose weight.
Drink plenty of water while you are taking Zovirax to keep your kidneys working properly.
Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses may increase the risk of your virus becoming resistant to medication.
Lesions caused by herpes viruses should be kept as clean and dry as possible. Wearing loose clothing may help to prevent irritation of the lesions.
Store at room temperature away from moisture and heat.
What Are Common Side Effects Of Shingles Medication
Gastrointestinal side effects are common across shingles medications. These include nausea, diarrhea, upset stomach, and vomiting. Its important to stay hydrated while taking medications that cause these side effects, as dehydration could be more dangerous than the virus itself.
This is not a full list of side effects. Ask a healthcare professional, such as your physician or pharmacist, for more details regarding the possible side effects of your particular medication.
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How Does Shingles Spread
Someone with shingles can pass the virus to someone who hasnt had chickenpox or shingles before. That person is likely to contract chickenpox first. Then, the virus may reactivate later with symptoms of shingles.
The virus cannot be passed to someone who has already had chickenpox because they already have the virus. If they experience shingles, its because they already had the virusnot because they came into contact with you.
You can go to work, school, and other public places with shingles as long as youre otherwise healthy. However, you should take precautions and keep the shingles rash covered, regularly wash your hands, and avoid at-risk people. Infants, children, pregnant women, and people with weak immune systems are at higher risk for contracting a virus, like shingles, than other people.
Home Remedies And Lifestyle
In addition to triggering an uncomfortable rash, shingles can cause symptoms that are similar to those of other viral infections.
While prescription and over-the-counter drugs can help, one of the most important things you can do while dealing with the illness is to take good care of yourself. If you’re caring for someone else who has shingles, “creature comforts” can be enormously soothing.
Verywell / Laura Porter
Integrate these basic tactics into even the busiest daily routine:
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Acyclovir May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- numbness, burning, or tingling in the arms or legs
- temporary inability to move parts of your body
- shaking of a part of your body that you cannot control
- loss of consciousness
Acyclovir may cause other side effects. Call your doctor if you have any unusual problems while you are taking or using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
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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Who Shouldnt Take Antiviral Medications
Antivirals are relatively safe medicines. Children as young as two weeks, as well as pregnant and breastfeeding individuals, can take certain antiviral medications. Guidelines for who shouldnt take antivirals vary depending on the drug. Your healthcare provider can determine whether an antiviral medicine is safe for you.
A note from Cleveland Clinic
Antiviral medications can treat certain viruses, putting an end to symptoms. For people with chronic viral infections, antiviral drugs can stop the virus from multiplying and causing problems. The medicine also lowers your chances of giving the virus to others. Your healthcare provider may prescribe an antiviral as a preventive measure if you have a known viral exposure. Taking antiviral medicines for a long time, or failing to take them as prescribed, can lead to antiviral resistance.
Last reviewed by a Cleveland Clinic medical professional on 05/11/2021.
References
What To Do If You Think You Have Shingles
If you suspect that you have shingles, its important to visit a healthcare professional as soon as possible. According to the American Academy of Dermatology , treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain.
Antiviral medications or other medications only available by prescription can shorten the duration of your shingles or lessen the severity.
If a cream or other topical isnt reducing your pain, its a good idea to visit your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.
If a product is making your symptoms worse, its important to stop taking it right away.
You may be able to reduce your symptoms using home remedies while youre waiting to see a healthcare professional. These include applying a wet cold compress or taking a cool bath.
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Can Valacyclovir Treat Shingles
Yes. Valacyclovir is an FDA-approved treatment for herpes zoster . It decreases the duration and severity of symptoms . It should be started as soon as possible after the rash starts. You will get the best response if you take the medication within 72 hours of the rash appearing .
Data shows that even if valacyclovir is started more than 72 hours after a rashs appearance, there can still be some benefit . Sometimes, depending on your pain level, your healthcare provider may recommend pain medication or over-the-counter remedies along with valacyclovir. As with other herpes viruses, valacyclovir does not cure shinglesit can make your current episode less painful and resolve faster if started right away.
What Other Drugs Will Affect Valacyclovir
Valacyclovir can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine for high blood pressure, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines .
Other drugs may interact with valacyclovir, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
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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.
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.
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How To Use Famciclovir
Read the Patient Information Leaflet if available from your pharmacist before you start taking famciclovir and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food, usually 2 to 3 times a day or as directed by your doctor.
This medication works best when started at the first sign of an outbreak, as directed by your doctor. It may not work as well if you delay treatment.
The dosage is based on your medical condition and response to treatment.
This medication works best when the amount of drug in your body is kept at a constant level. Take this drug at evenly spaced intervals. To help you remember, take it at the same times each day.
Continue to take this medication until the full prescribed amount is finished. Do not change your dose, skip any doses, or stop this medication early without your doctor’s approval.
Tell your doctor if your condition persists or worsens.
Comparison With Existing Literature
Studies from the US, Italy, and Australia report higher proportions of patients with herpes zoster receiving antiviral prescriptions. A retrospective study of healthcare records in Italy between 2003 and 2005 found 78% of 3260 immunocompetent patients with herpes zoster aged 50 years received antivirals.15 In Australia analysis of healthcare records between 20002006 showed that 73.5% of 379 incident zoster cases aged 50 years received antivirals16 and a similarly high proportion was found in the US where 71.3% of 8741 newly diagnosed zoster adults received antivirals 17 both studies included immunosuppressed and immunocompetent individuals. In contrast, data from a large database of general practice records in the Netherlands in 2001 found 22.5% of 1129 patients with herpes zoster aged 44 years received antivirals.18 Observed variation in prescribing patterns between countries may reflect differences in healthcare systems or distribution of patients with characteristics more/less likely to get antivirals in study populations, or to variations in data quality.
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