Consider a more convenient option when prescribing
antiviral drug for herpes zoster
Herpes zoster or shingles is a
viral infection characterized by pain followed by a vesicular rash. It is
caused by reactivation of the varicella zoster virus (VZV). The aim
of treatment is to hasten healing, reduce the severity and duration of pain and
also to reduce the chances of complications such as post-herpetic neuralgia.
Timely administration of
antiviral drugs - acyclovir, valacyclovir and famciclovir – decreases viral
shedding and reduces the acute pain in patients with uncomplicated infection.
These clinical benefits have been demonstrated in various clinical trials.
Acyclovir has to be administered
five times daily, which may hinder patient compliance to prescribed treatment.
This is especially of concern in the elderly, in whom herpes zoster is most
prevalent.
The prodrug of acyclovir,
valacyclovir, is administered thrice daily as treatment for herpes zoster and
the serum levels achieved are 3 to 5 times higher than those obtained with oral
acyclovir.
Famciclovir is a prodrug of
penciclovir and is also administered thrice daily as treatment for herpes
zoster.
Therefore, when compliance is
a concern or convenience of dosing is required, valacyclovir and famciclovir
are useful and convenient alternatives to acyclovir as treatment for herpes
zoster.
Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA
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