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Medication for Shingles Pain

Controlling the pain associated with shingles, a recurrence of VZV (varicella-zoster virus, which also causes chickenpox), is a combination of targeting the virus with antivirals as well as relieving pain specifically. A number of methodologies are used, varying based on the severity of pain experienced by an individual patient.

  1. Antivirals with Corticosteroids

    • It is important to begin antiviral treatment as soon as possible after the first evidences of rash, within 72 hours according to the Mayo Clinic and GlaxoSmithKline, the maker of one treatment for shingles, Valtrex. Antiviral drugs interfere with the virus' reproduction cycle and can reduce how long the shingles rash is present as well as the severity of the outbreak itself.

      Antivirals in combination with a corticosteroid like prednisone are helpful in relieving the pain associated with shingles. According to Seth John Stankus, MAJ, MC, et al, corticosteroids used alongside antivirals reduce swelling of the nerves and may reduce lingering nerve damage; this treatment, then, is used also to reduce the chances of developing post-herpetic neuralgia, a condition in which the pain of shingles lingers long after the rash has cleared up.

    Analgesics

    • The use of over-the-counter (OTV) pain relievers may be enough for some sufferers of shingles. However the degree of pain experienced by sufferers of shingles varies greatly, and for some people OTC analgesics have little or no effect; in these cases narcotic pain relief may be required. According to the National Institute of Neurological Disorders and Stroke (NINDS), options include oxycodone, methadone and morphine .

    Capsaicin and Calamine

    • Calamine lotion (such as Caladryl) and capsaicin treatments may be used to relieve pain at the site of shingles blisters, before and after they have crusted over, respectively, according to Stankus, et al. Capsaicin, marketed as Zostrix, is a topical pain reliever also used to relieve joint pain in arthritis; however, NINDS notes that many people experience a burning pain when applying Zostrix.

    Lidocaine

    • According to the NINDS, topical analgesics like lidocaine, which can be applied in a patch, avoid the potential side effects of other pain relievers. The NINDS also reports that there is a lidocaine patch that has been approved specifically for use in patients whose shingles pain lingers.

    Complications

    • According to GlaxoSmithKline, herpetic blisters that appear during shingles may develop bacterial infections, and this may cause scarring. If blisters become infected, an antibiotic treatment may also be required to control that infection along with other treatments for shingles.

      For those who develop post-herpetic neuralgia, a number of other pain-relief measures may be used, including tricylic antidepressants and anticonvulsants, along with the continued use of capsaicin and lidocaine.

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