The chickenpox virus causes shingles. In people with a history of chickenpox, the chickenpox virus may reactivate after several years to form painful rashes. There is no cure for this viral infection. Treatment for shingles focuses on reducing pain, duration and severity of the infections.
Shingles is primarily treated with antiviral drugs that help to speed up the healing process. Non-prescription pain relief drugs are commonly used for alleviating pain during shingles outbreak. Topical anesthetics and narcotic pain relief drugs are used for treating severe shingles pain. If shingles pain lasts for months, your physician may prescribe antidepressants or anticonvulsants.
Medications To Treat Shingles
Antiviral Medicines
Antiviral drugs help to shorten the duration of shingles. To diminish the risk of developing shingles-related complications, antiviral medicines should be started within the first three days after the symptoms of shingles appear.
Acyclovir
Acyclovir belongs to a class of drugs called nucleoside analogues. It works by preventing replication of the virus.
It is taken orally two to five times daily for five to ten days. Remember to drink plenty of water while you are on this antiviral medicine. Vomiting, stomach upset, diarrhea, vision change, joint pain and fatigue are possible side effects of the drug.
Famciclovir
To treat shingles, famciclovir should be taken thrice daily for up to seven days. This antiviral is most effective when taken within three days after the early symptoms of shingle appear. Possible side effects of the drug include nausea, vomiting, headache, diarrhea, stomach pain, gas, itching, rash, painful menstruation and fatigue.
Valacyclovir
During a shingles attack, you can take valacyclovir every eight hours for up to seven days.
For best results, this antiviral drug should be taken as soon as possible after the first shingle rash appears. Stomach upset, diarrhea or constipation, vomiting and headache are common side effects of the drug.
Pain Relief Drugs
Shingles pain is treated with common over-the-counter pain relief drugs such as aspirin, ibuprofen and acetaminophen.
Aspirin
Adults may take aspirin for treating shingle pain. If you are not susceptible to allergic reactions to aspirin, you can take an aspirin tablet four to six times a day.
Ibuprofen
Ibuprofen is considered safe for adults as well as children for alleviating pain during shingles outbreak. Children can take ibuprofen up to four times a day, whereas adults can take the pain relief medication up to six times a day. Ibuprofen may cause stomach upset and heartburn if not taken with food or milk.
Codeine
Codeine, an opoid pain relief drug, is occasionally used for treating severe shingles pain. To prevent addiction, it should be used for a short time under strict medical supervision.
Acetaminophen (Paracetamol)
Acetaminophen (paracetamol) is one of the safest pain relief medications for children and adults. When used appropriately, acetaminophen does not cause serious side effects.
Topical Anesthetics
Severe pain during shingles attack that does not respond to conventional oral painkillers may be treated with topical anesthetics such as benzocaine and lidocaine.
Benzocaine
Benzocaine is a topical anesthetic available over-the-counter. It is available in the form of gels, liquids and sprays. A small amount of benzocaine can be applied directly on the shingle rash to numb the sensation of pain. Benzocaine overdose increases the risk of developing pulmonary aspiration.
Lidocaine
Lidocaine patches are recommended by doctors for reducing persistent shingle pain, known as post-herpetic neuralgia, that lasts for months and even years. It is used only once a day.
Lidocaine overuse may cause serious side effects. Swelling, redness and burning of the application site are common side effects of the drug.
Anticonvulsant
Anticonvulsants commonly used for treating neuropathic pain in shingles patients include gabapentin, carbamazepine and phenytoin. Although the anticonvulsants are equally effective for treating post-herpetic neuralgia, effectiveness of individual drugs may vary from patient to patient.
The dosage required for treating shingles pain is lower than that used for treating seizures. Usually 100 to 300 mg of an anticonvulsant drug is taken daily at bedtime. Your doctor may consider changing the dosage every three days. Side effects of the drugs include drowsiness, liver problems, electrolyte abnormalities and memory problems.
Tricyclic Antidepressants
Post-herpetic neuralgia in shingles patients may be treated with tricyclic antidepressants. By boosting the level of the neurotransmitters serotonin and norepinephrine they tend to reduce the sensation of pain. Antidepressants commonly used for treatment include imipramine, nortriptyline, desipramine and amitriptyline.
About 10 to 25 mg of the drug is taken at bedtime. Depending upon the response of the patient to the drug, the dosage may be changed every two to four weeks. These drugs may cause drowsiness, postural hypotension, urinary retention, blurred vision and dry mouth.
