From the Guidelines
Zoster covers a limited area corresponding to the dermatome supplied by a single sensory nerve, typically appearing as a single stripe of blisters that wraps around either the left or right side of the torso. The condition is caused by the varicella-zoster virus, which remains dormant in nerve tissue near the spinal cord and brain after a person recovers from chickenpox, and may reactivate years later as shingles. Key characteristics of zoster include pain, itching, or tingling in the affected area, followed by the appearance of fluid-filled blisters that eventually crust over. According to the study by 1, treatment for zoster typically includes antiviral medications like acyclovir and famciclovir, which have been shown to accelerate the rate of cutaneous healing and reduce the severity of acute pain in adults when administered within 72 hours of rash onset. Some key points to consider about zoster coverage include:
- The rash typically appears on one side of the torso, but can occur anywhere on the body
- The condition is caused by the reactivation of the varicella-zoster virus
- Treatment with antiviral medications like acyclovir and famciclovir can help reduce symptoms and accelerate healing
- Pain management may also be necessary, ranging from over-the-counter pain relievers to prescription medications for severe cases.
From the FDA Drug Label
Herpes Zoster (Shingles) Two randomized, double-blind trials, 1 placebo-controlled and 1 active-controlled, were conducted in 964 immunocompetent adults with uncomplicated herpes zoster. VALTREX is indicated for the treatment of herpes zoster (shingles) in immunocompetent adults. Acyclovir tablets is indicated for the acute treatment of herpes zoster (shingles).
Zoster is covered by the following medications:
- Famciclovir: for the treatment of uncomplicated herpes zoster in immunocompetent adults.
- Valacyclovir: for the treatment of herpes zoster in immunocompetent adults.
- Acyclovir: for the acute treatment of herpes zoster. 2, 3, 4
From the Research
Zoster Coverage
- Zoster, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox 5, 6, 7, 8.
- The condition is characterized by a painful rash, usually on one side of the body, and can lead to complications such as postherpetic neuralgia (PHN) 6, 7, 8.
- Antiviral medications, such as valacyclovir, famciclovir, and acyclovir, are commonly used to treat herpes zoster and can help reduce the severity and duration of symptoms 5, 6, 8.
- Valacyclovir, in particular, has been shown to be effective in reducing the incidence of PHN and hastening the healing of zoster-associated pain 5, 7, 8.
- Combination treatment with gabapentin and valacyclovir has also been found to be effective in preventing PHN in patients with acute herpes zoster 7.
Treatment Options
- Valacyclovir is an oral antiviral agent that is approved for the treatment of herpes simplex, herpes zoster, and other viral infections 8.
- Famciclovir and acyclovir are also oral antiviral agents that can be used to treat herpes zoster, although valacyclovir has been shown to be more effective in some studies 5, 6, 8.
- Gabapentin can be used in combination with valacyclovir to prevent PHN in patients with acute herpes zoster 7.
Benefits of Treatment
- Early treatment with antiviral medications, such as valacyclovir, can help reduce the severity and duration of symptoms, as well as the risk of complications such as PHN 5, 6, 7, 8.
- Valacyclovir has been shown to be safe and effective in the treatment of patients with herpes simplex and herpes zoster, and may be useful in other viral infections 8.