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STDs  (Expert Forum)
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Acyclovir problems
Answered by
University of Washington Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Acyclovir problems

by missdel, May 21, 2007 12:00AM
About 3 weeks I was diagnosed with genital herpes.  I was put on acyclovir for my first outbreak and about 5 days into my 10 day cycle I began to experience difficulty urinating.  It wasn't painful to urinate I just simply had to work very hard to get it to leave my body.  When I could finally make it happen, I didn't really notice a huge decrease in urine production.  I spoke with my doctor but she didn't seem concerned and told me to finish my pills.  I have been off acyclovir for about 4 days and am still having a hard time urinating.  Could this be the sign of possible kidney damage?  Additionally, I think I might be getting another outbreak right away.  Is this possible or might it just be my initial outbreak is still running its course?  I am experiencing some itchiness a small increase in vaginal discharge (it never really stopped from the first time)and I think I might have spotted a new sore forming.
Thanks for your help.  This is all so new and incredibly scary!

by H. Hunter Handsfield, M.D., May 22, 2007 12:00AM
More likely than a side effect of acyclovir, you probably are experiencing neuropathy from the HSV infection, causing partial bladder paralysis or other neurological dysfunction of the lower urinary tract.  Many cases of initial genital herpes are associated with such localized neurological side effects.  And yes, the initial outbreak of herpes can have a stuttering course that lasts up to 3-6 weeks; not commonly, but it happens.  In general, acyclovir and its relatives (valacyclovir, famciclovir) are very safe and have almost no side effects, and I certainly have never heard of anything like this due to the drug. Whether or not due to acyclovir, your symptoms suggest lower urinary tract obstruction, not kidney damage.  Mostl likely you need more acyclovir, not less--or perhaps a switch to valacyclovir, which gives better blood levels of the drug than acyclovir.  But your provider needs to make the decision; no online expert can make a definite diagnosis from afar, and I also cannot be responsible for any treatment decisions.

I hope this helps. Best wishes--  HHH, MD
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