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Shingles-Herpes Zoster virus - what antiviral and what dosage and how long ?

raghav

Senior Member
Messages
809
Location
India
Guys,
I had shingles (Herpes zoster) virus 35 years back at the base of my spine. The marks are still there. So what antiviral should i try. i googled and found that acyclovir is suitable for this (Cheapest). Or should I try something else ? What dosage and what duration should I be on it ? I dont want to over load my liver and kidneys since I am already on a lot of medications for epilepsy and depression. Please advice. Thx.
 

raghav

Senior Member
Messages
809
Location
India
If I take famciclovir then what is the daily dosage ?(I am asking this from cost point of view).
 

raghav

Senior Member
Messages
809
Location
India
@Hip You had prepared a table for the antivirals and the viruses they act upon. I searched but could not find it. Please give me the link to it. Thanks.
 

Wonkmonk

Senior Member
Messages
1,006
Location
Germany
One drug that is not in the road map, but is extremely effective against Varicella Zoster Virus is Brivudine.

But it's not recommended for use longer than a week because of possible hepatotoxicity (probably that's why it's not in the roadmap). It is used for acute Herpes zoster treatment.

I used it for 6 weeks with still normal liver tests, but that's of course just me, and it's not recommended for chronic use.

Also note there is a possibly fatal interaction with some chemotherapeutic agents. Other than that, it has only very few side effects and interactions.

But it sounds like you need a long-term medication, so it's probably not the first choice anyway.
 

Hip

Senior Member
Messages
17,824
But it's not recommended for use longer than a week because of possible hepatotoxicity (probably that's why it's not in the roadmap). It is used for acute Herpes zoster treatment.

Because for herpesviruses, ME/CFS is primary linked to EBV, HHV-6 and cytomegalovirus, and brivudine only targets VZV and HSV-1, so it may not be much use in ME/CFS. Although there are some theories that VZV and HSV may be involved in ME/CFS.

I can't find any instructions or info saying that brivudine is not recommended to be used for more than a week due to hepatotoxicity. Would you have a link to this?
 
Last edited:

Wonkmonk

Senior Member
Messages
1,006
Location
Germany
It's from the patient information from the package insert (in German):

https://beipackzetteln.de/zostex

"Sie sollten Zostex nicht länger als 7 Tage anwenden, da eine Verlängerung der Behandlung über den empfohlenen Zeitraum von 7 Tagen hinaus mit einem erhöhten Risiko für die Entstehung einer Leberentzündung (Hepatitis) verbunden ist."

Which means:

"You should not use Zostex longer for more than 7 days, because treatment of longer than 7 days is associated with an elevated risk for inflammation of the liver (Hepatitis)."
 

Hip

Senior Member
Messages
17,824
One drug that is not in the road map, but is extremely effective against Varicella Zoster Virus is Brivudine.

I have now added brivudine to the roadmap, in the antiviral table and in the varicella treatment section.