For herpes, there is no quick fix, nor is there a cure. Medications called antiviral drugs can, however, attack the virus and give those afflicted with this disease some relief, helping to reduce the duration and severity of symptoms.
Many herpes sufferers take small doses of antiviral medications daily to prevent symptoms. Plus, these individuals can take the drugs in larger doses when they do experience symptoms. Research shows that daily use of antiviral therapy dramatically lessens the rate of asymptomatic viral shedding, as well as reduces outbreak frequency.
Controlling outbreaks and minimizing discomfort are two goals of antiviral agent use. The severity of a first episode of genital herpes can be dramatically minimized by the use of an initial 10-day course of medication that helps sores to heal faster, reduces swollen glands, and curbs viral shedding.
Recommended for those who have severe or prolonged recurrences and prodromes is episodic therapy, taking medication at the first warning sign of an outbreak; this serves to shorten duration of symptoms and speed sore healing.
The patient who takes the drug before lesions appear makes more significant gains, and, in some cases, early preventive medication forestalls formation of lesions altogether.
A third kind of treatment regimen is suppressive therapy, intended to reduce the likelihood of recurrences or to extinguish them. The patient takes a small dose of antiviral medication daily for long periods. Typically, those on suppressive therapy dramatically reduce their symptom recurrence, and in about one-fourth, there are no recurrences at all.
Often, the physician treating the herpes sufferer stops suppressive therapy once a year to assess the need for the medication. Recent research suggests yet another advantage of suppressive therapy—a 95 percent reduction in days per year of viral shedding and risk of transmission.
It has not been shown, however, that transmission can be completely prevented by use
of suppressive therapy.
The most commonly used medications for herpes are acyclovir (Zovirax) and valacyclovir (Valtrex), which disrupt the replication process of the virus and thus its spread. A patient who takes either drug can reduce the duration and severity of symptoms during a first episode and speed healing during recurrences and prodrome (when there are warning signs and symptoms).
They work especially well when initiated within 24 hours of onset of symptoms. Many experts think that this therapy also may reduce the risk of transmission to sexual partners.
Acyclovir is taken at different doses either three or five times a day for a first episode and usually 400
mg is taken three times a day for treatment of recurrences. This drug is used worldwide and is only rarely associated with any serious adverse effects.
The Acyclovir in Pregnancy Registry has shown no rise in birth defects or other problems in more than 10 years. Similar safety is reported in the newer entries on the market—valacyclovir (Valtrex) and famciclovir (Famvir).
Valtrex has acyclovir as its active ingredient but has the advantage of being better absorbed by a person’s body. For episodic therapy, the dosage is only twice daily for three days. For chronic suppression, Valtrex is taken once daily. Famciclovir (Famvir) lasts longer in the body than acyclovir, and the herpes patient takes only twice-daily doses.
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