American Journal of Clinical Dermatology

, Volume 3, Issue 9, pp 591–598 | Cite as

Oral Antivirals Revisited in the Treatment of Herpes Zoster

What Do They Accomplish?
Current Opinion

Abstract

Oral antiviral agents currently represent the most important therapeutic keystone in the treatment of herpes zoster. Three oral antiviral agents are available for the treatment of herpes zoster: acyclovir, its derivative valacyclovir, and famciclovir. Meta-analysis of published data has shown that oral acyclovir significantly reduces various herpes zoster-related symptoms as well as the duration, intensity and prevalence of zoster-associated pain (ZAP). However, this drug does not influence postherpetic neuralgia. The newer agents famciclovir and valacyclovir exhibit a better oral bioavailability than acyclovir. These agents have demonstrated similar efficacy to acyclovir with ZAP and they require less frequent administration.

When initiated within 72 hours, oral antiviral therapy of herpes zoster is beneficial in selected, elderly immunocompetent patients, reducing the duration and intensity of ZAP and providing more rapid skin lesion healing. Oral antivirals are also of benefit in immunocompromised patients with uncomplicated herpes zoster. However, signs of cutaneous and visceral dissemination should be monitored; if signs occur, intravenous antiviral therapy is indicated.

Keywords

Herpes Zoster Acyclovir Varicella Zoster Virus Famciclovir Varicella Zoster Virus Infection 

Notes

Acknowledgments

The authors have provided no information on sources of funding or on conflicts of interest directly relevant to the content of this review.

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© Adis International Limited 2002

Authors and Affiliations

  1. 1.University Medical Center, University of LiègeLiègeBelgium

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