Only prompt topical or oral therapy will alleviate symptoms of herpes labialis. Penciclovir cream showed similar effects in 2 other studies (534 and 2209 patients). Two treatment regimens with famciclovir (single 1500-mg dose or 750 mg twice daily for 1 day) were studied in 701 patients. Many patients do not consult their general practitioners and instead use over-the-counter medications. Antiviral agents can be used to treat disease (a therapeutic strategy), to prevent infection (a prophylactic strategy), or to prevent disease (a preemptive strategy). For the treatment of first episode genital herpes, the dose of oral acyclovir is 200 mg orally five times per day, or 400 mg orally three times per day (Table 64. The most frequent indication for suppressive acyclovir therapy is in patients with frequently recurrent genital infections, in whom chronic suppressive acyclovir therapy reduces the frequency of recurrences by approximately 75 (Douglas et al. Topical penciclovir (Denavir) for the treatment of recurrent herpes labialis reduces time to healing and duration of pain by about half a day (Boon et al. Oral prodrugs of penciclovir (famciclovir) and acyclovir (valaciclovir) were subsequently developed to improve their oral bioavailability (5, 97), although the oral formulation of acyclovir continues to be used widely. Antiviral treatment of herpes simplex virus (HSV) infections with nucleoside analogues has been well established for over two decades, but isolation of drug-resistant HSV from immunocompetent patients remains infrequent (0. The isolation of resistant HSV from immunocompromised patients is more common (4 to 7 13, 14, 27, 98; J. Accordingly, an IC50 of 2 g/ml is often used as a breakpoint in in vitro assays.
However, if uncertain, the diagnosis of herpes labialis can be made by viral culture, polymerase chain reaction, serology, direct fluorescent antibody testing, or Tzanck test. Oral acyclovir, valacyclovir, and famciclovir are effective in treating acute recurrence of herpes labialis (cold sores). Topical acyclovir, penciclovir, and docosanol are optional treatments for recurrent herpes labialis, but they are less effective than oral treatment. 0.020 genital HSV-1 infections, and 0.001 oral HSV-2 infections.6 This shows that recurrences are more likely when HSV-1 is oral and HSV-2 is genital. Herpes simplex virus infection is increasingly common in the United States. Famciclovir and valacyclovir offer improved oral bioavailability and convenient oral dosing schedules but are more expensive than acyclovir. Famciclovir, another new antiviral medication, is the oral form of penciclovir, a purine analog similar to acyclovir. Both types of herpes simplex virus (HSV), HSV-1 and HSV-2, can cause oral or genital infection. Give IV acyclovir to patients with serious infections. For mucocutaneous infections, consider oral acyclovir, valacyclovir, or famciclovir; for herpes labialis, an alternative is topical penciclovir or docosanol.
The major drugs developed to work against herpes simplex virus (HSV) are antiviral agents called nucleosides and nucleotide analogues, which block viral reproduction. All three oral antiviral drugs are very effective and reasonably safe. Penciclovir has a higher affinity for HSV TK than acyclovir (2), and consequently the levels of penciclovir triphosphate in infected cells are much higher than the levels of acyclovir triphosphate. Patients should be counseled to use safer sex practices in combination with suppressive therapy with Valtrex. While there is no cure for herpes simplex virus (HSV) infections, there are various treatment options available. Antiviral medication is commonly prescribed for patients having a first episode of genital herpes, but they can be used for recurrent episodes as well. Many patients with herpes lesions of their lips and mouth use topical creams or ointments to treat their sores. Topical creams and ointments like Zovirax (acyclovir) and Denavir (penciclovir) are available and have been studied for oral herpes (herpes labialis). Antiviral therapy with acyclovir, famciclovir (Famvir), or valacyclovir (Valtrex) hastens the healing of lesions if treatment is initiated in the early stage.
Nongenital Herpes Simplex Virus
A diagnosis of herpes labialis, presumably type 1 infection, with secondary bacterial infection was made. In one study, a 5-day course of oral famciclovir (500 mg tid), started 48 hours after herpes labialis was induced, reduced healing time from a mean of 6 to 4 days (P 1 Combination therapy with topical fluocinonide, applied q8h for 5 days, and famciclovir reduced lesion size and ameliorated pain to a greater degree than famciclovir alone.2 Topical penciclovir or acyclovir can be used instead of oral famciclovir in patients with herpes labialis. Genital and labial herpes simplex virus infections are frequently encountered by primary care physicians in the United States. Famciclovir, the oral prodrug of penciclovir, offers increased bioavailability as well as a substantially longer half-life compared with acyclovir. Unlike topical acyclovir, the oral form can prevent new lesion formation and modify accompanying constitutional symptoms, and does not cause local irritation on application. The efficacy of topical acyclovir cream used as treatment in primary or recurrent episodes of genital herpes varies between RCTs and overall does not appear to be as reliable as oral acyclovir. Oral antivirals include acylovir, valacyclovir, and famciclovir. They are used to shorten the length of the outbreak. Topical prescription antivirals include acyclovir cream, and penciclovir cream. Penciclovir is an antiviral drug that can be used either as topical cream or intravenously to treat herpes simplex virus (HSV-1, HSV-2) infections. A drug called famciclovir is the oral prodrug of penciclovir and is used to treat HSV-1, HSV-2, and VZV. For therapy of HSV-1 and HSV-2 in immunocompromised patients, penciclovir is equal in efficacy to acyclovir, but can be administered less frequently because of its extended half-life in the cell. The most widely prescribed herpes meds are acyclovir (Zorifax), valacyclovir (Valtrex), and famaciclovir (Famvir). There is herpes simplex virus- 1, oral herpes, which is known in the medical community as herpes labialis. Any person who is infected with herpes simplex virus- 2 will continue to be contagious even while they are taking acyclovir, and even if there are no symptoms present. Herpes simplex virus 1 (HSV-1) is the main cause of oral herpes infections that occur on the mouth and lips. Genital herpes can be caused by either HSV-2 or HSV-1. Be aware that nonoxynol-9, the chemical spermicide used in gel and foam contraceptive products and some lubricated condoms, does not protect against sexually transmitted diseases (STDs). Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus.
Comparison Of Herpes Antiviral Drugs
Famciclovir tablets are indicated for the treatment of recurrent herpes labialis. After oral administration, Famciclovir (prodrug) is converted to penciclovir (active drug). In addition, acyclovir is available in topical form, as is penciclovir (a related drug). Patients often ask the dental hygienist and dentist, What is this? Both HSV-1 and HSV-2 can spread to other parts of the body, for example, the eyes, genitals, and fingers (herpetic whitlow). Administration of oral acyclovir can be used before situations known to precipitate herpes lesions, such as a ski trip or wedding (stress), or a dental appointment that will produce trauma. Famciclovir and valacyclovir. Drugs used in managing herpes virus are discussed. The broadest application of acyclovir is in the treatment of genital herpes simplex virus infections.2 IV or oral acyclovir as well as oral valacyclovir reduce symptom duration, and viral shedding, while facilitating healing in primary genital HSV infection. Patients resistant to acyclovir with HSV or VZV infection often respond to foscarnet.2. After oral administration, famciclovir is converted to penciclovir through a process catalyzed by two enzymes.
Most of the time, pills taken by mouth can be used to treat shingles. Famciclovir is the pill form of a topical cream called penciclovir (Denavir).