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Urgent Concern Re: Suppressive Therapy and Liver Damage
Hello!
I have Herpes 2. I have been on 500 milligrams of Valtrex daily for a year and a half as suppressive therapy. My gynocologist just told me that I need to stop taking it because it causes liver damage. I asked her if I could take Famir or Zovirax on a daily basis instead. She said no because all anti-virals cause liver damage.
My husband does not have Herpes. I have a stressful job and frequent outbreaks, hence my interest in daily suppressive therapy. Do you agree with my doctor that I don't have any medication options? Is' it possible to take a lower dose? I just had a test of my liver function. I don't have the results yet. Do you have a list of Herpes specialists? Thank you for your help. My disease is all I think about anymore.
I have Herpes 2. I have been on 500 milligrams of Valtrex daily for a year and a half as suppressive therapy. My gynocologist just told me that I need to stop taking it because it causes liver damage. I asked her if I could take Famir or Zovirax on a daily basis instead. She said no because all anti-virals cause liver damage.
My husband does not have Herpes. I have a stressful job and frequent outbreaks, hence my interest in daily suppressive therapy. Do you agree with my doctor that I don't have any medication options? Is' it possible to take a lower dose? I just had a test of my liver function. I don't have the results yet. Do you have a list of Herpes specialists? Thank you for your help. My disease is all I think about anymore.
MEDICAL PROFESSIONAL
Welcome to the STD forum.
MedHelp encourages forum moderators to avoid overt disagreement with questioners' own doctors. However, I'm afraid your doctor is mistaken. Valacyclovir (Valtrex) does not cause significant liver damage. In fact, it is one of the most nontoxic drugs there is; many patients have taken it for several years without difficulty. Of course any drug can cause very rare or atypical toxicity. Acyclovir (Zovirax) and famciclovir (Famvir) are similarly nontoxic. The official prescribing information for valacyclovir indicates a 1% chance of minor abnormalities of liver function in people taking valacyclovir, which was slightly higher than 0.5% for placebo. That difference was not statistically significant and there is no suggestion even for routine liver tests in people taking the drug. Here is a link to the official prescribing information about the drug, as approved by the US Food and Drug Administration: http://us.gsk.com/products/assets/us_valtrex.pdf
Also, your doctor is mistaken about "all antivirals" causing liver damage. It simply is not true. There are great differences between drugs and the various antivirlas have widely different toxicity and side effect profiles.
I wonder whether your doctor is over-interpreting guidelines for using the anti-HSV drugs. The official prescribing information advises stopping the drug periodically, like once a year. But that's not because of toxicity. It is only to encourage a discussion with the patient about whether the drug needs to be continued.
My advice is to continue to work with your doctor about this. You might print out this thread as a starting point for discussion. But if s/he still dclines to continue your prescription, I suggest you find another doctor. Sorry, but MedHelp doesn't make specific referrals -- but it shouldn't be hard to find a physician to help you out with this.
Best wishes-- HHH, MD
MedHelp encourages forum moderators to avoid overt disagreement with questioners' own doctors. However, I'm afraid your doctor is mistaken. Valacyclovir (Valtrex) does not cause significant liver damage. In fact, it is one of the most nontoxic drugs there is; many patients have taken it for several years without difficulty. Of course any drug can cause very rare or atypical toxicity. Acyclovir (Zovirax) and famciclovir (Famvir) are similarly nontoxic. The official prescribing information for valacyclovir indicates a 1% chance of minor abnormalities of liver function in people taking valacyclovir, which was slightly higher than 0.5% for placebo. That difference was not statistically significant and there is no suggestion even for routine liver tests in people taking the drug. Here is a link to the official prescribing information about the drug, as approved by the US Food and Drug Administration: http://us.gsk.com/products/assets/us_valtrex.pdf
Also, your doctor is mistaken about "all antivirals" causing liver damage. It simply is not true. There are great differences between drugs and the various antivirlas have widely different toxicity and side effect profiles.
I wonder whether your doctor is over-interpreting guidelines for using the anti-HSV drugs. The official prescribing information advises stopping the drug periodically, like once a year. But that's not because of toxicity. It is only to encourage a discussion with the patient about whether the drug needs to be continued.
My advice is to continue to work with your doctor about this. You might print out this thread as a starting point for discussion. But if s/he still dclines to continue your prescription, I suggest you find another doctor. Sorry, but MedHelp doesn't make specific referrals -- but it shouldn't be hard to find a physician to help you out with this.
Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
Glad to have helped. Best wishes.
Thank you so much for your response. You have really put my mind at ease, seriously thank you so much. Bless you for the work you do.
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