From the Guidelines
The treatment of shingles should involve the administration of antiviral medications such as acyclovir or famciclovir within 72 hours of rash onset to accelerate cutaneous healing and reduce the severity of acute pain. The choice between acyclovir and famciclovir depends on various factors including patient tolerance, potential side effects, and specific clinical scenarios. According to the study by 1, both acyclovir and famciclovir have been approved by the FDA for treating herpes zoster (HZ) and have shown similar efficacy when administered orally within the same period.
Some key points to consider in the treatment of shingles include:
- Starting antiviral therapy as soon as possible, ideally within 72 hours of rash onset, to maximize its effectiveness 1.
- Using antiviral medications in conjunction with pain management strategies, such as acetaminophen or NSAIDs, to alleviate discomfort and reduce the risk of complications like postherpetic neuralgia.
- Implementing supportive care measures, including keeping the rash clean and covered, to prevent bacterial infection and transmission to others.
- Considering the use of corticosteroids in certain cases to reduce inflammation, although this should be done under the guidance of a healthcare professional.
- Avoiding contact with susceptible individuals, such as those who haven't had chickenpox, pregnant women, newborns, and immunocompromised people, to prevent the spread of the virus.
It's essential to note that while the study by 1 provides valuable insights into the treatment of shingles, the specific details of treatment, such as dosage and duration, may vary depending on individual patient needs and clinical guidelines. Therefore, healthcare professionals should consult the most recent and relevant clinical guidelines when making treatment decisions.
From the FDA Drug Label
Herpes zoster (shingles):The recommended dosage of famciclovir tablets for the treatment of herpes zoster is 500 mg every 8 hours for 7 days. Herpes Zoster VALTREX is indicated for the treatment of herpes zoster (shingles) in immunocompetent adults. Herpes Zoster Infections : Acyclovir tablets is indicated for the acute treatment of herpes zoster (shingles).
The treatment of shingles is:
- Famciclovir: 500 mg every 8 hours for 7 days 2
- Valacyclovir: treatment is indicated, but the dosage is not specified in the provided text 3
- Acyclovir: treatment is indicated, but the dosage is not specified in the provided text 4
From the Research
Treatment of Shingles
The treatment of shingles typically involves antiviral medications, pain management, and in some cases, vaccination to prevent the condition.
- Antiviral medications such as acyclovir, valacyclovir, or famciclovir can decrease the duration of the rash and alleviate symptoms 5, 6, 7.
- Pain management is crucial in treating shingles, with options including opioid analgesics, tricyclic antidepressants, or corticosteroids for acute pain, and tricyclic antidepressants, gabapentin, pregabalin, long-acting opioids, or tramadol for postherpetic neuralgia 5, 6.
- The varicella zoster virus vaccine can prevent herpes zoster and postherpetic neuralgia, with recommendations for adults 60 years and older 5, 6, 8.
- Topical treatments such as lidocaine or capsaicin cream may also be used to relieve pain associated with shingles 6.
Antiviral Medications
Comparative studies have shown that valacyclovir and famciclovir are effective in treating herpes zoster, with valacyclovir offering significant benefits in pain resolution and management 7.
- Valacyclovir has been shown to accelerate the resolution of zoster-associated pain and provide a well-tolerated and favorable safety profile 7.
- Famciclovir is also an effective treatment option, although valacyclovir may be more efficacious in some cases 7.
Vaccination
The recombinant zoster vaccine (Shingrix) has been shown to be effective in preventing herpes zoster and postherpetic neuralgia, with a vaccine effectiveness of 70.1% for two doses and 56.9% for one dose 8.