From the FDA Drug Label
Herpes Zoster VALTREX is indicated for the treatment of herpes zoster (shingles) in immunocompetent adults. The efficacy of VALTREX when initiated more than 72 hours after the onset of rash and the efficacy and safety of VALTREX for treatment of disseminated herpes zoster have not been established.
The treatment for herpes zoster (shingles) near the eye is not explicitly stated in the provided drug labels. However, valacyclovir (PO) is indicated for the treatment of herpes zoster in immunocompetent adults.
- The efficacy of valacyclovir when initiated more than 72 hours after the onset of rash has not been established.
- There is no information on the treatment of herpes zoster in the eye. It is essential to consult a healthcare professional for proper diagnosis and treatment, especially for sensitive areas like the eye 1.
It is not known if famciclovir is safe and effective for: • shingles in the eye(s)
Famciclovir (PO) also does not provide information on the treatment of shingles in the eye 2.
From the Research
Herpes zoster near the eye should be treated with oral antiviral medications, such as valacyclovir (1000 mg three times daily), as soon as possible, ideally within 72 hours of rash onset, to reduce the risk of vision damage and postherpetic neuralgia, as supported by the most recent study 3.
Treatment Overview
The treatment of herpes zoster near the eye involves a combination of antiviral medications, pain management, and supportive care.
- Oral antiviral medications, such as valacyclovir (1000 mg three times daily) or famciclovir (500 mg three times daily), are the primary treatment for herpes zoster ophthalmicus.
- These medications are most effective when started within 72 hours of rash onset, as they can reduce the severity and duration of the outbreak, as well as prevent complications like postherpetic neuralgia 3.
Pain Management and Supportive Care
- For pain management, acetaminophen, NSAIDs, or in severe cases, opioid analgesics may be prescribed.
- Topical antibiotics might be used to prevent secondary bacterial infections.
- If the infection involves the eye itself, additional treatments may include topical steroids, cycloplegic eye drops to reduce inflammation and prevent scarring, and possibly intraocular pressure-lowering medications.
- Cool compresses can help soothe the affected area, but patients should avoid touching or scratching the rash to prevent spreading the infection.
Importance of Early Treatment
- Early treatment is crucial in reducing the risk of vision damage and postherpetic neuralgia, as highlighted in the study 3.
- The study found that suppressive treatment with valacyclovir for 12 months reduced the prevalence, severity, and duration of postherpetic neuralgia, and lowered the dosage of neuropathic pain medication.
Regular Follow-up
- Regular follow-up with an ophthalmologist is essential to monitor for complications and adjust treatment as needed.
- This is particularly important in cases where the infection involves the eye itself, as prompt treatment can help prevent long-term vision damage.