by EBSCO Medical Review Board

Medicines can help control symptoms and future outbreaks. Episodic therapy is used to control symptoms. Suppressive therapy is used to prevent future outbreaks.

The virus can still spread even when suppressive medicine is taken. It may lower your risk of infecting others, but it will not get rid of the risk.

Episodic Therapy

When you have early signs of an outbreak, you can take medicine to control how bad the outbreak is and how long it lasts. You take the it only when you are having the symptoms. The down side is that it may not lower the risk of spreading the virus to your partner. This is because some outbreaks may not start symptoms.

Suppressive Therapy

Suppressive therapy is used to prevent future outbreaks. This involves taking the medicine each day. You may want to take it if you have a lot of outbreaks. It can also be used to lower the risk of spreading the virus to a partner who has not had the infection. Keep in mind this only lowers the risk, it does not get rid of the risk.

Antiviral Medications for Episodic and Suppressive Therapy

Antiviral medicines are prescribed to treat genital herpes. You may be given:

  • Acyclovir—May be given through an IV for severe infections. It can also be taken as a pill or a cream. Pills appear to help more than the cream.
  • Oral famciclovir
  • Oral valacyclovir

Possible side effects include:

  • Headache
  • Lightheadedness
  • Nausea and vomiting
  • Diarrhea
  • Skin irritation
  • Feeling tired or weak
  • Stomach pain

If you are pregnant or nursing, or have another health problem such as HIV infection, talk to your doctor. Your treatment plan may not be the same.

Pain Management

Pain relievers can help ease your symptoms until the antiviral medication takes effect.

Special Considerations

Pain medicine can help ease your symptoms until the antiviral medicine begins to work.

  • Take your medicine as directed. Do not change the amount or schedule.
  • Ask what side effects could happen. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your prescription medicine.
  • Medicines can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one, including over the counter products and supplements.
  • Plan ahead for refills.

References

2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/std/tg2015/default.htm. Updated January 25, 2017. Accessed August 10, 2018.

Acyclovir. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T908696/Acyclovir  . Updated August 9, 2018. Accessed August 10, 2018.

Aoki FY, Tyring S, Diaz-Mitoma F, Gross G, Gao J, Hamed K. Single-day, patient-initiated famciclovir therapy for recurrent genital herpes: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2006;42(1):8-13.

Famciclovir. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T233466/Famciclovir  . Updated July 9, 2018. Accessed August 10, 2018.

Genital herpes. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T114875/Genital-herpes  . Updated February 19, 2018. Accessed August 10, 2018.

Genital herpes. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/infectious-diseases/herpesviruses/genital-herpes. Updated February 2018. Accessed August 10, 2018.

Genital herpes—CDC fact sheet (detailed). Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm. Updated February 9, 2017. Accessed August 10, 2018.

Groves MJ. Genital herpes: a review. Am Fam Physician. 2016;93(11):928-934.

Martens MG, Fife KH, Leone PA, Dix LP, Brennan CA. Once daily valacyclovir for reducing viral shedding in subjects newly diagnosed with genital herpes. Infect Dis Obstet Gynecol. 2009;2009:105376.

Valacyclovir. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T233474/Valacyclovir  . Updated August 9, 2018. Accessed August 10, 2018.

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