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Valtrex Dosage for OB when already on suppressive 1g?
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Valtrex Dosage for OB when already on suppressive 1g?

Hi -
I have a call in to my doc but of course my OB is not waiting for her... I have also looked all over for this answer and couldn't find it, I apologize if this is a re-post.

I am a female, age 34, have had HSV-2 for at least 10 years. For many years, it wasn't that bad, and I didn't even take regular medication for it. It has only really gotten tough these past few months. Now I'm on daily suppressive therapy of 1000 mg of Valtrex/Valacyclovir, even with that, it seems I still get outbreaks, every month, the first week after my period.

Questions:

1) Is it reasonable to get regular monthly outbreaks while on suppressive therapy? Should I consider asking to up my daily dose? Or perhaps, knowing the pattern, should I just increase it at the end of my cycle? If so, starting when and how much?

2) In general, when I know an outbreak is coming on, can I start taking additional medication? How much and for how long? Please be an expert or someone who has received advice from one :)

3) Less important question, but curious: My virus was nearly dormant for so long and now it is so unmanageable! Is this common? What can I do?

Thanks!
L
4 Comments Post a Comment
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Avatar_f_tn
I thought of one more question. Should I look into something topical? I almost always get it in the exact same spot...
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101028_tn?1348750963
what sort of work up have you had so far since your ob pattern has changed?  having  monthly recurrences while on suppressive therapy and always at the same time, is a sign that this very well might not be your herpes recurring. getting tested for yeast and bacterial infections vaginally as well as thinking about changing whatever product you use when you have your period are all good ideas. even if you've used the same tampons and pads for a long time, they constantly are changing what they use in them to save money as well as improve products so starting to have a reaction to a feminine protection product is actually very common too.

when you have a recurrence, either break your pills in half and take 500mg 2x/day for 3 days or just take a pill twice a day for 3 days - either is fine.

grace
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Avatar_f_tn
Thanks Grace, I'll ask about getting a work up since I haven't had one.

A follow-up question about the dosage you suggest: I'm already on 1000mg of Valtrex taken once a day, so are you saying that I should keep the same amount, but just take half at a time? Like half in morning and half at night? That will be more effective in treating the breakout than taking it all at once?

I've heard mention of a topical acyclovir cream. Do you have an opinion on the efficacy?

Thanks! I see that you post a lot of great advice on here and it's very cool of you.
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101028_tn?1348750963
hitting it twice a day with 500mg works well during recurrences. Just  not wanting to break pills in half and just wanting to pop a 1gm pill twice a day is perfectly fine too.  

topical acyclovir cream is ineffective for genital herpes recurrences. we haven't recommended it for genital herpes for probably close to 15 years now.  

you can use topicals for pain relief though. dermoplast spray ( the blue can for the genital area, not the red can ) is a topical anesthetic you can spray on when you have recurrences several times a day to help with itching and pain.

keep asking questions :)
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