Although there is no cure for herpes, antiviral medications can reduce the frequency and duration of herpes outbreaks. Medications are available to treat oral and genital herpes outbreaks caused by both herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Antiviral medications may be used to treat the initial herpes outbreak or single recurring outbreaks, or they may be taken regularly in an effort to prevent recurring outbreaks (suppressive therapy). Even if you are taking medication, you may still pass the virus to others, so it is important to avoid sexual activity during an outbreak and use latex condoms in between outbreaks.
Acyclovir (Zovirax)
Acyclovir (Zovirax) is an antiviral medication that has shown the most benefit in suppressing outbreaks among individuals experiencing six or more genital herpes recurrences per year and in treating the symptoms of primary genital herpes outbreaks. It may also be prescribed for the treatment of oral herpes.
Acyclovir is available in generic drug form, so it is the cheapest alternative of the existing antiviral medications. It is available in oral, intravenous, and topical form; however, the topical form is not thought to be effective in treating herpes.
Acyclovir is most effective when taken as soon as possible after the initial pain and burning sensations of an outbreak are detected. Mayo Clinic guidelines indicate that adults and children age 12 and older are typically prescribed 200 mg five times a day for 10 days in the treatment of oral herpes. Adults and children 12 and older may be administered 200 to 400 mg two to five times a day for five days or up to 12 months (suppressive therapy) for the treatment or prevention of recurrent outbreaks.
Common side effects of acyclovir include a general feeling of illness or discomfort. Less commonly, some may experience diarrhea or headache.
Valacyclovir (Valtrex)
Valacyclovir (Valtrex) is an antiviral medication that is administered orally (in tablet form) and is effective in suppressive therapy for those who experience frequent recurring outbreaks. It may also be used to treat the pain and symptoms associated with primary genital herpes outbreaks and oral herpes.
Valacyclovir is a derivative of acyclovir that is more efficiently absorbed into the blood stream and therefore can be taken less frequently. For treatment of a first outbreak, it works best if taken within 48 hours of the initial symptoms of pain, tingling or burning. When taking for recurrent outbreaks, it is most effective when taking within 24 hours of initial symptoms.
According to the Mayo Clinic, adults may be prescribed up to 2000 mg to be taken twice a day for one day for the treatment of oral herpes. For the treatment of a primary herpes outbreak, adults are typically prescribed up to 1000 mg to be taken two times a day for 10 days. Treatment of recurrent herpes outbreaks are generally treated with 500 mg two times a day for three days in adults, and adults on suppression therapy who are trying to prevent recurrent outbreaks may be prescribed between 500 and 1000 mg to be taken once a day on an ongoing basis.
Common side effects of valacyclovir include problems concentrating, sleep disturbances, body aches, muscle pain or stiffness, cramps, joint pain, loss of voice, bleeding, and nasal or ear congestion.
Famciclovir (Famvir)
Famciclovir (Famvir) is an orally-administered antiviral primarily used to treat or suppress recurrent genital herpes outbreaks and is commonly prescribed to immunocompetent (able to produce an immune response) HIV-infected individuals with recurrent genital herpes. It is known to reduce asymptomatic viral shedding, which occurs when the virus makes its way to the surface of the skin and "sheds," increasing the likelihood of being passed on to others.
Famciclovir is most effective when taken within 6 hours after the onset of symptoms of a recurrent herpes infection. The appropriate dose of the medicine varies depending upon whether it is being prescribed for suppression versus treatment of genital herpes and whether or not your immune system is compromised by an illness such as HIV. Typically, an adult will be prescribed up to 1000 mg.
The Mayo Clinic advises that adults being treated for suppression of recurrent genital herpes are typically prescribed 250 mg two times a day for up to one year. Treatment of recurrent genital herpes in adults usually involves taking 1000 mg two times a day for one day. HIV-infected patients who are being treated for recurrent herpes may receive a dose of 500 mg two times a day for seven days.
Common side effects include cramps, nausea, diarrhea, stomach pain and bleeding.
