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Cold Sores & Genital Herpes (HSV) treatment and education

  • Updated

Herpes cannot be cured by medication, but there are antiviral medications (valacyclovir) that can be taken to ease symptoms during outbreaks, speed up healing of outbreaks, suppress the virus to reduce the number of future outbreaks, and lower asymptomatic transmission risk.

Dosing

Whether you take your medication with outbreaks (episodic) or daily (suppressive) can depend on how often symptoms reoccur:

Episodic (valacyclovir)

  • Short course of higher dose medication (pills) taken by mouth as soon as herpes symptoms develop.
  • Meant to stop progression and speed recovery of outbreaks.
  • Typically used if someone has 3 or less outbreaks per 12 months.
  • Will not reduce the risk of spreading/transmitting herpes because there is an active outbreak (blister).

Suppressive (valacyclovir)

  • Daily, small dose of medication (pills) taken by mouth.
  • Meant to reduce the number of outbreaks and can reduce, but not eliminate, asymptomatic transmission.
  • Episodic therapy may still be required if a rare outbreak occurs.
  • Typically used if someone has 4 or more outbreaks per 12 months.
  • It is common to have a rebound outbreak if suppressive therapy is stopped.

Other medication considerations:

  • These medications are generally very well tolerated and some some people will choose to take suppressive therapy even if they have very few (less than 4) outbreaks per 12-month period.
  • Valacyclovir may be taken with or without food. Taking with food may reduce the chance of stomach upset.
  • Try to take pills with full glass of water and stay hydrated throughout treatment.
  • If you miss a dose, take the tablet as soon as you remember. If it is less than 12 hours till your next dose, skip the dose and resume your usual dosing time. Do not double dose.

Side Effects / Safety Considerations

Do not take without consulting with your healthcare provider if you have an allergy to any antiviral medication such as acyclovir (Zovirax®), famciclovir (Famvir®) or valacyclovir (Valtrex®).

  • Valacyclovir may be used with caution during pregnancy and during chest/breastfeeding. Please advise your healthcare provider
  • You may experience diarrhea, nausea, abdominal pain, vomiting, headache, lightheadedness or dizziness.
  • Inform any other healthcare providers that you take this drug
  • Do not take the following while taking valacyclovir:
    • Varicella vaccine (Varilrix®, Varivax®)
    • Herpes zoster vaccine (Zostavax®)
    • Measles, mumps, rubella, varicella vaccine (Priorix®-Tetra, ProQuad®)

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