The Medical Letter on Drugs and Therapeutics
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Antiviral Drugs for Varicella-Zoster Virus and Herpes Simplex Virus Infections

The recommendations for treatment of varicella-zoster virus (VZV) and herpes simplex virus (HSV) infections are listed in tables 1 and 2. Vaccination against VZV was reviewed in a previous issue.1

ACYCLOVIR — Acyclovir (Zovirax, and generics) is available in topical, oral, and IV formulations. Unlike famciclovir and valacyclovir, acyclovir has poor oral bioavailability; frequent high doses are needed for adequate antiviral activity.

VZV Infection – Oral acyclovir started within 24 hours of rash onset decreases the severity of primary varicella infection (chicken pox).2

In patients with localized herpes zoster (latent VZV reactivation), oral acyclovir started within 72 hours of rash onset reduces viral shedding, shortens the duration ... more      

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