Shingles medication

introduction

The shingles is caused by so-called Herpes zoster viruses caused. These arise within the framework of the Varicella zoster virus. This virus causes chickenpox when it first becomes infected. The viruses then remain in the body. As a rule, they rest there and do not cause discomfort. However, they can be reactivated decades after the initial infection. This can be due to an immune deficiency, cancer, HIV infection or for no reason. The reactivation of these viruses manifests as shingles.

The drug treatment of shingles has three different goals. The acute pain should be relieved. The aim is also to limit the spread of skin changes. Attempts are also made to prevent complications such as postherpetic neuralgia. Various drugs are available to achieve these goals.

You can find out how contagious shingles is in our article How contagious is shingles?

What prescription drugs are there?

Prescription drugs to treat shingles include antivirals and glucocorticoids, and some stronger pain relievers. Since shingles is caused by viruses, antiviral drugs are used. These should not only improve the symptoms locally on the skin, but also fight the viruses systemically in the body. Prescription drugs are acyclovir, zostex (brivudin), famciclovir and valaciclovir.

Learn more at: Zostex®

Prescription glucocorticoids taken orally, such as cortisone, are sometimes part of treatment for shingles. They can be anti-inflammatory. However, their use should be kept as low as possible due to the side effects of cortisone.
Read more about this drug below Cortisone.

If postherpetic neuralgia develops, it may require prescription medication to treat it. As part of this complication, patients can suffer from neuropathic pain for weeks after the rash has healed. The pain treatment is usually divided into 4 levels. For advanced, severe pain (levels 3 and 4), prescription painkillers from the opioid group are sometimes used. Examples of active ingredients here are morphine or buprenorphine. Prescription-only co-analgesics can also be given in all stages of pain treatment. These are drugs that are actually used for other diseases, but have an additional pain-relieving effect. For example, amitriptiline, a tricyclic antidepressant, is used as a co-analgesic. The antidepressant effect does not play a role in the case of shingles. Accordingly, the drug is prescribed in a much lower dose than it would be given in depression. Amitriptiline inhibits, among other things, the sodium channels. Since these sodium channels are increasingly built into the brain in the course of the development of neuropathic pain, the inhibition of the channels has a pain-relieving effect.

You can read about the side effects that can occur when taking morphine in our article Side effects of morphine.

Acyclovir

Aciclovir is a so-called nucleoside analog. Nucleoside analogs mimic a component of DNA. If this nucleoside analog is incorporated instead of a "real" component of the DNA, the DNA structure is broken off. Acyclovir is specific for the structure of viral DNA, so the active ingredient usually does not destroy human cells, only the structure of the viral DNA. This means that fewer side effects can arise. As a rule, acyclovir is well tolerated.

The dose is between 200 and 800 mg per tablet. The dosage depends on the severity of the shingles. As a rule, 4 - 5 tablets per day are prescribed. Side effects can occur in individual cases. According to the manufacturer, 1 - 10 out of 100 people treated complain of rashes, itching, headaches, nausea or dizziness. At the present time there are no known interactions with other drugs and the active ingredient acyclovir.

Since there are insufficient studies in pregnancy, you should - like any drug intake during pregnancy - weigh the benefit-harm ratio with the attending gynecologist. The active ingredient appears to be relatively harmless during breastfeeding. In any case, intake should be discussed with the doctor.

The dosage must be adjusted in patients with impaired renal function.

Read more about this drug on our website Acyclovir.

Valaciclovir

The active ingredient valaciclovir is a further development of the active ingredient acyclovir. It's a so-called Prodrug. This means that the active ingredient is only activated in the body. Since valaciclovir is only activated in the body, it has a better so-called bioavailability. This means that the active ingredient is distributed more widely in the body and can have a stronger effect. However, due to the increased effect, side effects can theoretically occur more frequently. But since the active ingredient is better absorbed, the side effects should be less common overall.

More than 1 in 10 patients will experience nausea and headache while being treated with valaciclovir. Occasionally there may be confusion, vomiting, and abdominal pain.
Valaciclovir is contraindicated in children, pregnant women, people over 65 years of age, people with cardiovascular diseases and people with kidney or lung dysfunction. If other drugs are used that put strain on the kidneys or liver, the dose may need to be adjusted.

Usually the drug is taken for 7 days. The dosage depends on the severity of the shingles. Most often it is 1000 mg 3 times a day. The commercial preparations containing Valaciclovir are for example Valtrex®, Viropel®, Valdacir® and Valaciclomed®.

What over-the-counter medications are there?

Most medications used to treat symptomatic symptoms are available over the counter. However, the application should still be discussed with the attending physician. Many ointments that dry out the oozing blisters are available without prescription. Zinc ointments are often used. Tea tree oil and most homeopathic remedies are also available in pharmacies without a prescription. Furthermore, for example, SIVASH® healing clay paste against itching can be purchased without a prescription. This is brine silt, which is applied to the affected skin areas as a mud pack.

In addition, packs made from apple cider vinegar and potato or corn flour can be used against the itching without a prescription. In addition, essential oils of lavender, chamomile and eucalyptus can be used against the itching without a prescription. In addition to conventional medical treatment, Japanese medicinal plant oil can be purchased without a prescription in pharmacies or drugstores for pain relief. Capsicain in ointment form is also used to support local pain treatment.

In addition, over-the-counter, high-dose vitamin B supplements are sometimes used as a supplement in the treatment of shingles. For example, Nervocom® is a commercial preparation that can also be helpful in some cases with shingles. The background to this is that all vitamins of the B family contribute to strengthening the immune system, well-being and regulating energy production in the body. Vitamin B 1, for example, plays a role in the transmission of nerve impulses, which are presumably also associated with shingles. Vitamin B 6 also strengthens the immune system and the nerves. The folic acid contained in Nervocom® can also promote the healing process. However, it is important to note that these remedies do not fight the cause, but only alleviate the symptoms in addition.

Zinc ointment

Many authors recommend zinc ointment for the symptomatic treatment of itching in shingles. The so-called zinc oxide is contained in zinc ointment. According to the manufacturer, it has an antiseptic and slightly disinfectant effect. Other ingredients of the zinc ointment have the ability to absorb large amounts of water. This property is beneficial for weeping blisters. They can therefore promote better healing, especially at wound edges. The ointment also contains vitamin A. This supports the synthesis of new skin cells. The zinc ointment should be applied directly to the skin cells.

There are also zinc oxide shake mixes and zinc pastes that act similarly. A distinction is made between hard and soft pastes for zinc pastes. The hard pastes are mainly used on oily skin. The soft pastes are used for dry skin. There is also zinc oxide powder, which can be used for weeping blisters.

Do you suffer from dry skin? Then also read our article about Causes and care tips for dry skin.

Tea tree oil

Herbalists recommend tea tree oil for the symptomatic treatment of shingles. Tea tree oil has a disinfecting and antibacterial effect and is gentle on tissue. It can relieve the symptoms of shingles. It can also prevent an additional bacterial infection. It is important to use a diluted solution. A 20% solution is usually recommended. It is possible to combine the oil with almond or wheat germ oil. Some authors recommend slightly warming this mixture in a water bath before dabbing the damaged skin area with the oil mixture 3 to 4 times a day. In some cases it is advisable to use an envelope with the tea tree oil solution. This envelope should be changed 2 to 3 times a day. Use of a tea tree oil ointment is recommended at night. These measures should be discussed with the doctor beforehand.

Read more about this under Tea tree oil.

Homeopathy for shingles

Homeopathic remedies are supportive in some cases. Depending on the symptoms, certain homeopathics can have a soothing effect alongside other drugs. Arsenicum album is used for anxiety, restlessness and severe itching. If the shingles manifests itself in large skin blisters, swellings and itching, Apis mellifica is recommended. The application should be discussed with the doctor. Some homeopathic medicines require a prescription.