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About to start antivirals — pointers?

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Thank you all so much for helping out this newbie!

About to start acyclovir (400 mg 2x day) for recurrent EBV infections. I’ve been in the Lyme / mold world so long (although I treated for both I don’t think those are the causes of my issues!), I know the drill with taking those types of treatments — such as take binders 2-3x day, make sure you do detox methods like coffee enemas, lemon water, Alka selzter, skin brushing, must take a good probiotic with any antibiotic and 2 hrs away from them and on and on....

Are there similar “rules” or pointers with antivirals? My doc hasn’t given me any but he’s also a bit green to antivirals I think.

Thanks all!
 
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Acyclovir at 400 mg is a really low dosage when you consider the bioavailability of it. Which is actually good, to avoid side effects it's good to titrate up. But why acyclovir instead of valacyclovir?

Another pointer I have is: If you have severe side effects, ask to switch to famciclovir. I tried valacyclovir and I didn't like the side effects so I switched to famciclovir which is more tolerable for me personally (self-medicating but I think it was a good choice).
 
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Acyclovir at 400 mg is a really low dosage when you consider the bioavailability of it. Which is actually good, to avoid side effects it's good to titrate up. But why acyclovir instead of valacyclovir?

Another pointer I have is: If you have severe side effects, ask to switch to famciclovir. I tried valacyclovir and I didn't like the side effects so I switched to famciclovir which is more tolerable for me personally (self-medicating but I think it was a good choice).
+1

If you don't experience any positive impact from the acyclovir treatment, you should ask your doctor about moving to valacyclovir at slightly higher doses. You need relatively high doses of oral valacyclovir to inhibit the replication of EBV (2g/day would be a starting point) - that dose of acyclovir is typically used as a weak prophylactic for HSV1/HSV2 cold sores.
 
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+1

If you don't experience any positive impact from the acyclovir treatment, you should ask your doctor about moving to valacyclovir at slightly higher doses. You need relatively high doses of oral valacyclovir to inhibit the replication of EBV (2g/day would be a starting point) - that dose of acyclovir is typically used as a weak prophylactic for HSV1/HSV2 cold sores.
Thanks, yes. It’s just what my doc feels comfortable using at this point given side effect profiles. And, he’s seen results with his patients w acyclovir at this dose!
Good thing is that he’s open minded, so i imagine if after a month or so I’m not seeing any movement, he will be willing to switch me over to one of the others.
 

Zebra

Senior Member
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Hi, @Hoosierfans!

I take a different antiviral than you, famciclovir, but I wanted to let you know about a moderate, but unpleasant, side affect that I experienced upon starting the antiviral as well as each time I increased the dosage.

It's a little hard to describe, but it was a feeling of physical agitation/restlessness as well as tightness in the chest and increased heart rate. I also found it difficult to fall asleep because I was too "amped up."

I recall that others reported experiencing this type of reaction as well. This appears to be benign, but it was unsettling at first and quite uncomfortable at times.

It sounds like you've already "been around the block," with this illness so you probably already have a handful of remedies to counteract such side effects.

Hopefully you'll dodge this altogether, but I wanted to give you a heads up. And, for me, it always subsides after my body gets used to the new dosage.

I wish you the *best* of luck in your antiviral treatment. I hope you will keep us posted.

My best,
Z
 

Hip

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About to start acyclovir (400 mg 2x day) for recurrent EBV infections.
Dr Lerner used a much higher antiviral dose to treat ME/CFS linked to EBV: Valtrex 1,000 mg four times daily.

I think Valtrex 1000 mg four times daily is equivalent in efficacy to acyclovir 800 mg five times daily. Ref: here
 
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Dr Lerner used a much higher antiviral dose to treat ME/CFS linked to EBV: Valtrex 1,000 mg four times daily.

I think Valtrex 1000 mg four times daily is equivalent in efficacy to acyclovir 800 mg five times daily. Ref: here
Thanks Hip, yeah I read that. My doc is just comfortable using acyclovir given side effect profiles and that he’s seen results in using it at this dosage with patients. But he’s an open minded guy who is always willing to read the research so I’m sure if I don’t respond, he’ll be more than willing to move me over to one of the other antivirals, like Valtrex or Valcyte.
 

Seadragon

Senior Member
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@Hoosierfans I've been given a three month trial of 400mgs Acyclovir three times a day by Dr Bansal in the UK. He also feels that Acyclovir as a drug and at these lower doses is less likely to give problematic side effects.

I started taking Acyclovir ten days ago and have not had any side effects so far. I will report back if that changes.

It's advisable to make sure you drink plenty of water/fluids with Acyclovir though as another poster said earlier.
 
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Well folks Day #6 on the acyclovir and so far only positive things to report. Of those 6 days, 4 of the days were days where my skin burning was down, dizziness was down, anxiety was WAY down, mood improved and I could get out of the house at least once per day (normally I leave the house once per week).

Today I’m back down, but that’s ok — I think the acyclovir is doing some good things. Will meet with my doc next week to see how long he wants me on the acyclovir before we decide whether to bump up to Valtrex or Valcyte.

👍🏻❤💪🏼