Family Medicine

Answer 7 Acyclovir. Antiviral drugs have been shown to decrease the severity of pain associated with the herpes zoster rash and rash duration.3 However, benefits have only been shown to occur in patients who received antiviral therapy within 72 hours after the onset of the rash. There are 3 antiviral drugs typically used to treat herpes zoster infection: acyclovir, famciclovir, and valacyclovir. Of these drugs, acyclovir is the least expensive but has the lowest bioavailability and must be taken 5 times daily. Famciclovir and valacyclovir are more bioavailable than acyclovir and both are taken 3 times daily.3 Intravenous use of acyclovir is used in patients who are severely immunocompromised or who cannot take oral medication. Ganciclovir is an antiviral drug that is generally used to treat cytomegalovirus infections. REFERENCE 3.  Stankus S, Dlugopolski M, Packer D. Management of herpes zoster (shingles) and postherpetic neuralgia. Am Fam Physician 2000;61:2437-44, 2447-8. Click here to return to the questions

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