HSV 1 (Oral Herpes) Treatment Plan

This treatment plan reviews the risks and benefits of the treatment we recommend. Please make sure to read this as well as the manufacturer’s pamphlet that comes with the medicine. The manufacturer’s pamphlet contains the full information on interactions, side effects, and other information you should know about the medicine before you start.

INSTRUCTIONS:

For episodic treatment of HSV 1 (Oral Herpes), you must take:

One (1) Acyclovir 400 mg tablet, orally, three times a day, for seven (7) days, immediately upon noticing the signs of an outbreak.

Alternatively, if the clinician prescribed Valacyclovir instead. You must take:

One (1) Valacyclovir 1 gram tablet, orally, once a day, for thirty (30) days, immediately upon noticing the signs of an outbreak.

or

One (1) Valacyclovir 1 gram tablet, orally, twice a day, for seven (7) days, immediately upon noticing the signs of an outbreak.

The signs of an outbreak are tingling, burning, sensitivity in the oral area, as well as blisters or cold sores on the mouth.

Acyclovir and Valacyclovir are antiviral drugs that slow the growth and spread of the herpes virus in the body. They will not cure herpes, but they can lessen the symptoms of the infection. Please keep in mind that episodic treatment does not reduce your risk of having herpes outbreaks or passing on herpes to your sexual partner(s). Episodic treatment, if started immediately upon noticing the initial signs of an outbreak can reduce the duration and/or intensity of the outbreak.

Herpes infections are contagious and you can infect other people, even while you are being treated with acyclovir or valacyclovir. Avoid letting infected areas come into contact with others. Avoid touching an infected area and then touching your eyes. Wash your hands frequently to prevent passing the infection to others. Taking this medicine will not prevent you from passing herpes to sexual partners, so it is best to avoid sexual activity when experiencing active symptoms of an outbreak. Oral herpes may still be contagious through “viral shedding” from your skin as well, even without a visible outbreak.

ACTIVE INGREDIENTS:

These medicines contain the following active ingredients. If you are allergic to any of these components, similar components, or any of the other components listed in the manufacturer’s pamphlet, please do not take it.

  • Acyclovir (Zovirax)
  • Valacyclovir hydrochloride

ALLERGIES:

These medicines may cause an allergic reaction if you are allergic to similar medicines or components. If you are allergic to any of the following, please stop the medicine and see your doctor in person:

  • Acyclovir (Zovirax)
  • Antiviral medicines
  • Valacyclovir hydrochloride

CONDITIONS:

We evaluate your health history and the specific health information you provide us; however, if anything changes and you develop or discover that one of these conditions applies to you, please stop taking this medicine and seek care in person:

  • HIV
  • Liver problems
  • Immunocompromised
  • Kidney failure
  • Seizure disorder

PREGNANCY AND BREASTFEEDING:

While Acyclovir and Valacyclovir are safe to take during pregnancy and breastfeeding, if you become pregnant or are breastfeeding, a decision should be made whether to continue or discontinue the use of your prescription. This decision should be made with direction from your primary care physician or another source of local medical care.

EMERGENCY SIDE EFFECTS:

These medicines can cause dangerous and potentially life-threatening side effects. If any of the emergency side effects listed in the manufacturer’s pamphlet or those below happen to you, please stop taking the medicine and call 911 or seek immediate medical help in person:

  • Abdominal swelling
  • Anxiety or agitation
  • Difficulty swallowing or throat swelling
  • Jaundice or yellow skin
  • Liver and kidney disease
  • Severe skin rash or changes
  • Severe weakness or fatigue
  • Shortness of breath or wheezing

OTHER SIDE EFFECTS:

These medicines can also cause other side effects. If any of the other side effects listed in the manufacturer’s pamphlet or those below happen to you please stop taking the medicine and see your doctor in person:

  • Abdominal pain
  • Change in vision or behavior
  • Depression
  • Dizziness
  • Easy bruising or bleeding/Pale skin
  • Fatigue
  • Hair loss
  • Hallucination/Headaches
  • High blood pressure
  • Joint pain
  • Nausea or vomiting
  • Painful periods

MEDICINES, SUPPLEMENTS, AND FOODS:

We evaluate your health history and the specific health information you provide us; however, if anything changes and you start or discover that you are taking any of the medicines, foods, or supplements listed below, consult with your physician or local care before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan:

  • Foscarnet
  • TiZANidine
  • Varicella
  • Zoster Vaccine
  • Tenofovir
  • Zidovudine
  • Mycophenolate

ACCURATE INFORMATION:

We evaluate the specific health information you provide and make our recommendations based on it. If you incorrectly provide that information, we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment.

TREATMENT FAILURE:

This treatment is not 100% effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If it is an emergency, call 911 or seek immediate medical help in person.

MISDIAGNOSIS AND DELAYED DIAGNOSIS:

There is also a risk that we will misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. This risk exists with a doctor in person as well but they may have additional signs and symptoms to aid their evaluation. We use an evidence-based practice and guidelines as well as clinical decision support to try to minimize these risks.

ACCEPTING OR DECLINING OUR RECOMMENDATION:

We recommend this treatment because the potential benefits of treatment outweigh the risks. You should evaluate this information as well as the manufacturer’s pamphlet, and any input from your in-person healthcare team, or other information to decide if this treatment plan is appropriate for you. You are free to decline our treatment recommendations although, doing so may prolong symptoms and be associated with negative outcomes.

OTHER TREATMENTS:

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can’t provide.

SHARE WITH YOUR IN-PERSON HEALTHCARE TEAM:

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.