From the Guidelines
Alternatives to Valtrex (Valacyclovir) for Herpes Simplex Virus (HSV) include Acyclovir, which can be administered at a dose of 400mg twice daily for suppressive therapy 1, and Famciclovir, which can be administered at a dose of 250mg twice daily for suppressive therapy 1.
Episodic Treatment
- Acyclovir can be administered at a dose of 400mg three times daily for 7-10 days for episodic treatment.
- Famciclovir can be administered at a dose of 125mg twice daily for 5 days for episodic treatment.
Suppressive Therapy
- Acyclovir can be administered at a dose of 400mg twice daily.
- Famciclovir can be administered at a dose of 250mg twice daily. Other options include Zovirax (Acyclovir) cream, applied topically five times daily for 4 days, and Valganciclovir, which may be considered in certain cases 1. It's essential to note that the choice of treatment should be based on the individual patient's needs and medical history, and that routine prophylaxis to suppress virus replication should be considered for patients with frequent recurrent attacks or those already taking intermittent suppressive antiviral therapy 1.
From the Research
Alternatives to Valtrex (Valacyclovir) for Herpes Simplex Virus (HSV)
- Aciclovir: a study comparing valaciclovir and aciclovir found that valaciclovir 500 mg twice daily is equivalent in efficacy to aciclovir 200 mg five times daily as episodic treatment of recurrent genital HSV infection 2
- Famciclovir: a study found that valacyclovir appears to be somewhat better than famciclovir for suppression of genital herpes and associated shedding 3
- Acyclovir: a study found that acyclovir therapy remains an effective and often less expensive option for the treatment of common cutaneous herpes simplex virus infections 4
- Penciclovir: a study mentioned that famciclovir, a highly bioavailable prodrug of penciclovir, is an alternative to valacyclovir for the treatment of herpes simplex and herpes zoster 5
Treatment Options
- For patients who have six or more recurrences of genital herpes per year, treatment options include:
- Acyclovir, 400 mg twice daily
- Valacyclovir, 1 g daily
- Famciclovir, 250 mg twice daily 4
- For episodic treatment of recurrent genital herpes, valacyclovir and aciclovir have been shown to be effective 2, 6
- For suppression of genital herpes and associated shedding, valacyclovir and famciclovir have been compared, with valacyclovir appearing to be somewhat better 3