Brivudine

What is brivudine?

Brivudine is the active ingredient in drugs used to treat specific diseases caused by herpes viruses. It is one of the so-called nucleoside analogues and is significantly more effective than similar antiviral drugs. Nucleoside analogs are structurally similar to the building blocks of DNA. If a nucleoside analog is incorporated instead of the actual DNA building blocks, DNA synthesis will stop.
Brivudine is mainly used to treat herpes zoster. However, it can also be used for other forms of herpes, for example on the face.

Side effects are rare. The most common result is nausea. Caution is advised when taking certain medications (cytostatics) at the same time. Life-threatening interactions can occur.

The trade name of the active ingredient brivudine is Zostex®. Read more about this under: Zostex®

Brivudine for shingles

The most important indication for brivudine is shingles.
This is a disease of the nerves and the skin caused by the varicella zoster virus (chickenpox virus) from the herpes virus group. Once you've been infected with chickenpox, the viruses stay in the nerve cells of the spinal cord. When the body's defenses are weakened, the viruses can migrate along the nerve pathways to the skin and trigger shingles, which is manifested by pain and skin symptoms such as blisters. The symptoms are typically unilateral and belt-shaped on the trunk.

Brivudine prevents the virus from replicating, reducing the extent of shingles and allowing symptoms to subside more quickly. Brivudine is the first choice for treating shingles, especially for patients older than 50 years.

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Brivudine for cold sores

Brivudine is also effective in combating the pathogen responsible for cold sores, herpes simplex type 1. In principle, there can therefore be an indication for the drug for cold sores. In most cases, however, treatment with a less effective antiviral drug in the form of an ointment is sufficient.

Brivudine, on the other hand, is taken in tablet form. As a rule, however, an ointment treatment for cold sores is sufficient.
If necessary, the doctor can indicate treatment with brivudine in particularly severe cases of cold sores or if the patient's immune system is restricted.

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How fast does brivudine work?

How quickly brivudine works cannot be said in general terms.
The best and fastest possible effect can be achieved if the intake is started as soon as possible after the first symptoms appear. Treatment should be started within the first two to three days after the onset of the disease.

As a rule, the symptoms are alleviated after a few days and, in the best case, after completion of the treatment cycle, complete healing. However, it may take a few more weeks for the skin symptoms to heal.
In some cases, however, nerve pain or skin changes persist over the long term. This is especially the case if the drug has been taken too late or for too short a time.

How does brivudine work?

Brivudine is what is known as a nucleoside analog. Nucleosides belong to the building blocks of the DNA of our cells. If brivudine is used instead of a normal nucleoside in the DNA structure, further new synthesis of the genetic information stops.

The effect of brivudine is therefore that it interferes with the virus replication cycle. In technical terminology, this form of action is called virostatic, since the viruses are not killed directly, but their further reproduction is inhibited.
This will limit the extent of the disease and the symptoms that result from it. In this way, the body's defense system is supported in fighting the disease.

Side effects

Side effects are rare when taking brivudine properly.
Most often, the drug causes nausea.

There are a number of other symptoms that, in rare or very rare cases, can be caused by the use of brivudine, or for which at least a connection is suspected:

• Digestive tract disorders such as abdominal pain, gas, or constipation occur
• Insomnia, headache, dizziness, or anxiety
• In addition, the blood pressure can be influenced, both an increase and a decrease being possible
• In rare cases, serious consequences such as changes in the blood count, liver inflammation or delusions have occurred in connection with the use of brivudine.

Should symptoms arise after the start of treatment that could be attributed to the use of brivudine, the attending physician should be consulted as soon as possible. It is not advisable to stop taking the drug without consulting.

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Brivudine and alcohol - are they compatible?

Alcohol consumption can make various drugs less effective or less effective.
Although alcohol is not known to have a direct influence on brivudine, alcohol should be avoided while it is being taken.

In addition to potentially influencing drug therapy, the consumption of alcohol weakens the body's own defense system and can thus have a negative effect on the course of the disease in shingles.
This increases the risk of particularly difficult courses and permanent damage.
For this reason, too, alcohol should not be consumed again until the disease has completely healed and you feel healthy again. However, even then, alcohol should only be consumed in moderation, as excessive consumption increases the risk of recurrence of shingles or other diseases.

Interaction with other drugs

Brivudine can lead to serious interactions if certain medications are taken at the same time, which is why it is essential that all medications that have been taken regularly or recently be reported to the doctor.

These include primarily drugs that contain the active ingredient 5-fluorouracil (also called 5-FU). In addition to tablets, this also includes creams, ointments or eye drops that contain this active ingredient. Even with active ingredients that are converted to 5-fluorouracil in the body, such as capecitabine, floxuridine and tegafur, life-threatening interactions with brivudine can occur.

In addition, all other forms of cancer drugs or active ingredients that inhibit the immune system can trigger interactions.
Caution is also required if a fungal disease is present and this is treated with a drug that contains the active ingredient flucytosine.

When should brivudine not be given?

Brivudine must not be given in certain patient groups:

• during pregnancy and breastfeeding
• if the patient is younger than 18 years
• if you have a known hypersensitivity to brivudine and the other ingredients contained in the tablet
• not be given during simultaneous treatment with certain other active substances.

It is therefore imperative that the attending physician be informed of all medications that are taken regularly.

Brivudine during pregnancy and breastfeeding

Brivudine should not be used during pregnancy or while breastfeeding.
If the expectant mother takes the drug during pregnancy, the active ingredient can enter the baby's bloodstream. During breastfeeding, brivudine can also pass into the child's body through breast milk and cause developmental damage there.

For this reason, brivudine should not be used during pregnancy or while breastfeeding. The attending physician should also always be informed of whether you are pregnant or breastfeeding if drug treatment is being considered.

Does brivudine affect the way the pill works?

There is no known interaction between brivudine and the sex hormones in the pill. Therefore, taking brivudine at the same time does not affect the effectiveness of the pill.

In fact, it is important to use reliable contraception when using brivudine, as pregnancy can cause harm to the child.
If you do not take the pill, you should therefore avoid taking brivudine during sexual intercourse, for example with condoms.

Alternatives to brivudine

As an alternative to treating viral diseases such as shingles, various other drugs are available that also interfere with the virus' replication cycle.
The most widespread drug is acyclovir. It is also used to treat diseases caused by herpes viruses. However, this is significantly less effective than brivudine.

In milder cases, such as cold sores, treatment with brivudine is usually not necessary and the use of acyclovir is sufficient. In contrast to brivudine, acyclovir can also be applied in the form of an ointment, for example, so that there is no need to take tablets.

For shingles, however, brivudine is usually the first choice and alternatives should only be avoided if there are reasons that prevent it from being taken - for example, an intolerance to the drug. However, in such cases there is often an intolerance to the structurally related acyclovir. In such a case, the attending physician must individually decide which alternative treatment is suitable.

Read also the articles: Medicines for shingles, homeopathy for shingles

Is Brivudine available without a prescription?

Brivudine is a prescription drug, which means you can only get it with a doctor's prescription at the pharmacy.

Over-the-counter alternatives for the treatment of shingles or other forms of herpes are, for example, zinc ointments, which, however, do not contain any active ingredient that is directed against the viruses.

In most cases, shingles should be treated with brivudine or a comparable drug as early as possible. Therefore, you should go to the doctor immediately when the typical symptoms occur.
One of the reasons why the drug is only available with a prescription is that serious interactions can occur when certain other drugs are taken at the same time. An assessment of whether the drug can be given should therefore only be made by a doctor.

dosage

The dosage of brivudine is quite simple. One pack contains seven tablets, each with 125 mg of active ingredient and the duration of treatment is set at one week.

Treatment is started as early as possible, regardless of the time of day or food consumption, with the first tablet being taken.
This is swallowed whole with a glass of water. From now on, one tablet is taken every day at about the same time of day.

The seven-day treatment cycle should always be completed. This also applies if the symptoms subside earlier or even disappear completely. If a dosage deviating from the usual dosage is required, the prescribing doctor will point this out.

price

The price for a pack of brivudine, which contains seven tablets and is therefore designed for one treatment cycle, is around 100 euros.
The statutory health insurance usually covers a large part of the costs. Usually, an additional payment of around ten euros is required.

The price for the drug is usually not cheaper in online pharmacies and shipping costs are usually added, so it is advisable to redeem the prescription in a local pharmacy.

Recommendations from the editorial team:

• Cold Sores - What To Do?
• Everything to do with shingles
• Genital herpes
• Acyclovir against herpes viruses
• Homeopathy for shingles

Exclusion of liability / disclaimer

We would like to point out that medication must never be discontinued, applied or changed independently without consulting your doctor.
Please note that we cannot claim that our texts are complete or correct. The information may be out of date due to current developments.