Oral Antiviral Therapy for Shingles

Introduction to Oral Antiviral Therapy

• The Centers for Disease Control and Prevention recommends oral antiviral medications as the standard of care for shingles treatment, which is superior to topical treatments 1, 2, 3

Efficacy of Oral Antivirals

• Topical antivirals provide only modest clinical benefit and are substantially less effective than oral therapy for shingles treatment, as they cannot reach the site of viral reactivation in the dorsal root ganglia 1, 2, 3
• Topical antivirals cannot impact the host immune response or the inflammatory cascade that drives shingles symptoms, making oral antivirals a better option 2, 4

Safety and Administration

• The American Academy of Dermatology and other guideline societies do not recommend using acyclovir 8 grams per day in immunocompromised patients due to the risk of hemolytic uremic syndrome/thrombotic thrombocytopenic purpura 5
• Oral antivirals are well-tolerated with similar adverse event profiles, and the most common side effects include headache, nausea, and diarrhea, which are typically mild to moderate 3