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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest an alternative medicine to Valacyclovir for genital herpes

Answered by
Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3579 Questions

Posted on Thu, 30 Aug 2018 in Sexually Transmitted Diseases
Question: I have had genital herpes for 25 years. I take Valacyclovir 1x daily in the AM. My outbreaks are rare- usually when I don't take the meds for a few days or a week. Is there another therapy that I can consider that will not require a daily dose and do an even better job of reducing transmission to my partner if we are not using condoms?

Also, how exactly is herpes spread if there is not an outbreak?

Finally, is it more likely that a man or a women would spread the virus easier if there is not an outbreak and condoms and dental dams are not being used?
Answered by Dr. Suresh Heijebu 3 hours later
Brief Answer:
Valacyclovir being overused

Detailed Answer:

I have worked through your attached query in detail.

Long-term prophylaxis is not available for Herpes.

There seems to be no need for Valacyclovir.

You need antiviral agents only when there is a definitive clinical outbreak.

The cause of the outbreak is: when one of the partners shedding active virus during the sexual act.

Female sex is more at risk of acquiring the Infection in view of a greater surface area of the external genitalia.

Valacyclovir is the best agent known to be effective against herpes. Unfortunately, other therapies are actually inferior to this.

Hope I have answered your query. Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
Follow up: Dr. Suresh Heijebu 43 hours later
The valacyclovir is being used as a suppression therapy. I was once on acyclovir 2X per day for the same purpose. I was under the impression that the outbreak is due to stress and other factors. Sex is what contracted the virus. The outbreaks occur when not having sex, so I do not understand your comment above about the cause of the outbreak.

Should I not be using valacyclovir as a suppression therapy?

Can females and males give the virus when there is no outbreak?
Answered by Dr. Suresh Heijebu 1 hour later
Brief Answer:
Suppression therapy is not advocated

Detailed Answer:

Yes herpetic outbreaks results from stress and other environmental factors. Obviously virus is first aquired through sexual contact.

Outbreaks are unpredictable and can occur even without sexual activity.

There are no recommendations to prevent these unpredictable outbreaks using a suppression therapy.

Viral transmission can still occur between the partners even though there is no active outbreak.

Hence to conclude, considering the unpredictable nature of outbreaks, they should be treated only when there is an active outbreak but not on prophylaxis.

Long-term ingestion of Acyclovir/Valacyclovir will cause kidney and other organs. Hence I don't recommend.

Hope my answer is helpful.

Take care.
Dr. Suresh Heijebu

Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

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