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Herpes Medications Comparison


Price-RX provides unique comparison of herpes medications. Usual price-per-pill comparisons are generally inconclusive. That is because different medicines require different intake schedules and the length of anti-infective treatment may vairy noticeably.

Currently, there are three oral prescription medicines approved by the U.S. FDA for the treatment of herpes simplex virus (HSV) infections:

  • Acyclovir (Zovirax) is the oldest and the cheapest antiviral drug. Has been used for many years and is widely available in generic form. Main disadvantage - frequent dosing.
  • Valacyclovir (Valtrex) is an "improved" version of acyclovir. Main advantage - convenient dosing, which leads to better compliance. Main disadvantage - it is quite expensive.
  • Famciclovir (Famvir) is a prodrug of penciclovir. When taken, the body converts famciclovir to the long acting penciclovir. Main disadvantage - expensive.

All three antivirals are almost similarly effective against HSV-1, HSV-2, and herpes zoster and are equally safe.

Important notes!

  • The provided "RX dosage regimens" are recommended for otherwise healthy adults. Your dosage may be different. Follow your doctor's instructions.
  • "Price per pill" is calculated for 30- or 90-pills package. The remaining/excess medication you can use for subsequent outbreaks.

Genital Herpes: Suppressive Therapy

In persons with more than 6 recurrences of genital herpes per year, chronic antiviral therapy may be prescribed to reduce recurrences. Suppressive therapy means taking an antiviral medication daily as a preventative to keep HSV under control, reduce the number of outbreaks and, sometimes, prevent them altogether. Suppressive therapy also reduces asymptomatic shedding, and helps prevent the transmission.

Efficacy: Famciclovir appears somewhat less effective for suppression of viral shedding [1]. Valacyclovir suppressive therapy has also been proven to reduce the risk of transmission to a partner.

Genital Herpes: Treatment of Recurrent Outbreak

Episodic therapy means taking the drug only during an outbreak to speed up healing. Antiviral drugs work best if they are taken promptly during the prodromal stage (tingling and pain), just before blisters or sores appear. The healing time and severity of the first herpes episode can be dramatically reduced. The recurrent outbreak can be shortened by about two days.

Efficacy: Acyclovir, famciclovir, and valacyclovir appear equally effective for episodic treatment of genital herpes [2].


Cold Sores (Herpes Labialis): Treatment of Outbreak

Although oral acyclovir regimen is not FDA-approved for cold sores, it is widely used off-label in practice [3].


References:

  • 1. Wald A, Selke S, Warren T, Aoki FY, Sacks S, Diaz-Mitoma F, Corey L. Comparative efficacy of famciclovir and valacyclovir for suppression of recurrent genital herpes and viral shedding. Sex Transm Dis. 2006 Sep;33(9):529-33. PubMed
  • 2. Diseases Characterized by Genital, Anal, or Perianal Ulcers CDC
  • 3. Spruance SL, Stewart JC, Rowe NH, McKeough MB, Wenerstrom G, Freeman DJ. Treatment of recurrent herpes simplex labialis with oral acyclovir. J Infect Dis. 1990 Feb;161(2):185-90. PubMed
  • 4. Rooney JF, Straus SE, Mannix ML, et al. Oral acyclovir to suppress frequently recurrent herpes labialis. A double-blind, placebo-controlled trial. Ann Intern Med. 1993;118(4):268–272.
  • 5. Baker D, Eisen D. Valacyclovir for prevention of recurrent herpes labialis: 2 double-blind, placebo-controlled studies. Cutis. 2003 Mar;71(3):239-42.

Last Updated: December 14, 2013



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