Our doctors prescribe Valacyclovir to be used to limit outbreaks and reduce the risk of transmitting herpes by taking one pill every day. One of the most important advances in herpes treatment came with the knowledge that transmission from an infected person to their uninfected partner could be reduced by the use of daily Valacyclovir. Valacyclovir not only reduces the number of outbreaks a person experiences when using the medication every day but it reduces the number of days that someone sheds the virus asymptomatically (shedding of the herpes virus from normal skin when a person feels completely well). Asymptomatic shedding is how most transmissions occur. Reducing asymptomatic shedding results in fewer uninfected partners catching herpes. If a condom is worn and the medication used, the chances are cut in half compared to using a condom alone. Fewer outbreaks and fewer episodes of asymptomatic shedding means fewer people become infected.
In one study that followed the course of 144 couples in which one partner was infected and the other not infected, transmission occurred in 14 couples. In 9 of those cases, the person who transmitted the disease was completely free of symptoms—no outbreak, not even a prodrome (a warning that an attack was coming). The other 5 transmissions happened when the person who was infected had a prodrome or developed lesions near the time the infection was transmitted. As noted, the key to preventing transmission isn’t just limiting outbreaks but reducing asymptomatic shedding. Valacyclovir, taken daily, reduces the number of outbreaks a person experiences and the number of days that someone sheds the virus asymptomatically.
To reduce the number of outbreaks an infected person experiences and to reduce the risk of transmission to an uninfected partner (by up to 50%), the PDR recommends the infected partner take Valacyclovir 500 mg/day. The study measured results “in monogamous, heterosexual relationships when combined with safer sex practices.” The data are strong but refer to patients with 9 or fewer outbreaks each year. Also, the study ran only for 8 months.
An Important Point about transmitting herpes.
Herpes can be transmitted to a partner despite best efforts like using a condom and using antiviral suppression therapy. Patients should never engage in sex without a condom or when they have an outbreak or a prodrome. Also, as asymptomatic shedding is more common in the seven days following an outbreak, it is prudent to avoid sex during that period, as well.
Preventing Future Outbreaks
If you are just trying to abort outbreaks, make a note of everything you think may have made you more susceptible to an outbreak. Was there more irritation to the area? Did anything affect your immunity like another infection (e.g., a cold) or did you change something in your lifestyle that could have weakened your immune system (e.g., lack of sleep, stress, increased alcohol consumption)? No change is too small to note.
This is important because it will help you maintain the patterns that make herpes less likely to appear and makes it less likely you will need medication. For you, it may be a lack of sleep over a few consecutive nights that spurs most outbreaks. It might be excessive sun exposure or too much alcohol consumption. It could happen only when you are sick or just run down.
Whether oral or genital, people can take medication when their specific prodrome tells them an outbreak is on the horizon. The medication will stop an outbreak cold (often) and when it does not, it can shorten a milder outbreak than they might have had otherwise.
Other Ways To Use The Medication
Some patients ask if they can take the medication to prevent an outbreak when they least want to have one. The classic examples are a bride or groom on their wedding day when first engaging in sex with a new partner, or going on that long planned and much-needed vacation with your partner or spouse. You don’t need to be getting married or about to rendezvous for a much-anticipated tryst to want to prevent a herpes outbreak at particular times. It could be that an outbreak would be uncomfortable during the holidays or at any time you determine.
That is what we mean when we say you have control. At one point in life, a person may choose to abort outbreaks when they feel them coming on, at another point they might choose suppression therapy, but that may change, too. Circumstances change; only you will be able to know how your circumstances affect which option you choose. That is why learning all you can is so important. It gives you independence. Things change and how you choose to use Valacyclovir may change.
To Suppress Outbreaks For An Extended Period
Another way patients can take the medication is when they know they absolutely would like to do all they can to reduce their chance of having an outbreak at a pivotal time. The classic example would be during a honeymoon but taking medication to suppress outbreaks on a daily basis can be prudent when going on vacation, starting a new job, in a new relationship, or at any time a patient feels it is how they want to approach their condition. And that’s the key.
How medication is used is completely in your hands. Learn everything you can and do not worry about using the medication in the way that suits you best. That may change as your circumstances change, or as the condition changes, or even as your mind changes.
To Prevent Transmission to An Uninfected Partner
One of the most important advances in herpes treatment came with the knowledge that transmission from an infected person to their uninfected partner could be reduced by the use of valacyclovir. Valacyclovir not only reduces the number of outbreaks a person experiences when using the medication every day but it reduces the number of days that someone sheds the virus asymptomatically. That results in fewer uninfected partners catching herpes. If a condom is worn and the medication used, the chances are reduced at least in half compared to using a condom alone. Fewer outbreaks and fewer episodes of shedding means fewer people become infected.
Using your prescription
With Roman, you will be prescribed 30 pills of the 500 mg size of Valacyclovir every month. You should always have medication on hand, so renew your prescription well before you run out. As long as valacyclovir proves effective and you are free of significant side effects, you should never have to worry about having access to what you need.
You can always drop a note to your doctor, the pharmacist, or the care team with any questions, issues, or changes you want to consider. There is no “extra” visit charge or cost if you just want to ask questions and learn more about how you can manage your condition.
Lastly, if you would like to switch to intermittent therapy, you can always hold back on getting more Valacyclovir delivered.
This may be a new situation for you but as long as the medication works without causing you difficulties of any sort, you are in control.
Learn more about Valacyclovir