Feedback on Acyclovir Side Effects and Usage, page 59
If you’ve used Acyclovir, please help others by sharing your experience with side effects. What would you tell your best friend about this product? Please remember that we do not give medical advice. That is for your local health care provider, who is familiar with your medical history.
Antibodies and false negative?
I believe I got exposed to Herpes 6 weeks ago. I took Acyclovir 400 mg 2 times a day for 5 days starting exactly a week after the potential exposure. I had no symptoms anywhere except for some tingling on my lower lip. Then I started feeling some tingling again two weeks ago so I started the Acyclovir again in the same dosage. I took the herpes blood test (HSV1 IGg and IGm as well as HSV2 IGg and All were negative. Now the question is, could taking Acyclovir one week after the potential exposure have resulted in low antibodies and hence a false negative?
AskDocWeb: No, Acyclovir would not cause low antibodies or a false negative. It usually takes from 6 to 8 weeks before herpes shows up on a test, although in some cases it could be 4 months. If you test negative after that then you can be fairly confident that you don’t have it.
Side effects from suppressive dose of Acyclovir?
My daughter has ocular herpes and has been on oral acyclovir for over 2 years now. She contracted the virus when she was only 14 months old. She has scaring on her left cornea and it has affected her vision. I was wondering if there is anything else I can do to help prevent a further outbreak. She is so young that it is difficult for her to communicate the sideffects she feels from the medicine but I feel that from her recent behavior and night sweets that she is having some side effects. She did have and episode of hallucinations when she was on a treatment dose of acyclovir. Is it possibel to have side effects from the suppression dose as well?
AskDocWeb: While it is possible to have side effects from the lower dose used for suppression, if they do occur they are typically fewer in number and less severe than higher dosages.
Preventing the spread of herpes
Besides taking it during an outbreak, what if someone prefers to take acyclovir only when sexually active (and only sexually active in between outbreaks) – How many days, hours or minutes before sex should someone take acyclovir so that it is effective at preventing the spread of herpes to a sexual partner?
AskDocWeb: It is important to make a distinction between “reducing the risk” of infection and “preventing” it. Just reducing the risk does not guarantee that infection will not occur. Although using Acyclovir does reduce the risk it does not totally prevent spreading the infection.
If you have genital herpes it is recommended that you use a condom during sexual contact to reduce the chance of spreading the infection, even if treatment with Acyclovir has begun. However, if you have sores or blisters you should not have sex. This is the only sure fire way to prevent infection.
Can acyclovir cause a yeast infection, took for 5 days & developed a yeast infection.
AskDocWeb: No, Acyclovir treats viral issues and has no effect on yeast. Although it is common to get yeast infections the first year after getting herpes it has nothing to do with taking Acyclovir or any other antiviral medication.
Since starting on the medication I have noticed pain on the right side of my groin, guessing lymph node? Also can it cause vaginal dryness? Something doesn’t seem right down there!
AskDocWeb: Vaginal dryness can affect almost any woman at any age however, it is not listed as a side effect of Acyclovir. Your GYN has things that he/she can prescribe to help if your dryness persists. Many women resort to using lube, lube and more lube especially as women get older.
Diarrhea and vomiting
I started Acyclovir last night for my second time for shingles. It helped speed up healing when I had it three months ago. The only problem was diarhea on the last two days of the seven day trial, and vomiting three hours after the last pill. Hopefully, that was just due to an empty stomach. The diarhea actually lasted for several weeks after the pills were gone. This time I am on a ten day trial, and I hope I won’t be constantly getting shingles. Should I get the new vaccine? Also, since the shingles is on the side of my face and forehead, is there danger of affecting the inside of my mouth? I am a thankfull recipient of Acyclovir.
AskDocWeb: Although it is possible for the rash from shingles spread to other parts of the body, that only occurs in very rare cases. According to the CDC there are a number of contraindications for taking the vaccine:
Zoster vaccine is contraindicated for persons who have a history of anaphylactic reaction to any component of the vaccine, including gelatin and neomycin. Neomycin allergy is usually manifested as a contact dermatitis, which represents a delayed-type immune response. A history of contact dermatitis to neomycin is not a contraindication for receiving zoster vaccine.
Zoster vaccine should not be administered to persons with primary or acquired immunodeficiency including:
- Persons with leukemia, lymphomas, or other malignant neoplasms affecting the bone marrow or lymphatic system. However, patients whose leukemia is in remission and who have not received chemotherapy (e.g., alkylating drugs or antimetabolites) or radiation for at least 3 months can receive zoster vaccine.
- Persons with AIDS or other clinical manifestations of HIV, including persons with CD4+ T-lymphocyte values less than 200 per mm3 or less than 15% of total lymphocytes.
- Persons on immunosuppressive therapy, including high-dose corticosteroids (more than 20 mg/day of prednisone or equivalent) lasting two or more weeks. Zoster vaccination should be deferred for at least 1 month after discontinuation of such therapy. Short-term corticosteroid therapy (less than 14 days); low-to-moderate dose (less than 20 mg/day of prednisone or equivalent); topical (e.g., nasal, skin, inhaled); intra-articular, bursal, or tendon injections; or long-term alternate-day treatment with low to moderate doses of short-acting systemic corticosteroids are not considered to be sufficiently immunosuppressive to cause concerns for vaccine safety. Persons receiving this dose or schedule can receive zoster vaccine. Therapy with low-doses of methotrexate (less than 0.4 mg/Kg/week), azathioprine (less than 3.0 mg/Kg/day), or 6mercaptopurine (less than 1.5 mg/Kg/day) for treatment of rheumatoid arthritis, psoriasis, polymyositis, sarcoidosis, inflammatory bowel disease, and other conditions are also not considered sufficiently immunosuppressive to create vaccine safety concerns and are not contraindications for administration of zoster vaccine.
- Persons with clinical or laboratory evidence of other unspecified cellular immunodeficiency. However, persons with impaired humoral immunity (e.g., hypogammaglobulinemia or dysgammaglobulinemia) can receive zoster vaccine.
- Persons undergoing hematopoietic stem cell transplantation (HSCT). The experience of HSCT recipients with VZV-containing vaccines (e.g., zoster vaccine) is limited. Physicians should assess the immune status of the recipient on a case-by-case basis to determine the relevant risks. If a decision is made to vaccinate with zoster vaccine, the vaccine should be administered at least 24 months after transplantation.
- Persons receiving recombinant human immune mediators and immune modulators, especially the antitumor necrosis factor agents adalimumab, infliximab, and etanercept. The safety and efficacy of zoster vaccine administered concurrently with these agents is unknown. If it is not possible to administer zoster vaccine to patients before initiation of therapy, physicians should assess the immune status of the recipient on a case-by-case basis to determine the relevant risks and benefits. Otherwise, vaccination with zoster vaccine should be deferred for at least 1 month after discontinuation of such therapy.
Pregnancy: Zoster vaccine is not recommended for use in pregnant women, although these women are unlikely to be in the vaccine target age group. The effects of the live, attenuated VZV-based zoster vaccine on the fetus are unknown. Women should avoid becoming pregnant for 4 weeks following zoster vaccination. Having a pregnant household member is not a contraindication to zoster vaccination. If a pregnant woman is vaccinated or becomes pregnant within 1 month of vaccination, she should be counseled about potential effects on the fetus. Wild-type VZV poses a small risk to the fetus (3), and the fetal risk from the attenuated zoster vaccine is probably even lower. Furthermore, virtually all persons receiving the vaccine will have preexisting VZV immunity, which is expected to limit viral replication and presumably further reduce fetal risk. In most circumstances, the decision to terminate a pregnancy should not be based on whether zoster vaccine was administered during pregnancy. Merck & Co., Inc., in collaboration with CDC, has established a pregnancy registry to monitor the maternal-fetal outcomes of pregnant women who are inadvertently administered live-attenuated VZV-based vaccines within 1 month of pregnancy (telephone: 800-986-8999). Patients and health-care providers should report any exposure to zoster vaccine during pregnancy to this registry.
Precautions Moderate to Severe Illness: Zoster vaccination of persons who have severe acute illness should be postponed until recovery. The decision to delay vaccination depends on the severity of symptoms and the etiology of the disease. Zoster vaccine can be administered to persons who have mild acute illnesses with or without fever.
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