What Medications Are Used For Shingles

Treatment For Shingles Rash And Pain

Medications and lifestyle changes can provide relief.

Despite the availability of a highly effective vaccine, an estimated 1 million Americans develop shingles each year.1 Early diagnosis and treatment are key to limiting the severity of the outbreak as well as its associated complications, including nerve damage. There are also simple at-home remedies that can help patients stay as comfortable as possible.

Antiviral medications should be started within 72 hours of the first shingles symptoms. The three antivirals most often prescribed are acyclovir, valacyclovir, and famciclovir. They help the shingles rash crust over, dry up, and heal, shortening the course of the infection.

Pain is a major factor with shingles. Patients can consult with their health care provider on over-the-counter and prescription options to manage it. Nonsteroidal anti-inflammatory drugs like ibuprofen, naproxen, and acetaminophen can be effective, while prescription glucocorticoids such as prednisone can help with more aggressive pain. Short-term usage of opioid pain medicationlike oxycodone or hydrocodone/acetaminophen is reserved for the highest levels of pain.

Shingles typically lasts between 2 and 6 weeks patients are usually confined to their home for the duration both for their own comfort and to prevent spreading the virus to others. There are a number of simple steps they can take to promote healing and increase their comfort level.

References

What Is The Best Medication For Shingles

Your healthcare provider will determine the best medication for your case of shingles based on your symptoms, medical history, and response to shingles treatment. Heres an overview of the popular shingles medications that your doctor may prescribe.

Dosage is determined by your healthcare provider based on your medical condition, response to treatment, age, and weight.

Other possible side effects exist. This is not a complete list.

Treatment If The Condition Gets Worse

In some cases, shingles causes long-term complications. Treatment depends on the specific complication.

• Post-herpetic neuralgia is persistent pain that lasts months or even years after the shingles rash heals. Certain medicines, such as anticonvulsants, antidepressants, and opioids, can relieve pain. Most cases of PHN resolve within a year.
• Disseminated zoster is a blistery rash over a large portion of the body. It may affect the heart, lungs, liver, pancreas, joints, and intestinal tract. Treatment may include both antiviral medicines to prevent the virus from multiplying and antibiotics to stop infection.
• Herpes zoster ophthalmicus is a rash on the forehead, cheek, nose, and around one eye, which could threaten your sight. You should seek prompt treatment from an ophthalmologist for this condition. Treatment may include rest, cool compresses, and antiviral medicines.
• If the shingles virus affects the nerves originating in the brain , serious complications involving the face, eyes, nose, and brain can occur. Treatment depends on the nature and location of the complication.

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Help Is Available For Phn

Fortunately,early treatment for shingles can lower your chances of getting PHN.

For some people, the pain becomes refractory, or resistant to treatment, explains Dr. Rosenquist. So we want to treat shingles as fast as we can ideally as soon as somebody feels a tingling or burning sensation, even before a rash develops.

Sheadds that whenever nerve pain is involved, some people respond to treatment andsome dont.

However,medications taken orally or injected that can target the affected nerves may beable to stun the nervous system into behaving properly. That meanstransmitting the appropriate signal to the brain.

Prevent Shingles Or Another Shingles Outbreak:

• A vaccine may be given to help prevent shingles. You can get the vaccine even if you already had shingles. The vaccine comes in 2 forms. A 2-dose vaccine is usually given to adults 50 years or older. A 1-dose vaccine may be given to adults 60 years or older.
• The vaccine can help prevent a future outbreak. If you do get shingles again, the vaccine can keep it from becoming severe. Ask your healthcare provider about other vaccines you may need.

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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.

• NSAIDs such as ibuprofen

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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Is There A Vaccine Against Shingles

Shingix is currently the only shingles vaccine available in the United States. Its given to people over age 50.

Previously, an additional vaccine, Zostavax, was used, but it was phased out in the United States as of November 2020.

According to the CDC, two doses of Shingrix are over 90 percent effective at preventing shingles. Youll retain at least 85 percent protection for 4 years after being vaccinated.

If you get shingles after being vaccinated, your symptoms will likely be less severe. Youll also have a lower chance of developing postherpetic neuralgia a complication where pain remains even after a shingles rash goes away.

Shingles usually follows a pattern of development. It typically progresses with the following symptoms:

• First, you may notice a tingling or burning sensation in your skin.
• One to 5 days later a rash appears as small red spots.
• Fluid-filled blisters develop a few days later.
• After 7 to 10 days, the lesions crust over.
• The rash disappears over the next 2 to 4 weeks.

In some cases, pain may persist for several months or even years after the rash has disappeared. This complication, known as postherpetic neuralgia , can be severe enough to affect your quality of life.

Certain antiseizure medications can help manage the pain. Gabapentin and pregabalin are two that are commonly used.

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If You Have More Than One Area Of Blisters What Can You Expect If You Go To The Hospital

Its important to note that most people with shingles dont need to be in a hospital, but if you do:

• Youll be in a contact isolation room.
• The door will be kept closed.
• A sign on your door will remind people who have never had chickenpox or the vaccine not to enter.
• The sign will also remind staff to wear gowns and gloves when entering the room.

Is A Vaccine Available To Prevent Shingles

Two vaccines are available in the United States to reduce your chance of developing shingles and postherpetic neuralgia. One vaccine, Zostavax®, has been available since 2006. The second vaccine, Shingrix®, has been available since 2017. Shingrix is recommended as the preferred vaccine by the Advisory Committee on Immunization Practices, a group of medical and public health experts.

Shingrix is given as a two-dose shot in your upper arm. You should receive the second dose two to six months after receiving the first. Shingrix has been shown to be more than 90% effective in preventing shingles and postherpetic neuralgia. Its effectiveness remains above 85% for at least four years after receiving the vaccine.

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Are There Natural Ways To Boost Your Immune System To Help Lessen The Chances Of Developing Shingles

Stress is a risk factor for developing shingles, so limiting your stress can be helpful. Try meditation, yoga or other relaxation methods.

Other things you can do include:

• Eat a healthy diet.
• Aim for seven to nine hours of sleep each night.
• Dont smoke or use tobacco products.

These are all tips for an overall healthy lifestyle, not just for reducing your chance of getting shingles.

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.

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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.

Treat Your Body And Mind

You can get worn down mentally when youâre in constant pain. Stress can make it seem even worse. Self-care starts with treating your rash, but donât stop there. Your mind and emotional state need to be cared for as well.

5. Stick with good habits: Your bodyâs working hard to fight the varicella-zoster virus that causes shingles. To give it the right support, you can:

• Eat nutritious food and have regular meals. Ask someone to make a run to the grocery store for fresh fruit and such if youâre not up for it.
• Try to get a good nightâs sleep and rest anytime you need to.
• Do gentle exercises, such as walking or stretching. Light activity can help take your mind off the pain. Keep it simple though, and check with your doctor if youâre trying something new.

6. Distract yourself: Sometimes, the best thing you can do is to put your focus elsewhere. Here are a few things to try:

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How To Use Valacyclovir

Read the Patient Information Leaflet if available from your pharmacist before you start taking valacyclovir and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take valacyclovir by mouth, with or without food, as directed by your doctor. Drink plenty of fluids while taking this medication to lower the chance of side effects.

The dosage and length of treatment are based on your type of infection, medical condition, and response to treatment. For treating chickenpox in children, the dosage is also based on weight.

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. For shingles or chickenpox, start taking valacyclovir at the first symptom or as soon as possible after the rash appears. For cold sores or genital herpes, start taking this medication at the first sign or as soon as you feel tingling, itching, or burning.

Valacyclovir works best when the amount of medicine 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 time 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.

Rebooting The Nervous System

Its like restarting a computer, Dr. Rosenquist says. When its running slowly or acting weird, you restart it. We are trying to turn that nerve off. When it comes back on, hopefully, it will send an appropriate transmission as opposed to a pain transmission.

Treatmentoptions for PHN patients include:

Patientswith refractory PHN rarely need opioid pain medication. However,you should be evaluated by a physician. We cant make a blanket statement abouttreatment. It is individualized, she says.

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Where Does Shingles Come From

When you have chickenpox as a child, your body fights off the varicella-zoster virus and the physical signs of chickenpox fade away, but the virus always remains in your body. In adulthood, sometimes the virus becomes active again. This time, the varicella-zoster virus makes its second appearance in the form of shingles.

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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Liquid Dimethyl Sulfoxide And Idoxuridine

Idoxuridine is an antiviral medication approved in Europe for treating shingles.

One 2015 publication suggested frequent application of 5 to 40 percent idoxuridine dissolved in DMSO may speed up the healing time of shingles. However, in the United States, idoxuridine is only FDA-approved to treat keratitis, a herpes simplex virus infection of the cornea of your eye.

What Brings On An Attack Of Shingles

Its difficult to predict when a shingles episode might happen again. However, there are some risk factors you should consider.

• Unhealthy lifestyle
• Acute on chronic stress

The first risk factor is age. If you are above the age of 50, ask your doctor about the shingles vaccine. In addition to being an effective shingles treatment, this vaccine is used to prevent shingles.

The second risk factor of shingles is immunity. If your immune system is weakened by illness or medication, you are at risk for contracting shingles or experiencing another shingles episode. Fortunately, you can naturally strengthen your immune system with the right diet and vitamins.

Citrus fruits, green vegetables, organic meat, eggs, whole grains, and dairy products are all part of a healthy diet. You should avoid sugar, refined carbohydrates, saturated fat, and arginine-rich foods, like nuts and seeds.

Additionally, take a multivitamin that includes vitamin A, B-12, C, and E. The amino acid lysine is also protective against infection. Many people over the age of 60 are deficient in zinc, selenium, and vitamin D. You may need to incorporate these supplements into your daily routine as well. Ask your healthcare provider for recommendations as to which vitamins and supplements you need.

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Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later

After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.

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.

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