Antiviral Medicines for Genital Herpes

Antiviral medication for a first episode of genital herpes

An antiviral medicine is commonly prescribed for a first episode of symptoms. A five day course reduces the number of viruses causing the infection. If a first episode of genital herpes is not treated, the sores and blisters may last up to 2-3 weeks. This is usually much reduced if you start an antiviral medicine within five days of the onset of symptoms. The earlier the medicine is started, the better chance of easing symptoms.

Further episodes of symptoms (recurrences) tend to be milder and usually last just a few days. You usually have 3-5 days of symptoms rather than 2-3 weeks that can occur with a first episode. Antiviral medication is often not needed. Painkillers, salt baths, and local anaesthetic ointment (such as lidocaine) for a few days may be sufficient to ease symptoms. However, an antiviral medicine may be advised in the following situations:

• If you have severe recurrences. If you take a five day course of an antiviral medicine as soon as symptoms start, it may reduce the duration and severity of symptoms. You may be prescribed a supply of medication to have ready as soon as symptoms begin.
• If you have frequent recurrences. You may be advised to take an antiviral medicine every day. In most people who take medication every day, the recurrences are either stopped completely, or their frequency and severity are greatly reduced. A lower 'maintenance' dose rather than the full treatment dose is usually prescribed. A typical plan is to take a 6-12 month course of treatment. You can then stop the medication to see if recurrences have become less frequent. This can be repeated if necessary.
• For special events. A course of medication may help to prevent a recurrence during special times. This may be an option even if you do not have frequent recurrences, but want to have the least risk of a recurrence. For example, during a holiday or during exams.
• When you are pregnant. The risk to your baby is very low. Even if you have a recurrence of blisters during childbirth, the virus is rarely passed to the baby. (This very low risk is different to the high risk if you have a first episode or blisters during childbirth - before immunity has had a time to develop.) However, as there is a small risk to the baby, some doctors advise antiviral medication for the last four weeks of pregnancy to help prevent a recurrence during childbirth. Aciclovir is thought to be safe if you need it during pregnancy.

Most people who take antiviral medication get no side-effects, or only minor ones. Read the leaflet inside the medication packet for a full list of possible side-effects.

Further help and information

Herpes Viruses Association
41 North Road, London N7 9DP
Helpline (local rate) 0845 123 2305  Web: www.herpes.org.uk

© EMIS and PIP 2005   Updated: November 2005   PRODIGY Validated