Comparison of Herpes Treatments

Genital herpes is a sexually transmitted infection. It is caused by the herpes simplex virus. Symptoms include painful red bumps that turn into blisters, which eventually break open and crust over. Some people have symptoms so mild as to not be noticeable, and a few have no symptoms at all. For people who have painful symptoms, the three medications commonly used to treat genital herpes are acyclovir (sold under the brand name Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex).

Basics

• Herpes symptoms may occur anywhere in the pelvic area. They last about 10 days before the virus retreats back along nerve fibers. Recurrences may occur at intervals anywhere between once every few weeks to one a decade or so. The infection is spread through skin-to-skin contact. It is most contagious when sores are present but is sometimes spread even in the absence of symptoms. The infection cannot be cured, but symptoms can be controlled.

Acyclovir

• Acyclovir is prescribed to lessen the pain and the number of sores in a first herpes breakout. It can also make subsequent flare-ups less severe and less frequent. It's usually taken orally in a dosage of between 200 and 800 mg, five times per day. It can also be applied as an ointment. The medication was approved for use in 1982 by the U.S. Food and Drug Administration.

Famciclovir

• Famciclovir has antiviral properties like those of acyclovir, but it works for a longer period of time. It does not fight herpes directly. Rather, it is converted to penciclovir by the body, and the penciclovir fights the virus. Approved by the U.S. Food and Drug Administration in 1994, famciclovir can be taken fewer times per day than acyclovir. Once or twice a day is generally enough. Like the other medications for herpes, famciclovir reduces the pain, itching and tingling associated with herpes outbreaks. A typical dosage for a recurrent outbreak is 1,000 mg twice daily. For suppressive therapy, 250 mg twice daily is common.

Valacyclovir

• Like famciclovir, valacyclovir is not itself active against the herpes virus. It is, instead, converted in the body to acyclovir, which does have a direct action. Valacyclovir was approved by the FDA just a year after famciclovir, in 1995. It, too, can be taken less frequently than acyclovir--generally 500 mg twice daily for five days in the case of a recurrent episode of genital herpes.

Considerations

• Acyclovir, famciclovir and valacyclovir are similar on many counts. The offer similar control of herpes symptoms, and can be used both to control a given outbreak (episodic therapy) and long-term to prevent outbreaks (suppressive therapy). In addition to their indications for genital herpes, they can also be used oral herpes (cold sores) and herpes zoster (shingles). For the patient, the main difference between the medications is in their duration of action; famciclovir and valacyclovir can be taken less frequently than acyclovir.