From the Guidelines
Yes, you can take both suppressive and abortive medications for herpes, though typically not at the same time. Suppressive therapy involves taking antiviral medications daily to reduce outbreak frequency and viral shedding, commonly using valacyclovir (500-1000mg daily), acyclovir (400mg twice daily), or famciclovir (250mg twice daily) 1. Abortive therapy is used at the first sign of an outbreak, with higher doses taken for a short period, such as valacyclovir 1000mg twice daily for 3 days. If you're on suppressive therapy and experience a breakthrough outbreak, your doctor might recommend temporarily increasing your dose or adding an abortive regimen. This dual approach works because suppressive therapy reduces viral replication continuously, while abortive therapy delivers higher medication concentrations to quickly stop an active outbreak. Some key points to consider when taking both suppressive and abortive medications for herpes include:
- The most practical treatment regimens for first clinical episode of genital herpes, episodic therapy, and suppressive therapy should be prioritized based on patient adherence 1.
- Dosing strategies that are most feasible for patient adherence should be prioritized, such as valacyclovir (500-1000mg daily) or acyclovir (400mg twice daily) 1.
- The same medication dosages and frequencies are recommended for genital HSV-1 infection as for genital HSV-2 infection 1. It is essential to discuss with your healthcare provider to create a personalized treatment plan based on your outbreak frequency, severity, and medical history.
From the Research
Suppressive and Abortive Medication for Herpes
- The use of antiviral medications such as acyclovir, valacyclovir, and famciclovir for the treatment of genital herpes is well-established 2, 3, 4, 5, 6.
- These medications can be used for both suppressive and abortive therapy, with the goal of reducing the frequency and severity of outbreaks 2, 3, 4.
- Suppressive therapy involves taking medication daily to prevent outbreaks, while abortive therapy involves taking medication at the first sign of an outbreak to reduce its severity and duration 4, 5.
- Studies have shown that suppressive therapy with acyclovir, valacyclovir, and famciclovir can reduce the frequency of outbreaks by 70-90% 3, 5, 6.
- Abortive therapy with these medications can also reduce the severity and duration of outbreaks, with some studies showing a reduction in outbreak duration of 1-2 days 4, 5.
Combination Therapy
- There is limited research on the use of combination suppressive and abortive medication for herpes, but some studies suggest that it may be effective in reducing the frequency and severity of outbreaks 5, 6.
- One study found that patients who received suppressive therapy with acyclovir and then took additional medication at the first sign of an outbreak had a reduced frequency of outbreaks compared to those who received suppressive therapy alone 6.
- However, more research is needed to fully understand the effectiveness and safety of combination therapy for herpes 5.
Safety and Efficacy
- The safety and efficacy of antiviral medications for the treatment of genital herpes have been well-established in numerous studies 2, 3, 4, 5, 6.
- Common side effects of these medications include nausea, headache, and fatigue, but they are generally well-tolerated 3, 4, 5.
- Resistance to antiviral medications is a concern, but it is relatively rare and can be managed with dose adjustments or changes in medication 3, 6.