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Medical Forum / Diseases and Disorders / Herpes / April 2004

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Treatment for Oral Herpes?

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John Smith - 17 Apr 2004 19:16 GMT
Does anyone have a breakdown of the different Acyclovir medications
available for treating oral herpes?

My HMO pushes generic Acyclovir and stays away from famvir or valtrex
etc because of cost.

Are there 1-a-day brands, etc.

Thanks,

JS
Tim Fitzmaurice - 19 Apr 2004 10:47 GMT
> Does anyone have a breakdown of the different Acyclovir medications
> available for treating oral herpes?
[quoted text clipped - 3 lines]
>
> Are there 1-a-day brands, etc.

1 a day doesnt exist for acyclovir - the halflife of the drug is about 0.7
hours if I remember correctly. The prodrug (ie Valtrex) was produced to
address this precise issue.

For oral herpes you have the following drugs if Im up to date

A fistful of general antiseptics and disinfectants sold as over the
counter remedies Blistex, blisteze etc etc etc. All non specific and
general use. Too much variation in name and content from territory to
territory to go into. Many include anaesthetics that dull the pain.

For specific antiherpes drugs the list is....

Acyclovir - In tablet or topical form (there is an IV form but that is
hospital use so its not something yuo'd use or be able to use).
The tablets are pretty much available round the world and
essentially are prescription meds. Zovirax is  the well known tradename,
but pills are also available in generic makes now the patent expired a few
years ago. The topical forms vary round the world in exactly what they
are, and whether they are licensed or not, and also on the level of
licensing (in the UK the 5% cream is over the counter, in the US that
formulation is not as far as I am aware licensed, another ointment is
available and that is prescription only I believe). As the generics are
about this will be the cheapest drug in most places.

Penciclovir - You can get this in topical form, its still under patent if
I remember so only the one maker. Its been marketed as Vectavir or Denavir
in different places. It is also prescription only as far as Im aware.

Valacyclovir - This is Valtrex. Its designed to release acyclovir into the
body more effectively allowing the same efficacy on a lower dose rate. Its
also the big drug of expanding uses - all the studies for asymptomatic
studies, shorter dosing periods, one off dosing etc done recently that Ive
seen have been based on this one.

Famciclovir - This is Famvir. Its the same idea as Valtrex but ends up
releasing penciclovir as the active bit. It is I think more expensive than
the rest and lags a bit behind on how much research has been done on it -
not becuase it isnt any good but because it got spun out sideways when
Glaxo and Smithkline merged, it had to be parcelled out to another company
and this sort of thing can take time...work is still being done with it.
Its had a number of bits of information about how it may affect latency in
some way that havent yet been fully worked up so it has its own area of
excitement.

Abreva - nDocosanol - recent in the market - Its an over the counter med
in the US, not sure where  else it has been released yet, but not in the
UK...

There are some others but they are mostly special use (eg known resistant
forms, immunosuppressed people, optical only etc) including foscarnet,
TFT, idoxuridine etc.

Tim
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