From the Guidelines
The recommended treatment for a 62-year-old male with genital herpes includes antiviral medications such as valacyclovir (1 gram twice daily for 7-10 days) for initial outbreaks, as it has enhanced absorption after oral administration and is a more practical treatment regimen for patient adherence 1. For recurrent episodes, the same medication can be used at a similar dose for a shorter duration of 5 days. For patients with frequent recurrences (more than 6 per year), suppressive therapy may be appropriate, with valacyclovir 500-1000 mg once daily, as it has been documented to reduce the frequency of genital herpes recurrences by greater than or equal to 75% among patients who have frequent recurrences 1. Some key points to consider when treating genital herpes include:
- Starting treatment as soon as symptoms appear for maximum effectiveness
- Maintaining good hygiene to prevent irritation and transmission
- Wearing loose-fitting clothing to prevent irritation
- Abstaining from sexual activity during outbreaks
- Using condoms during sexual activity even when symptoms are not present to reduce transmission risk
- Regular follow-up to assess treatment effectiveness and adjust therapy if needed, as the frequency of recurrences decreases over time in many patients 1. The medications work by inhibiting viral DNA synthesis, preventing the herpes simplex virus from replicating 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment Options for Genital Herpes
The recommended treatment for a 62-year-old male with genital herpes includes:
- Antiviral medications such as valacyclovir, acyclovir, and famciclovir to alleviate symptoms, suppress recurrences, and reduce transmission 2, 3
- Episodic treatment for recurrent episodes, which can be initiated early by the patient to abort the episode 4
- Suppressive therapy for patients with frequent recurrences, with a starting dose of 200mg 4 times daily for aciclovir, although 400mg twice daily may suffice 4
- Daily suppressive therapy with valacyclovir, which is the only antiviral drug approved for a once-daily dose for genital herpes 2
Considerations for Treatment
When choosing a treatment, factors to consider include:
- Cost and ease of dosing 3
- Acyclovir resistance, particularly in immunocompromised patients 4
- Patient preference and clinical characteristics 5
- The need for interrupting treatment on a yearly basis to determine the need for continuing suppression 4
Efficacy and Safety of Antiviral Medications
Studies have shown that:
- Valacyclovir has similar efficacy to acyclovir in the episodic and suppressive treatment of genital herpes 2
- Valacyclovir is effective in reducing the sexual transmission of herpes simplex virus infection 2
- Antiviral medications are safe and effective for the treatment of genital herpes, with an acceptable safety profile 2, 3