From the Guidelines
The recommended treatment for genital herpes includes antiviral medications such as acyclovir, valacyclovir, or famciclovir, with the goal of reducing the severity and duration of symptoms, as stated in the 2022 guidelines 1. The treatment regimens for genital herpes can be categorized into three main types:
- First clinical episode treatment:
- Acyclovir (400mg three times daily for 7-10 days)
- Valacyclovir (1000mg twice daily for 7-10 days)
- Famciclovir (250mg three times daily for 7-10 days)
- Episodic therapy for recurrent outbreaks:
- The same medications can be used at similar or slightly lower doses for a shorter duration of 3-5 days
- Suppressive therapy for patients with frequent recurrences (more than 6 per year):
- Daily acyclovir (400mg twice daily)
- Valacyclovir (500-1000mg once daily)
- Famciclovir (250mg twice daily) These medications work by inhibiting viral DNA replication, which reduces the severity and duration of symptoms, though they do not cure the infection, as noted in the 1998 guidelines 1. In addition to medication, patients should keep the affected area clean and dry, wear loose-fitting clothing to prevent irritation, avoid sexual contact during outbreaks, and use condoms during sexual activity to reduce transmission risk, as recommended in the 1998 guidelines 1. Pain relievers like acetaminophen or ibuprofen can help manage discomfort, and warm baths may provide symptom relief. It's essential to prioritize dosing strategies that are most feasible for patient adherence, as stated in the 2022 guidelines 1.
From the FDA Drug Label
The recommended dosage of famciclovir tablets for the treatment of recurrent episodes of genital herpes is 1000 mg twice daily for 1 day. The recommended dosage of VALTREX for treatment of recurrent genital herpes is 500 mg twice daily for 3 days
The recommended treatment for genital herpes is:
- Famciclovir: 1000 mg twice daily for 1 day
- Valacyclovir: 500 mg twice daily for 3 days Therapy should be initiated at the first sign or symptom of a recurrent episode 2 3
From the Research
Treatment Options for Genital Herpes
The recommended treatment for genital herpes includes antiviral medications such as valacyclovir, acyclovir, and famciclovir. These medications can help reduce the severity and frequency of symptoms, as well as prevent transmission to others.
Antiviral Medications
- Valacyclovir: effective in suppressing recurrent episodes of genital herpes in immunocompetent and immunocompromised individuals 4, 5
- Acyclovir: commonly used to treat genital herpes, with a recommended dose of 200mg 5 times daily for 5 days for initial infection, and 200mg 4 times daily for suppressive therapy 6
- Famciclovir: also effective in treating genital herpes, with a similar efficacy to valacyclovir 5, 7
Treatment Regimens
- Episodic treatment: involves taking antiviral medication for a short period (e.g. 3-5 days) to treat individual outbreaks 7, 8
- Suppressive therapy: involves taking antiviral medication daily to prevent outbreaks 4, 6
- Oral acyclovir 1g twice a day for 3 days: a convenient and effective treatment regimen for genital herpes 8
Safety and Efficacy
- Valacyclovir is well-tolerated at dosages used to suppress recurrent episodes of genital herpes, but may cause headache and other side effects 4
- Acyclovir is generally safe and effective, but may cause side effects such as nausea and diarrhea 6, 8
- Famciclovir is also safe and effective, but may cause side effects such as headache and fatigue 5, 7