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antivirals
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antivirals

Hi,

I recently got an outbreak of oral herpes, type 1. I typically get these once a year but now it seems I'm getting them more often so I want to invest in some antivirals.

I did some research and came up with this:
    * Valacyclovir (e.g. Valtrex) is currently the only oral antiviral approved for treatment of oral herpes in people with healthy immune systems.
    * Acyclovir (e.g. Zovirax)
    * Famcyclovir (e.g. Famvir)

I just wanted to ask the general community which antiviral seems to work the best with the least and most tolerable side effects. I also read that doctors don't typically prescribe antivirals for cold sores. Are there any major risks with taking antivirals? How effective have they been for you?
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101028_tn?1348750963
No issues with taking antivirals. the most common side effects are headache, nausea and abdominal pain and usually they go away after a few weeks if on suppressive therapy.

Are you looking to go on suppressive therapy or just to treat each cold sore as it occurs?

How often are you getting cold sores lately? Are they typical cold sores on the outer lip area or inside your mouth?

grace
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Avatar_n_tn
It seems I'm getting a typical cold sore on my mouth every 5-6 months. The triggers are too much sun, stress, or not getting enough sleep. I'm a student and I've pulled an all-nighter on more than one occasion. I'm looking to do episodic therapy... but I'm open to suppressive if it doesn't cost too much. It does help with shedding right? That would give me peace of mind to know I'm not potentially spreading herpes.
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Avatar_f_tn
Hi There!
I can get cold sores (HSV-1) that deserve their own zip code :) eek!
and I never leave home without Valtrex.
The Valtrex has made me dizzy and nauseous at times, but not so much now. I"ve been using it for a little over a year now. I take it nearly weekly, around the end of the week, I guess because I am run down, often I feel something coming up, and take 2grams in the am and 2grams in the pm, or vice versa. Do you think that weekly is a lot, Grace?

So, if in the case that I am having tingling or a potential oral cold sore outbreak weekly, how would YOU recommend taking the tablets? A gram daily to prevent, or 2 grams morning and night at first sign? I have pushed it and taken 3 grams in a day- it can be done, but I think you're supposed to take the tablets 8 hours apart.

Have you ever heard that HSV-1 or HSV-2 can mutate or build a resistance to the Valtrex? I haven't.

Why is it recommended that the oral cold sore dosage of 2g and repeat 12 hours later, is not to be continued for over 1 day? The acyclovir is a nucleoside that lacks 2 carbon atoms of its ribose ring- it's a brethren to allopurinol (for gout) and well, some other stuff that is has antitumor/antileukemic properties (mercaptopurines)- and these have all been around since the 1950's, so therefore, I would think that any metabolic hazards would be well known by now?

What do you think?

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101028_tn?1348750963
Depending on how money is for you - you can get 30 200mg acyclovir tabs for $4 thru walmart and similar programs.  You can take 4 pills 3x/day for 2 days at the very first sign of an impending cold sore ( 800mg 3x/day would be the actual dose ).  You can also do a round of antivirals anytime you know you might've triggered one to try to ward one off - like if you were out in the sun all day and forgot chapstick and got your lips burnt or you have a cold or finals week etc.  

suppressive therapy - valtrex is the easiest because it's just one pill daily for suppressive therapy. If you don't have decent insurance though it's going to be pricey unfortunately.  

grace
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101028_tn?1348750963
are you sure these are cold sores? Weekly cold sores would be highly unusual.

If after a thorough work up by a dermatologist it is decided they really are cold sores then suppressive therapy is your better choice and not episodic therapy.  

grace
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Avatar_n_tn
She brings up a good question.. Herpes doesnt build up resistance right?
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Avatar_f_tn
You are right, Grace,

I could be allergic to coffee or something- (mangoes, for example, make my lips, tongue, and parts of my face swell up and itch). I will see the dermatologist then, that's a good idea! Thanks! I have seen general practitioners about this and they have tossed scrips for Valtrex at me.

Oh, and Esmith, the Valtrex is really good stuff by the way.
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101028_tn?1348750963
Herpes doesn't become resistant to the antivirals like say some forms of staph bacteria have become ( MRSA I"m sure is something we've all heard about on the news frequently over the last several years ).  The thing about herpes is - all of us do occassionaly shed tk ( Thymidine kinase ) deficient strains of the virus naturally.  Sometimes even during the same ob they can swab say the anal area and detect  tk deficient herpes and the vaginal area and get regular ole tk containing herpes.  That's completely natural.  Only in a small percentage of folks does the tk deficient strains become the dominant strain and won't respond to the antivirals we currently use now for herpes ( it's ~1% of healthy folks and 5% of immunosuppressed folks that it becomes the dominant strain so thankfully it's not something we really have to be too concerned about ). The antivirals we use currently for herpes work by disrupting the viral replication process ( see you knew you should've paid better attention in high school biology  class!!! ) they don't work like antibiotics and "kill" off the virus - they disrupt it's life cycle.   You really don't have to worry about long term use of the herpes antivirals meaning that some day they will stop working for you.  

Ok science class is over - time for lunch :)

grace
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101028_tn?1348750963
have you ever been tested for a latex allergy? Mango allergies are often associated with latex allergies.  

also look at the toothpastes/mouthwashes you are using as well as the gum you chew.  Use only plain ole toothpaste - nothing whitening or tartar control or complete. Same with gum - not the strongly flavored ones or the whitening ones. They all contain acids that many folks are sensitive to.  

grace
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Avatar_f_tn
Yep, I use all of those products ... huh, who woulda thought... I do get cold sores, mostly from the sun ... but thanks, I will look into it about the latex and mangoes! I have quite decent health insurance. Will let you know if anything turns up! It would be a shame if it is a latex allergy, my boyfriend looks so cute in those little black latex shorts, hee hee.

Thanks again!
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Avatar_n_tn
Hi grace,

While looking up home remedies for cold sores (Type 1), I found this:

"Know what works if you have an outbreak--reduce your causes and maximize your cures!By the way--NEVER--EVER open a sore or put peroxide on an open sore--you will only SPREAD this disease to ANY and EVERY part of your body (including genitalia and eyes and nose and any other part of your body taht has a mucous membrane) YUK--Wash your hands!!!"

Is this true? I've always been worried about spreading it to my eyes or other areas. I read somewhere else that it is difficult to spread cold sores even if you intentionally try to infect yourself by rubbing your sore and rubbing somewhere else on your body.
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207091_tn?1337713093
Oh nice scare tactic that site uses to try and sell their product.  Its not true.

You have antibodies to help prevent you from spreading it.

Think of little kids.  They get hsv1.  They touch EVERYTHING they can get their hands on.  They touch their mouths, then their tummy, then their genitals, then their brother's genitals if they are quick, then their mouths again, etc.  They don't spread it.

AJ
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207091_tn?1337713093
Oh and before any one thinks anything strange, I have twin nephews who are 3.  They both got hsv1 at about a year and a half.  Diaper changes were a challenge with two squirmy little boys.  ;)

AJ
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