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valtrex/acyclovir/famvir some effect on cmv reactivation, maybe hhv6??

Discussion in 'Antivirals, Antibiotics and Immune Modulators' started by heapsreal, Jul 10, 2011.

  1. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    This is a patent i came across stating that the above antivirals have a substantial effect of lowering immune response to cmv, most like by their ability to reduce subclinical episodes of cmv reactivation.

    So it appears that the above AV's can help with most of the herpes viruses, so using them before valcyte can reduce die of symptoms which has been noticed by those who have done this, as well as by those who have changed over to valtrex/famvir after doing a course of valcyte to keep these viruses supressed.

    Certain antiviral drugs are known for the treatment of herpes virus infections. In particular, nucleoside analogues such as acyclovir (also known as aciclovir) (9-(2-hydroxyethoxymethyl)guanine-GB 1 523 865) are known for the treatment of human herpes viruses, being most effective against herpes simplex viruses (HSV-1 and HSV-2) and varicella zoster virus (VZV). Acyclovir has minimal activity against CMV replication in vitro, with an ID50 (the concentration at which the drug reduces viral plaque formation by 50% or more) of greater than 100 ?M, compared to values of 0.15 ?M, 1.62 ?M and 3.75 ?M against HSV-1, HSV-2 and VZV respectively (according to the assays of Crumpacker et al.). Valacyclovir is the L-valine ester of, and acts as a prodrug for, acyclovir, and hence has the same mechanism of action. Both drugs produce a number of side effects at common doses, including nausea, vomiting, diarrhoea and/or headaches.

    Ganciclovir and valganciclovir are homologues of acyclovir and valatyclovir respectively, which have been developed for their markedly improved activity against CMV. These drugs are widely used in the management of CMV disease in immunosuppressed patients. However, ganciclovir is considered a potential human carcinogen, teratogen, and mutagen, and is considered likely to cause inhibition of spermatogenesis. Known side-effects include granulocytopenia, neutropenia, anaemia, thrombocytopenia, fever, nausea, vomiting, dyspepsia, diarrhoea, abdominal pain, flatulence, anorexia, raised liver enzymes, headache, confusion, hallucination, seizures, pain and phlebitis at injection site (due to high pH), sweating, rash, itch and increased serum creatinine and blood urea concentrations.

    Penciclovir is an analogue of acyclovir which is able to treat herpesvirus infections with fewer side effects. The antiviral spectrum of penciclovir is similar to that of acyclovir, and it therefore has minimal activity against CMV. Famciclovir is a prodrug for penciclovir, having improved bioavailability.

    There is therefore a prejudice in the art against treatment of CMV in immunocompetent patients, based on the following beliefs: most antiviral drugs are not able to effectively treat CMV; those drugs that are able to treat CMV have unacceptably high toxicity and level of side-effects; CMV infection is near-ubiquitous and has been considered to be asymptomatic in immunocompetent patients.

    However, the inventors have discovered that CMV infection is not entirely asymptomatic, and that surprisingly there are in fact benefits in treating CMV infected patients with antiviral drugs which have low activity against cytomegalovirus as estimated by in vitro assays. When given to patients these drugs cause a substantial reduction in the immune response to cytomegalovirus, most likely by their ability to reduce subclinical episodes of CMV reactivation and hence limit recurrent stimulation of the CMV-specific immune response.

    The dosage administered to a patient will normally be determined by the prescribing physician and will generally vary according to the age, weight and response of the individual patient, as well as the severity of the patient\'s symptoms. However, in most instances an effective therapeutic daily dosage will be in the range of 200-2000 mg and, preferably, of 400-1000 mg (e.g. for valacyclovir or acyclovir) administered in single or divided doses. In some cases, however, it may be necessary to use dosages outside these limits.

    http://www.freshpatents.com/-dt20101104ptan20100280052.php
    rest of the article is interesting too.

    cheers!!!
  2. aepalisades

    aepalisades

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    Famvir and CMV and Medicare

    I just recently was started on Famciclovir (Generic TEVA BRAND) after mild help from Valcyte (and no longer tolerating it due to developing persistent diarrhea). I have been diagnosed with persistent CMV, and although my IGM titers have come down to within "normal" range, my IGG titers are still very elevated and according to my doctor I still have the CMV infection. (I know this is controversial among doctors)

    I did not really want to take Famciclovir since antivirals are tough on me and I am highly medication and food sensitive. I was started slowly on 1 gram a day for three days, then ramped it up to 2 grams per day for three days then up to three grams a day. I was suppose to go up to 4 grams per day but I felt so dehydrated and was up all night peeing and not sleeping, so I have remained at 3 grams per day.

    I have felt much better on this medication once I got up to 2 grams a day for three days. I have only been on it for about a month, so I won't say that I am absolutely certain it's the medicine because my energy levels fluctuate between a 3-5 out of ten, ten is great). However I am leaning that way since my energy has been more consistently a 5 and I usually have a significant increase in fatigue when I ovulate and when my cycle starts. When I last ovulated I had fatigue but only for about three days, which is half as long as usual. When my cycle started this time, I had zero fatigue, but still had some additional tiredness, which is a great improvement.


    This medication is covered with a $5 copay under Medicare (a plus) but is expensive once you get in the donut hole (about $1800-$1900/ month at 4 grams per days).
    But I learned something today that I thought I should share: When I compared prices at different pahrmacies, I found that one pharmacy had a much better price- though still way too expensive- if I had them run it through without my Medicare insurance (retail price, with no insurance). I could not believe the price difference:
    Walgreens: $2436
    Meijers: $2344
    Walmart $1511.62
    COSTCO $504.18
    If I get a COSTCO membership for $50, it save me a little more. New cost with membership: $491.28 for a 1 year savings of $154.80 - $50 membership dues= Total Additional savings $104.80

    How can Medicare be negotiating such poor prices for their patients that we pay more money for a script if we admit we have Medicare than we would would pay without any insurance at all? Is this why Medicare is going bankrupt?

    I am more than a little irritated by this because I have to choose between paying a crazy aount of money each month ($1800-$1900) so it goes against my $4550 Medicare gap, or pay the less expensive $504.18 and have none of that cost go against my Medicare gap since I will be paying for it as if I don't have any insurance! Once out of the gap, Famciclovir would cost about $92 / month or 5% of the cost of the drug (not the cost I can buy it for at Costco, but the cost Medicare says I have to pay for it: the Medicare negotiated pricing- what did Medicare do during negotiations? Roll over?!)

    I hope this helps at least one patient!
  3. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Hi, thanks for sharing your experience. I am also cmv positive and famvir has helped lower my high lymphocytes down, in australia we cant get viral titres measured so this test is the next best thing. Your doses are very high, to high for me to afford as its not covered by the health system here. I started on 250mg twice a day which helped alot for the first 12 months then abit of a backward slide, now using 500mg twice a day and starting to feel better again and those persistant headaches have decreased within 10 days of dosage increases but past experience tells me it takes time with antivirals.

    I posted the above link to give others an alternative to valcyte and also to show that maybe once the virus is suppressed by something like valcyte that other antivirals can be used to keep it suppressed. Personally im still not where i want to be health wise and will/maybe use valcyte in a couple of months in a low dose with a lower dose of famvir, once finished with the valcyte i will continue with the famvir. Currently i pay $155 for 60x500mg for generic famvir from an online pharmacy, so thats what it cost me a month.

    Please keep us posted on how you go, the high dosage sounds interesting and maybe the sort of dosage to put cmv into latency. I was questioning the famvir dosage that dr lerner has in his study which i read as 1500mg every 6 hours, this seems to be what you are on and i believe he uses famvir for those who have bad reactions to valtrex and valcyte, so famvir must be generally better tolerated.

    cheers!!!
  4. aepalisades

    aepalisades

    Messages:
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    Michigan
    Update famciclovir and cmv

    I purchased my most recent famciclovir scripts at Costco.
    I decided to try this because the cost is so much less than Walgreens, walmart or Meijer.

    I found out that Costco does run my famciclovir through Medicare eventhough
    I am in the donut hole. But I still pay the lower price of about
    $500 for 30 day supply of 3 grams per day in divided doses.
    Costco said they do not charge the higher price just because I have insurance eventhough the Medicare
    Negotiated price is nearly $1900 per month. I was super glad to hear this.
    Costco also has an online pharmacy with similar pricing and they deliver. My sort of local Costco will
    Not deliver. I am stuck having someone drive three hours round trip monthly to pick up
    My famcyclovir at the closest costco because my doc wants me on Teva brand famcyclovir and online
    Costco does not carry the same generic teva brand as the "local" Costco store.

    I am still doing better on famciclovir two months in but I am noticing the
    Tiredness returning around ovulation and the start of my cycle.

    I have however been able to return to doing normal household
    Tasks that I had not routinely been able to do. Light housework, dishes,and laundry are an option now

    I'm not running any marathons and still struggle with fatigue sometimes. But my trigger seems to
    Be chemicals offgasing in the store from clothing and packaging material.

    I know I am nowhere near normal but I am happy to just be able
    To get off the couch- and DO anything!!
  5. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    australia (brisbane)
    cool, another ME/cfs person sponsored by famvir or maybe us sponsoring them, lol.
    good to see your feeling better, keep us updated on how you go.

    cheers!!!

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