Herpes pills: list of effective drugs. Latest generation anti-herpes tablets and their analogues Development of a medicine for herpes

There are 8 types of herpes virus that affect the human body. The symptoms of some of them are similar, for others they vary greatly - the diseases manifest themselves as skin rashes, fevers, sore throat, mental damage and even oncology.

Treatment of herpes in most cases is monotonous: it is aimed at suppressing viral activity with certain drugs and increasing immunity. For different types of infection, complex therapy requires additional medications to combat specific symptoms.

What drugs are used in therapy against herpes infection?

To treat the herpes virus in modern domestic medicine, the following drugs are usually used:

For different types of disease and affected areas, different forms of drugs are prescribed. So, for labial (simple) herpes, external agents are usually used, for extensive rashes - tablets and injections. In case of genital infection, suppositories also come into play. Low-dose injections are recommended for newborns because they cannot take other forms of medication.

Attention! If a herpetic infection is complicated by additional fungal or bacterial diseases, antibiotics are additionally prescribed. In other cases, these drugs are dangerous to take; they can only worsen the patient’s condition. When prescribing, they try to limit themselves only to forms for local/external use; oral medications are prescribed only for particularly extensive internal bacterial damage.

How to treat herpes during pregnancy

During pregnancy, primary infection with herpes is most dangerous. If a woman has already encountered this disease, her body produces antibodies that are transferred to the embryo, thereby protecting it (albeit not 100%) from infection. Recurrences of herpes infection are also not so scary; with adequate treatment, the risk of infecting a child is minimal.

First of all, therapy is aimed at suppressing the activity of the virus and reducing the duration of the acute period of the disease.

In the first 24 hours after the onset of herpes symptoms, you should start taking antiviral drugs:

• Acyclovir;
• Valacyclovir;
• Penciclovir;
• Famciclovir.

You can take any analogues of these drugs. Safer and more effective than others for treatment are acyclovir medications, which include Zovirax, Gerpevir, Supraviran, Acigerpin. These substances are active against herpes viruses types 1, 2, 3, 4 and 5.

Typically, the prescription of antiviral drugs in pregnant women is limited to local administration - in the form of ointments, gels, creams. This is justified by the low percentage of penetration of the active substance into the mother’s body, since at the same time it passes through the placental barrier (enters the child’s body). Antibacterial ointments are also recommended for external use - oxolinic, tetracycline, erythromycin and tebrofen, Neosporin, Vidarabine, Riodoxol.

It is important to know! In case of significant damage to the body by herpes, in case of primary infection or a particularly acute relapse, drugs are prescribed in tablets: 500 mg of Valaciclovir twice a day for 10 days or 200 mg of Acyclovir three times a day for 5 days.

For severe pain, women are advised to lubricate their skin with Xylocaine 2%. To speed up the regeneration of affected areas, you can take sitz herbal baths with chamomile or string, and then apply drying ointments, such as zinc, to the damaged areas.

Features of treatment of newborns and children up to one year

If the mother has a herpes infection, the newborn must be isolated during the incubation period of the virus. It does not matter whether the child has clinical symptoms or not. However, if the mother was healthy, the baby is isolated only if characteristic signs are present.

Traditionally, herpes treatment is carried out according to the following scheme:

• If symptoms of herpes occur, 30 mg of Acyclovir per kilogram of body weight is prescribed intravenously daily for 10 days.
• Generalized infection is treated with increased doses of Acyclovir - up to 60-90 mg - for 2-3 weeks.
• Human immunoglobulin is also used at 4-6 mg per kilogram intravenously through a dropper in the first 3 days. The drug can be replaced with Viferon, Roncoleukin or Reaferon.

If the organs of vision are damaged or there are skin rashes on the newborn’s body, in addition to intravenous therapy, local antiviral agents are used - Acyclovir ophthalmic ointment and interferon-based gels. Herpetic rashes on the gums () and the inner sides of the lips are treated with hydrogen peroxide 3%. To anesthetize feeding, anesthesin or lidocaine is used before feeding.

Treatment of labial and genital herpes (types 1 and 2) in men and women (on the butt)

Labial herpes simplex usually “spreads” over the skin of the face, neck, mucous membranes of the nose and mouth, and touches the eyes. Scratching and frequently touching affected areas can spread the infection throughout the body.

Mainly located in the groin area: on the external genitalia, inner thighs, butt. The disease can spread to the vagina in women or to the urethra and testicles in men. Touching also transfers the infection to any other parts of the body - to the stomach, armpits, face.

Treatment for both of these types of herpes is similar. Therapy is usually carried out in three stages:

1. Taking antiviral drugs for 5-10 days: Acyclovir, Ganciclovir, Cytarabine, Famciclovir, Ribavirin, Trifluorothymidine, Bofanton, Tromandathrin, Oxolin, Tebrofen, Amiksin in the form of injections, ointments or tablets.
2. Raising immunity during a period of remission of 30-60 days: human immunoglobulin, Pentaglobin, Cytotect, Vesikbulin, Camedon, Kagocel, Viferon, Cycloferon, Ridostin, Leukinferon, Neovir, etc.
3. Prevention of relapse of the disease once every 6 months: Amiksin + polyvalent vaccine against herpes is prescribed (a total of 5 subcutaneous injections of 0.2 ml every other day).

With labial herpes, it is often enough to carry out the first stage of treatment, while the genital form is treated with a full course. Often, only boosting immunity (simplified second stage of treatment) without vaccination is used to prevent relapses.

How to treat herpes zoster (type 3)?

Shingles often goes away on its own, but treatment against the zoster virus is still used to improve the immune system, relieve uncomfortable symptoms, and reduce the risk of relapses. Therapy is especially necessary for elderly people (over 50) and with severe immunodeficiency. In this case the following is prescribed:

• Antiviral drugs. Acyclovir, Famciclovir, Valacyclovir, Penciclovir. It is advisable to start treatment in the first 3 days.
• Painkillers. To alleviate the physical and psychological condition of the patient, narcotic analgesics (for example, Oxycodone) are prescribed in the USA; in Russia, non-narcotic analgesics are prescribed: Ketoprofen, Ketorolac, Ibuprofen, Naproxen.
• Anticonvulsants. Sometimes, for severe neuropathic pain, patients are recommended to take Gabapentin or Pregabalin.

Several drugs should be noted separately, since their use is most effective and is often prescribed by doctors: deoxyribonuclease, Isoprinosine, acyclovir drugs, ganglion blockers (Gangleron). Additionally, patients are recommended to take vitamin B complexes and interferon ointments/aerosols (Eridin, Alpizarin, Florenal, Helepin). If herpes reaches a gangrenous form, antibiotics and Solcoseryl are added to therapy.

Recovery from shingles is usually incomplete - neuralgic symptoms of the disease remain (postherpetic neuralgia). Treatment continues with the same anticonvulsants and analgesics, opioid drugs are added, but antiviral drugs are no longer required. Neurological therapy is aimed primarily at eliminating the pain syndrome.

Antiviral therapy for ophthalmoherpes (in the eyes)

In the treatment of herpetic eye lesions, the same antiviral drugs are used, but in the forms of eye ointments, drops, or for internal use. The clinic actively uses drugs based on 5-iodo-2-deoxyuridine:

• Keretsid;
• Stoxyl;
• Idukollal;
• Herplex;
• Dendryl;
• Oftan-I'm coming.

Patients are also prescribed other compounds of this group- acyclovir, ganciclovir, valacyclovir, famciclovir, sorivudine, vidarabine, TFT, brivudine and foscarnet. Florenal, Riodoxol, Tebrofen can be added to the list of antiviral drugs against eye herpes. Interferon-type drugs include leukocyte interferon, Poludan, Cycloferon, Timalin, Taktivin and Amiksin.

Treatment of Epstein-Barr virus (herpes type 4) and herpetic sore throat

There is no specific treatment regimen for patients with EBV infection; the therapeutic complex is determined according to the individual indications of the patient’s condition. Persons with high fever, severe tonsillitis/sore throat, jaundice, anemia and airway obstruction should be hospitalized. In other cases, treatment can be done at home.

Patients need maintenance therapy with rinsing the mouth with antiseptic solutions (for severe pain, 2% lidocaine or xylocaine is added to the solution). It is important to ensure you drink plenty of fluids.

First of all, the prescription of antiviral drugs is required:

• Acyclovir, Ganciclovir, Valaciclovir and other acyclic nucleoside analogues;
• Cidofovir, Adefovir and other acyclic nucleotide analogues;
• Foscavir, Foscarnet, phosphonoacetylic acid and other pyrophosphate analogues.

Additionally, the following groups of drugs are prescribed:

• non-steroidal anti-inflammatory drugs: Tylenol, acetaminophen, paracetamol;
• antibacterial(in the presence of concomitant infections): selected depending on the sensitivity of the microflora, mainly cephalosporins, macrolides, lincosamides;
• antifungal: fluconazole, metronidazole;
• glucocorticosteroids(for severe disease): orazone, dexamethasone, prednisolone, deltazone, hydrocortisone;
• immunoglobulins and immunomodulators: Alphaglobin, Gammar-P, Sandoglobulin, Intron A, Reaferon, Cycloferon, Viferon.

Cytomegalovirus infection (herpes 5): treatment for adults and children

There is also no correct separate treatment regimen for CMV. Symptoms of the acute phase of the disease are treated with the same antiviral drugs as other herpes viruses. More often, however, Ganciclovir and Valganciclovir are used.

Additionally, immunomodulatory therapy is required, including vitamin support and stimulation of the immune system with interferons and globulins. Cycloferon, Viferon and other similar drugs are prescribed, the course of treatment is several weeks. The patient also needs to improve their lifestyle: change their diet, exercise, take enough fluids, and walk in the fresh air.

Often the acute form “attaches” other diseases that require adequate treatment with antibiotics. This therapy is concomitant and does not reduce the severity of the symptoms of the herpes virus itself, so it is used only as an addition to the complex of antiviral and immunomodulatory agents.

Features of herpes treatment 6

When a child or adult exhibits symptoms of this form of herpes, a typical antiviral therapy regimen is prescribed. Comprehensive treatment usually includes Ganciclovir, the most effective drug against HHV-6 from the group of acyclic nucleoside analogues, as well as Foscarnet and Cidofovir. For children under 12 years of age, only the latter is allowed to be used.

Acyclovir is ineffective against herpes type 6. Adefovir and Lubocavir are sometimes used, and experimental vaccines are being developed. To relieve the symptoms of infection, use antipyretics (Paracetamol or Ibuprofen), drink a lot of water and diuretic herbal teas.

Herpetic rashes in children practically do not itch, so external antibacterial ointments are not required to prevent additional infection. However, care should be taken to take vitamin complexes in order to strengthen the body’s natural defenses and accelerate the production of a sufficient amount of antibodies against HHV-6.

In adulthood, the infection manifests itself with severe immunodeficiency, so suppression of symptoms should be carried out primarily with interferon immunomodulators. However, such treatment is prohibited if the disease manifests itself after an organ transplant, since during this period a weak immune system is necessary to prevent tissue rejection.

How are herpes types 7 and 8 treated?

These two types of herpes have been studied so little that there are no definite treatment regimens. In individual therapeutic complexes, classical antiherpetic drugs are used in combination with medications aimed at eliminating the symptoms of concomitant diseases.

Thus, in the presence of oncological diseases from herpes type 8, treatment with interferons is contraindicated, however, chemotherapeutic antitumor drugs can be added to the complex. Surgery and radiation therapy may be required. If the mental state of a patient is affected by herpesvirus-7, adequate psychotherapy is necessary with the possible use of antidepressants and psychoanalysis sessions.

Treatment of herpes of internal organs

Herpes on internal organs is treated according to the classical scheme, but the drugs are prescribed orally - there is no place to use them locally.

The most commonly prescribed antiviral drugs are:

• Acyclovir;
• Famvir;
• Valtrex;
• Ganciclovir;
• Cytarabine et al.

They are used in the form of suppositories, tablets and injections. Immunomodulators are also used in the same forms:

• Viferon;
• Cycloferon;
• Isoprinosine;
• Lycopid.

Attention! It is highly not recommended to self-prescribe medications that affect the immune system. This should be done by the attending physician or immunologist.

In addition to classical therapy, auxiliary drugs are prescribed: for the liver - hepetoprotectors, for severe inflammatory processes - anti-inflammatory drugs, for those with concomitant fungal or bacterial diseases - antimycotics and antibiotics.

Folk remedies for the treatment of herpes

Every year they deserve more and more popularity in medical circles. In case of minor damage, treatment with natural herbal preparations can give an excellent result; in case of extensive spread of the disease, it is recommended to combine them with drug treatment.

Domestic doctor L.V. Pogorelskaya offers the following treatment regimen for recurrent herpes:

1. Decoction from a collection of herbs. Mix lemon balm, thyme, raspberry leaves, wormwood, juniper and oregano in a ratio of 4:3:4:2:3:3. Brew 1 tsp daily for an hour. in a glass of boiling water and drink in two doses for 14-28 days.
2. Alpizarin in the amount of 0.1 g three times a day for 21 days.
3. Twice before lunch, 40 drops of Eleutherococcus extract before meals.
4. Alpizarin or helepin ointment for rashes three times a day for 14-28 days.

Infusions, decoctions and compresses from the following plants also help against herpes: Amur velvet, pinnate Kalanchoe, Canadian desmodium, medicinal calendula, warty birch, yellowing kopek, common juniper and pine, kopek lespesda, buckthorn, cotton, twig-shaped eucalyptus and western thuja

Tablets for herpes are used when the disease occurs with complications or is generalized. These medications effectively suppress the effects of the virus. Their active component is quickly released, penetrating the nervous system. Thus, herpes medications prevent further spread of the virus and speed up the patient’s recovery. The dosage of medications in tablets is determined by the doctor. To avoid side effects from their action, it is recommended to follow the prescribed rules of administration. Otherwise, drugs for herpes in adults cause disturbances in the functioning of the gastrointestinal tract and liver.

Herpes is a chronic disease. It cannot be completely cured. Therefore, medications for herpes are selected in such a way as to achieve several goals at once:

• suppress the activity of herperovirus;
• restore the immune system;
• eliminate symptoms of the disease, including skin manifestations.

Also, drugs in tablet form are used to prevent relapses of herpes. In the latter case, the attending physician prescribes the drug in a lower dosage.

All antiherpetic medications must be taken in combination with medications whose action is aimed at restoring immunity. In addition, it is necessary to use drugs to treat herpes at the first manifestations of the pathology. This approach allows you to quickly cope with this problem, avoiding the development of complications. Antiviral treatment in the initial stages of herpes prevents the spread of infection to healthy cells. As a result, the rash is localized in a strictly defined area and quickly disappears.

All drugs that are available in tablets should not be taken for longer than the prescribed period or in excess of the prescribed dosage. The course of treatment averages 1-2 weeks. If necessary, the duration of tablet therapy can be increased.

"Acyclovir" - antiviral tablets proven over the years

These effective herpes pills have a highly targeted effect on the virus. Acyclovir does not affect internal organs, tissues and cells. It is prescribed for various forms of pathology. “Acyclovir” for herpes in tablets is the cheapest and most accessible drug that can quickly eliminate rashes on the body and genitals. The substance in them, penetrating the human body, is integrated into the DNA structure of the virus and prevents its replication.

In addition to the indicated effect of Acyclovir, the medicine allows you to achieve the following results:

• prevent the development of rashes on the body;
• strengthen the immune system;
• accelerate the healing of wounds on the skin and mucous membranes;
• reduce the likelihood of complications (including damage to internal organs);
• relieve pain.

The manufacturers of Acyclovir recommend treating the symptoms that have arisen for a period determined by the attending physician. Despite the fact that this drug is considered one of the best pills, over time the virus develops resistance (resistance) to it. Therefore, subsequent use of antiviral drugs will not have the desired effect on the body.

“Acyclovir” in a dosage of 800-1000 mg daily is prescribed for herpes simplex, for Zoster infection 2000 mg daily. To prevent the disease, you need to take the drug 3 tablets a day for one week.

Acyclovir tablets are contraindicated:

• persons with individual intolerance;
• pregnant women and women during lactation.

Instead of Acyclovir, Valtrex is prescribed. It is recommended:

• for all types of herperovirus;
• in case of relapse of the disease;
• for the prevention of herpetic rashes.

"Valtrex" tablets in the treatment of diseases, unlike "Acyclovir", have a less aggressive effect on the body. However, both drugs achieve similar results. Valtrex contains valacyclovir. After penetration, the component is transformed into acyclovir. Therefore, the effect of this drug is similar to the results that Acyclovir tablets can achieve.

Valtrex causes many side effects. The drug is allowed to be used for one day if an immunodeficiency state is detected.

Zovirax is a reliable and modern antiherpetic drug

Zovirax is often used to treat the herpes virus. It comes in the form of:

• ointments;
• injection solutions;
• tablets;
• capsules;
• rectal suppositories.

The latter, when administered to children, have the best effect on the child’s body, suppressing the herperovirus. All of the above drugs against herpes are based on the substance acyclovir. Zovirax is recommended for the treatment of:

• herpes simplex;
• herpes zoster;
• recurrent form of the disease;
• complicated pathology.

Medicines like Zovirax are prescribed to patients with immunodeficiency to prevent pathology. These effective drugs are taken for one week. For the treatment of herpes of the first or second types, Zovirax is prescribed only in the form of ointments. During the day, the drug must be applied to the problem area up to 5 times.

"Famvir" is a medicine based on Famciclovir, which was developed recently

Famvir is a new generation antiherpetic drug. The medicine package contains 7-40 tablets in various daily dosages:

• 150 mg;
• 250 mg;
• 500 mg.

Famvir is prescribed when modern medications based on acyclovir do not give the desired result. This new remedy is also recommended during pregnancy and lactation. In addition, Famvir effectively suppresses the activity of herperovirus in patients with immunodeficiency.

Regardless of the type of herpes, the drug quickly eliminates the external manifestations of the disease. Famvir is based on famciclovir, a substance that is transformed in the human body into penciclovir. The action of this component does not damage healthy cells.

With the help of Famvir you can get rid of the symptoms of the pathology. The product provides a long-term antiviral effect, reducing the likelihood of relapse by 80%. The newest substances included in the medication accelerate the healing of wounds on the surface of the skin and mucous membranes.

Among the disadvantages of Famvir, its high price should be highlighted. The cost of the drug varies between 1-4 thousand rubles. In addition, the medicine has the following contraindications: individual intolerance, age under 18 years.

Tablets or ointments: which is better and more convenient?

The choice between antiviral tablets and ointments, which is better, should be made by a doctor. Drugs produced for local treatment provide relatively quick results. Such medications against herpes eliminate the symptoms of the disease and allow you to achieve a lasting effect for a long time.

Ointments are usually prescribed for exacerbations of pathology. They speed up the healing process of open wounds and prevent secondary infections. Ointments are more often used in the treatment of the disease in pregnant women and children.

Any effective medicine penetrates into the blood. The active components of the drug penetrate the bloodstream into the internal organs, and in pregnant women, through the placenta into the child’s body. As a result, medicinal substances have a negative effect on the development of the fetus or the condition of the liver and kidneys. Therefore, the effectiveness of such treatment often does not justify the consequences it causes.

To avoid complications, herpes therapy is mainly carried out using antiviral ointments. Their components have a local effect on the problem area. The use of these drugs ensures stable remission with minimal damage to internal organs.

It is difficult to decide which medications are more convenient in treating pathology. All agents suppress the activity of herperovirus. But some of them act directly on the DNA of the virus, while other drugs mainly relieve symptoms.

There are many medications used in the treatment of herperovirus infection. The selection of medications should be done by a doctor. So, one medicine can cope with the manifestations of a virus on the lips, but another will not create the desired effect. In addition, the doctor takes into account the individual characteristics of the patient’s body.

In some cases, the doctor advises taking specific pills for various manifestations of herpes. When taken, the symptomatic manifestations of the pathology are significantly reduced and recovery occurs faster.

Treatment will be more effective if the effect of antiherpetic drugs is enhanced with a drug that increases the body's immune defense.

Shingles

Most often, this type of herpetic lesion appears in people over 50 years of age who had chickenpox in childhood. The prodromal period lasts from 2 to 4 days. At this time, general weakness increases, various digestive disorders are recorded, and headaches occur. All these symptoms appear against the background of low-grade fever. The patient also begins to be bothered by itching, burning and pain at the location of future lesions.

Then nodular, purple-colored lumps appear on the skin. The rash is located along the nerve trunks. Most often, the rashes are localized along the intercostal nerves and are located in a strip on one side of the body. After a few days, the nodules turn into serous papules. After two weeks, the blisters burst and become crusty. The pathology is accompanied by excruciating pain along the nerve, aggravated by any touch. This happens due to the damage of nerve fibers by viruses.

The consequences of this type of herpes can be extremely serious:

• possible destruction of the tissue structure of the spinal cord and brain as a result of the penetration of the virus into the tissue;
• damage to internal organs, leading to various disorders of their function;
• development of blindness due to destruction of the optic nerve.

Very long lasting. External remedies are not effective, but their use will protect the healthy tissue surrounding the lesion from infection. For this purpose, ointments containing Acyclovir are prescribed.

The main emphasis in therapy is on taking tablets that have an antiherpetic effect. This is, first of all, the new generation drug Famvir, as well as Zovirax and Panavir. Acyclovir in tablet form is also highly effective for herpes zoster. Additionally, the doctor may prescribe pills that relieve pain, as well as antidepressants.

Genital herpes

Infection with a virus that affects the genital tract occurs through unprotected sexual contact. In this case, specific rashes characteristic of the herpetic process appear in the perineal area, on the external genitalia and their mucous membranes. The infection affects both men and women.

If the pathology appears in pregnant women, then there is an extremely high risk of infection of the child with the virus during childbirth or in utero, which can lead to the death of the baby. Also, this form of the disease can lead to the development of cervical cancer.

The most effective medicine in this case is Acyclovir. This drug is used not only to treat the manifestations of the disease, but also as a preventive therapy. If genital herpes recurs more often than once every two months, this drug is taken for several months. This allows you to completely suppress the activity of the virus in the body. Treatment must be supplemented with drugs that increase the body’s immune strength.

Effective therapy

Acyclovir is most successfully used in the treatment of herpes infection. This drug is cheap and highly aggressive against viruses that cause herpes. Most of the various topical preparations, as well as tablets of specific action, contain this component.

Acyclovir inhibits the ability of the virus to multiply by selectively targeting it with deoxyribonucleic acid. In this case, the DNA of healthy human cells is not affected.

Treatment with the drug lasts 5 days. During this time, all symptoms completely disappear. For adults and children over 2 years of age, Acyclovir is prescribed 1 tablet up to 5 times a day. For children under two years of age, the dose is halved. For the treatment of herpes zoster, the dosage of the drug is increased to 4 tablets per dose.

The drug is also effective in preventing the development of relapses of the disease. An eye ointment of the same name with this substance is also produced for the treatment of keratitis caused by the Zoster virus.

The advantages of the drug also include its good tolerability. Side effects during treatment with Acyclovir appear extremely rarely.

How to take pills correctly

For the most effective action, a tablet taken for herpes of any form must be absorbed in the desired part of the digestive tract. To ensure that the active ingredient of the drug along the route to the small intestine is not destroyed under the influence of salivary enzymes and stomach acids, you must adhere to the following rules:

• Treatment should begin from the first day of the disease. With this approach to the treatment of the herpetic process, there will be the fastest possible therapeutic effect. The period of manifestation of symptoms of the disease will also be reduced, and the patient will be protected from the development of complications;
• Even if recovery occurs in the first days of taking the drug, take the full course prescribed by your doctor. Only if this condition is met can the manifestations of the disease be completely cured. Herpes viruses are very insidious and easily adapt to drug exposure. A full course of therapy will completely stop the process of vital activity, reproduction and aggressiveness of the pathogen. If the course of treatment is not completed, the pathogen will lie low under the influence of drugs, but after a few days the activity of the infection will increase sharply. At the same time, it will be much more difficult to fight the virus, and even the most effective herpes pills may be powerless, and the lesions and severity of symptoms will be much greater;

Antiviral medications should be taken with or immediately after meals. You can take the tablets only with clean water.

Contraindications, warnings and side effects

Drugs for the treatment of herpes have a very narrow list of contraindications. Even the best remedies can cause an allergic process if the patient has a hypersensitive reaction of any type. Therefore, in order to avoid the development of allergies, such drugs should not be taken in case of individual intolerance to any of the components of the medicine. Also, children under 3 years of age should not be treated with such tablets.

The list of relative contraindications includes:

• various disorders of the nervous system, even if they were in the past;
• dehydration of the body;
• renal failure.

Can pregnant and breastfeeding women take antiviral drugs for herpes? All these drugs easily overcome the blood-brain and placental barrier. Also, the embryotoxic effect of drugs against herpes has been proven in laboratory conditions, so any drug in this group is undesirable to take during pregnancy and lactation.

However, some women took antiviral drugs while expecting a child. Sometimes your doctor may prescribe medicine for herpes to women during pregnancy. This happens if there is a threat of infection of the child during childbirth. Most often, this situation occurs with genital herpes. In this case, the doctor makes a decision depending on the balance of risks from taking the medicine and the dangerous effect of the herpes virus on the developing fetus.

Side effects such as dyspepsia, headache, and a slight decrease in performance are also rarely observed.

For elderly people, in order to prevent the development of dehydration, doctors strongly recommend drinking large amounts of water during treatment with antiherpetic drugs.

Drugs of this group should be used with caution in patients with diseases of the liver, kidneys, various organs of the gastrointestinal tract, as well as the central nervous system.

Immunomodulators

Herpetic infection always develops against the background of reduced immunity. Therefore, any antiviral drugs for herpes are prescribed in combination with taking immune agents. Increasing the body's defenses will significantly enhance the effect of herpes medications in tablets and increase their antiviral properties. Healing will also be accelerated by using local remedies such as antiherpetic ointment, cream, etc.

Immunomodulators that act in cases of herpes are divided into three groups:

• endogenous origin (i.e. produced by the body);
• endogenous;
• chemically synthesized.

From the endogenous group, you can take thymic compounds produced from the thymus gland of cattle. These are medications such as Timalin, Timostimulin, Taktivin. Cytokines, including interferons and its derivatives, also have a good effect. The best remedy for cytokines is Cycloferon. This drug has not only an immunomodulatory effect, but also antiviral and anti-inflammatory.

A distinctive feature of taking Cycloferon is the scheme of its use. The doctor prescribes taking pills every other day during the first week, and two days later on the third for the next two weeks. Moreover, you need to drink the entire course, even if the illness went away on the third day.

The exogenous group is represented by drugs of bacterial (Bronchomunal, Pyrogenal and others) and herbal origin. Plant-based immunomodulators contain the juice of the Echinacea purpurea herb or Cordyceps mushroom. The substances contained in these plants not only normalize the body’s immunity, but can also easily deprive the pathogen of the opportunity to grow and reproduce.

The newest drugs created chemically can be low- and high-molecular compounds. Such drugs include Polyoxidonium, Galavit, Alloferon and others.

It should be noted that doctors give preference to exogenous and endogenous immunomodulators, which enhance the effectiveness of phagocytes and other protective cells of the body. While chemically synthesized substances take over the work of the body's immune system, which leads to a decrease in its function, up to the need for lifelong replacement therapy in the future.

Herpes is a viral disease that affects the mucous membranes and skin. As a rule, this disease is recurrent. affects leukocytes and reduces immunity. Unfortunately, modern medicine has not yet developed methods for removing this virus from the body. The main goal of specialists at this stage is to suppress its reproduction during the period of exacerbation. For this purpose, the most effective for herpes are those containing acyclovir, valacyclovir, famciclovir, penciclovir or allostatin as the active ingredients.

Treatment of herpes

According to statistics, about 95% of people of reproductive age on our planet are affected by the herpes virus. Exacerbation of the disease in such individuals usually occurs 4 times a year. It manifests itself in the appearance of small blisters on the lips, mucous membranes and skin. If rashes appear more often, you should consult a specialist who will prescribe antiviral drugs. Such medications block the DNA synthesis of herpes and thereby suppress its reproduction.

During the period of exacerbation of the disease, people in whose blood HSV is detected should take certain preventive measures:

• Avoid prolonged exposure to the sun and cold rooms. Overheating and hypothermia suppress the immune system and provoke the appearance of herpes.
• Limit the consumption of beer and other alcoholic beverages.
• Regularly take a course of vitamin therapy.
• Lead a healthy lifestyle. Stop smoking.
• Carry out regular treatment for chronic diseases, as they can provoke the development of pathology.

Ointments for herpes

Ointments are effective antiviral drugs for herpes on the lips. They act directly on the visible manifestations of the disease and allow you to quickly get rid of them.

Let's look at the most popular remedies for eliminating herpes on the lips and skin:

• "Viru-Merz Serol" - antiviral gel. The main active ingredient is tromantadine. This remedy quickly relieves pain, burning and itching. Effective in the fight against herpes zoster.
• "Panavir" is an immunomodulating gel with antiviral properties. The main active ingredient is hexose glycoside. The gel acts directly on the site of inflammation, inhibiting the virus there. Can be used for genital and
• "Bonafton" is an antiviral ointment. The main active ingredient is bromonaphthoquinone.

For rashes on the lips and mucous membranes of the nose and mouth, it is recommended to use auxiliary ointments - “Dexpanthenol”, “Depanthenol”, “Bepanten”. They promote tissue regeneration and accelerate the healing process of crusts.

Herpes pills

Experts say that the most effective antiviral drugs for herpes are tablets. Many people have the opinion that such drugs inhibit HSV, saturating the body with harmful “chemicals”. However, tablets, unlike ointments, affect the activity of the virus, and do not simply eliminate symptoms.

Let's consider the mechanism of action of such medications.

When the tablet enters the human stomach, the main active ingredient of the drug is released. Then it is absorbed into the blood and with its help spreads throughout the body. Special enzymes that are necessary for the reproduction of the pathogen are blocked in the cells.

It is important to take antiviral drugs for herpes in a timely manner. The course of therapy should begin in the prodromal period - before the first visible symptoms appear. In this case, you will be able to avoid the appearance of ulcers on the mucous membranes and body.

You should also remember that these drugs can only be used after consulting a specialist.

Acyclovir-based drugs

Medicines in which acyclovir is the main active ingredient are the most effective antiviral drugs against herpes. This substance belongs to the group of acyclic nucleosides. Acyclovir, entering a cell infected with a virus, is activated and inhibits the reproduction of HSV. This is a non-toxic and absolutely harmless component that can be used to treat herpes at any stage. It is well tolerated by the human body and rarely causes adverse reactions. However, this substance has one significant drawback - the resistance of some patients to its action.

The most effective drugs:

• "Zovirax". Available in the form of tablets, cream, eye ointment and solution for injection.
• "Virolex". Available in the form of tablets, eye ointment and cream. It is used for genital herpes, lesions of the skin, mucous membranes of the eyes, and chickenpox, including in children under 1 year of age.
• "Herperax". Available in the form of tablets and ointments.

Other drugs

Let's consider other popular antiviral drugs for herpes ("Cycloferon", "Valacyclovir", "Famvir", "Fenistil Pencivir", "Allomedin").

• "Cycloferon". having antiviral properties. It is used in the treatment of many diseases, including herpes. Has a wide spectrum of action.
• "Valacyclovir." New generation drug. Its mechanism of action is similar to acyclovir. Available exclusively in tablet form.
• "Famvir." An antiviral drug, an effective remedy in the fight against herpes. Well absorbed in the body.
• "Fenistil Pentsivir". Available in ointment form. It is highly effective in the most advanced stages of the disease.
• "Allomedin". Available in ointment form. The action of the product is aimed at increasing the natural immunity of the skin of the lips.

Treatment of genital herpes

Genital herpes is a disease that is transmitted through sexual contact. The causative agent is HSV. Statistics show that this disease is the second most common among other sexually transmitted diseases.

The most effective antiviral drugs for genital herpes:

• "Acyclovir".
• "Virolex".
• Famciclovir.
• "Valacyclovir."

There are several groups of antiviral drugs that differ in clinical-pharmacological characteristics and features of practical use:

antiherpetic,
anticytomegalovirus,
anti-influenza,
extended spectrum drugs,
antiretroviral.

ANTIHERPETIC CHEMICAL DRUGS

The main antiherpetic drugs with effectiveness proven in randomized clinical trials include four structurally similar drugs from the group of nucleoside analogues - acyclovir, valacyclovir, penciclovir And famciclovir. Moreover, valacyclovir and famciclovir are initially inactive compounds that are converted in the human body to acyclovir and penciclovir, respectively. All of these drugs block DNA synthesis in reproducing herpes viruses, but do not affect viruses that are in a latent state.

With HSV and virus resistance varicella-zoster foscarnet is used intravenously.

For topical use, acyclovir, penciclovir, idoxuridine, foscarnet And Tromantadine.

In Russia, the domestic drug Poludan, which has interferonogenic and immunomodulatory properties, is used for ophthalmoherpes, but no randomized clinical trials of this drug have been conducted.

Nucleoside analogues

Mechanism of action

Acyclovir is the founder of antiherpetic drugs - blockers of viral DNA synthesis. The antiviral effect is exerted by the active metabolite of acyclovir - acyclovir triphosphate, which is formed in cells affected by the herpes virus. By inhibiting viral DNA polymerase, acyclovir triphosphate blocks viral DNA synthesis. The drug has very low toxicity, since it does not affect the DNA polymerase of human cells and is inactive in healthy cells.

Penciclovir is activated in human cells affected by the virus, turning into penciclovir triphosphate, which disrupts the synthesis of viral DNA. Penciclovir has a long intracellular half-life (7–20 hours), which is significantly higher than that of acyclovir (less than 1 hour). But it has less affinity for viral DNA polymerase than phosphorylated acyclovir.

In general, all three drugs (acyclovir, valacyclovir and famciclovir) have comparable clinical efficacy when taken orally.

Foscarnet forms inactive complexes with DNA polymerase of herpetic viruses and CMV.

Activity spectrum

HSV types 1 and 2 are most sensitive to acyclovir. Virus varicella-zoster more than 20 times, and CMV is 470 times less sensitive to acyclovir than HSV type 1. Penciclovir is very close to acyclovir in activity against HSV types 1 and 2 and the virus varicella-zoster.

Resistance to antiherpetic drugs is a rare phenomenon, especially in patients with normal immunity. Acyclovir-resistant strains with moderate immunodeficiency can occur in 6–8% of patients, and in patients receiving long-term immunosuppressive therapy and AIDS, resistance increases to 17%. It should be taken into account that acyclovir-resistant strains are also resistant to valacyclovir and famciclovir. In this case, the drug of choice is foscarnet.

The dosage form for intravenous administration is not registered in Russia

Pharmacokinetics

Three drugs are used for oral administration: acyclovir, valacyclovir and famciclovir, and only acyclovir is administered intravenously. Acyclovir has the lowest bioavailability when taken orally (15–20%), but even a daily dose of 0.8–1.0 g is sufficient to suppress HSV. Valaciclovir is the valine ester of acyclovir for oral administration and has significantly higher bioavailability (54%). During absorption in the gastrointestinal tract and liver, it is converted into acyclovir.

The bioavailability of famciclovir when taken orally on an empty stomach is 70–80%. In the gastrointestinal tract it is converted into penciclovir, which is then phosphorylated in cells affected by the virus.

Penciclovir is used only externally, since when taken orally it has very low bioavailability (5%).

Acyclovir is well distributed in the body. Penetrates into saliva, intraocular fluid, vaginal secretions, and the fluid of herpetic vesicles. Passes through the BBB. When applied topically, it is slightly absorbed through the skin and mucous membranes.

Both acyclovir and penciclovir are excreted primarily by the kidneys, 60–90% unchanged. Acyclovir is eliminated by glomerular filtration and tubular secretion. The drugs have approximately the same half-life - 2-3 hours, in young children - up to 4 hours. In case of renal failure (creatinine clearance less than 30 ml/min), the half-life increases significantly, which requires adjustment of doses and administration regimens.

The pharmacokinetics of foscarnet when administered topically has not been studied.

Adverse reactions

Acyclovir is generally well tolerated by patients, and adverse reactions occur rarely.

Local

Burning when applied to mucous membranes, especially when applied vaginally;

phlebitis with intravenous administration.

System

Gastrointestinal tract: abdominal pain or discomfort, nausea, vomiting, diarrhea.

Central nervous system: in 1–4% of patients with intravenous administration of acyclovir, lethargy, tremor, convulsions, hallucinations, delirium, and extrapyramidal disorders are observed. Symptoms usually appear in the first 3 days of treatment, are associated with high levels of acyclovir in the blood serum (more than 25 mcg/ml) and gradually disappear as it decreases. Risk factors: renal failure, concomitant use of other neurotoxic drugs, interferon, methotrexate.

Kidneys: Due to crystallization of the drug in the renal tubules, 5% of patients with intravenous administration develop obstructive nephropathy, manifested by nausea, vomiting, lower back pain, and azotemia. Risk factors: childhood, rapid intravenous administration, large doses, high plasma concentrations of acyclovir, dehydration, kidney disease, concomitant use of other nephrotoxic drugs (for example, cyclosporine). Prevention measures: drink plenty of fluids. Help: drug withdrawal, infusion therapy.

Other: headache, dizziness (more often in older people).

Valaciclovir is similar in tolerability to oral acyclovir. A special feature is the rare cases of the development of thrombotic microangiopathy in patients with immunosuppression (AIDS patients, cancer patients) receiving multiple pharmacotherapy.

In terms of safety profile in adults, famciclovir is close to acyclovir. The most common adverse events are headache and nausea.

Indications

Infections caused by HSV types 1 and 2:

infections of the skin and mucous membranes;

ophthalmoherpes (aciclovir only);

genital herpes;

herpetic encephalitis;

neonatal herpes.

Infections caused by a virus varicella-zoster:

shingles;

chicken pox;

pneumonia;

encephalitis.

Prevention of CMV infection after kidney transplantation (acyclovir, valacyclovir).

Local therapy

Infections of the skin and mucous membranes caused by HSV.

Contraindications

Allergic reactions.

Warnings

Pregnancy. The safety of systemic therapy with acyclovir, valacyclovir and famciclovir in pregnant women has not been fully proven. Prescribing acyclovir in the first trimester of pregnancy does not increase the risk of birth defects compared to the average level in the population. The results of the use of valacyclovir and famciclovir during pregnancy are preliminary and cannot be a basis for their regular use. However, acyclovir can be used orally with caution in pregnant women, both during the initial episode and during relapses of herpes.

Lactation. Acyclovir passes into breast milk, so acyclovir and valacyclovir should be used with caution in women who are breastfeeding.

Pediatrics. The main drug for use in pediatrics is acyclovir, as it has been most well studied in children. There are recommendations on the possibility of using valacyclovir and famciclovir in children over 12 years of age with immunodeficiency. However, valacyclovir should not be used in children with immunodeficiency caused by HIV. The dose of acyclovir in children under 12 years of age is better calculated based on body surface area: 0.25 g/m2, instead of 5 mg/kg; 0.5 g/m2, instead of 10 mg/kg.

Geriatrics. Given the age-related decline in renal function, glomerular filtration should be assessed before starting therapy, especially in large doses and with intravenous administration. Dosage regimen adjustment may be required.

Renal dysfunction. Before using systemic antiherpetic drugs, it is advisable to determine glomerular filtration. This must be done when used orally in large doses and when administered intravenously. In patients with impaired renal function, the dose should be reduced. In patients receiving hemodialysis, valacyclovir is used in the dose recommended for creatinine clearance less than 15 ml/min, and the drug is best taken after a hemodialysis session.

Liver dysfunction. In patients with hepatic impairment, no dose adjustment is required for acyclovir and valacyclovir, but there is insufficient experience with these drugs in patients with severe hepatic impairment. In case of liver failure, the dose of famciclovir should be reduced.

AIDS. When using valacyclovir in high doses (0.8–3.2 g/day) in patients with AIDS, an increased incidence of thrombotic microangiopathy was noted. With long-term suppressive therapy with valacyclovir at a dose of 0.25–1 g/day, the frequency of its development does not increase.

Drug interactions

When acyclovir is combined with aminoglycosides or other nephrotoxic drugs, the risk of adverse effects on the kidneys increases.

When acyclovir is combined with zidovudine, the risk of developing neurotoxic reactions increases.

When valacyclovir is combined with cimetidine, the blood concentration of acyclovir increases.

Patient Information

The use of antiherpetic drugs should be started as early as possible, after the first symptoms of the disease appear. Can be taken orally regardless of meals.

You should strictly follow the prescribed regimen during the entire course of treatment, and do not stop treatment before the due date. If you miss a dose, take it as soon as possible. Do not take it if it is almost time for the next dose (do not double the dose).

You should consult your doctor if improvement does not occur within a few days or if new symptoms appear.

The affected areas of the skin should be kept clean and, if possible, do not wear tight-fitting clothing. In case of herpetic rashes on the genitals, refrain from sexual intercourse until the ulcerations are completely healed. Taking antiherpetic drugs does not prevent the transmission of genital herpes through sexual contact, so it is recommended to use barrier methods of contraception (condom).

The use of antiherpetic drugs does not lead to a complete cure, since the herpes virus remains in the body in an inactive (latent) state.

Idoxuridine

An antiherpetic drug that is used only in ophthalmology for the treatment and prevention of infections caused by HSV.

Adverse reactions

Irritation, pain, itching, redness, swelling, clouding of the cornea, the appearance of spots or pinpoint defects on the corneal epithelium.

Allergic reactions in rare cases.

Indications

Herpetic keratitis caused by HSV, especially the epithelial form, the superficial “tree-like” form.

Prevention of relapses of herpetic keratitis in the early postoperative period after therapeutic keratoplasty.

Contraindications

Hypersensitivity to the drug.

Pregnancy.

Warnings

Do not use for deep forms of keratitis.

Use caution when used together with glucocorticoids.

Ineffective for adenoviral conjunctivitis.

Tromantadine

Tromantadine is a derivative of amantadine used to treat influenza. The antiviral effect is due to inhibition of the replication of herpes viruses.

Currently, instead of tromantadine, more active drugs from the group of acyclic nucleosides (acyclovir, etc.) are used.

Adverse reactions

Contact dermatitis.

Indications

Infections of the skin and mucous membranes caused by HSV and varicella-zoster.

Contraindications

Allergic reactions to the drug.

Warnings

There are no data on the safety of tromantadine during pregnancy and breastfeeding.

Table. Antiherpetic drugs.
Main characteristics and application features