Treatment in these patients is limited because immunocompromised hosts often develop severe herpes disease refractory to antiviral drug therapy.
It is therefore imperative that physicians develop regimens to deal with both receptive and refractory HSV disease. The following treatment protocol modified from Balfour and colleagues might serve as a guide until further investigation of new drugs is performed. In all patients standard oral ACV therapy should be initiated at a dose of mg orally, five times a day for the first 3 to 5 days. Prior to treatment, cultures the lesions should be obtained to verify HSV etiology.
If the response is poor, the dose of oral ACV should be increased to mg five times a day. If no response seen after 5 to 7 days, it is unlikely that the lesion will respond to intravenous ACV or chemically and structurally related drugs such as VCV or famciclovir , so an alternative regimen must be assigned. Resistance usually develops due to mutations in the thymidine kinase pathway that cause patients to become non-sensitive to acyclovir and its pro-drug valacyclovir, according to Dr.
He adds that these mutations occur randomly in immuno-competent patients but can be predicted by the severity of the disease state in immuno-incompetent patients.
In this particular case, the prescriber followed the appropriate treatment course but ran into a rare situation, says Dr.
Thimons, who offers several treatment recommendations moving forward. His first suggestion is switching the patient from acyclovir to famciclovir or topical ganciclovir, both of which do not belong to the same family as acyclovir and contain different molecules that the patient could be sensitive to, he notes.
He adds that these drugs have different mechanisms of action, so patients might be more sensitive to them. According to Dr. Thimons, the solution to this problem could be as simple as switching medications, but he warns doctors not to wait too long or else they could risk the chance of glaucoma developing in their patient.
If new drugs are administered but are not effective within a week or two, Dr. Thimons advises referring to a corneal specialist for cellular analysis to determine what type of mutation is present and, from there, what path to take for the most successful results. Toggle navigation Leadership in clinical care.
Q: I have a chronic herpes simplex patient with significant epithelial keratitis who might be resistant to acyclovir. Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription. There are other drugs available to treat your condition.
Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you. Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional.
You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Recurrent herpes simplex labialis is a condition of the mouth caused by the herpes simplex virus. It takes some time after contracting herpes simplex virus HSV for symptoms to show. This is referred to as the herpes incubation period.
We'll cover…. A serum herpes simplex antibodies test checks for antibodies to the herpes simplex virus. Learn what to expect during the test and what the results…. Do you have sores near your mouth or persistent itchiness in your groin area? Are you concerned that you may have herpes? HSV-2 is rarely transmitted through oral sex, but that doesn't mean it's impossible. Here's what you need to know about herpes transmission. Genital herpes is a sexually transmitted disease.
It causes herpes sores, which are painful blisters fluid-filled bumps that can break open and ooze…. There are home remedies, over-the-counter medications, and prescription medication for herpes. The herpes simplex virus can cause blisters or sores to erupt on various parts of the body, including the buttocks. Genital herpes is a common sexually transmitted disease, and the way it looks can vary from person by person and outbreak to outbreak.
Genital herpes sores may look similar to pimples, but they require different treatment. Health Conditions Discover Plan Connect. Valacyclovir, Oral Tablet. Written by University of Illinois — Updated on March 2, Important warnings About Side effects Interactions Other warnings Dosage Take as directed Important considerations Alternatives Highlights for valacyclovir Valacyclovir oral tablet is available as a brand-name drug and a generic drug.
Brand name: Valtrex. Valacyclovir comes only as a tablet you take by mouth. Valacyclovir oral tablet is used to treat viral infections caused by a group of viruses called herpes simplex viruses. Important warnings. What is valacyclovir?
Valacyclovir side effects. Valacyclovir may interact with other medications. Valacyclovir warnings. How to take valacyclovir. Take as directed. Important considerations for taking valacyclovir. Are there any alternatives? Herpes Incubation Period.
Serum Herpes Simplex Antibodies Test.
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