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Shingles Treatment with Aciclovir (Acyclovir)
1. Indication:
Aciclovir is an antiviral medication used to treat herpes zoster (shingles), caused by reactivation of the varicella-zoster virus. Early treatment helps reduce pain, severity, and complications like postherpetic neuralgia (PHN).
2. Dosage & Administration:
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Adults & Adolescents: 800 mg orally 5 times daily (every 4 hours while awake) for 7 days.
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Immunocompromised Patients: IV aciclovir (10 mg/kg IV every 8 hours for 7-10 days) may be required.
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Renal Impairment: Dose adjustment is necessary.
3. Mechanism of Action:
Aciclovir inhibits viral DNA replication by targeting viral thymidine kinase, thereby reducing viral spread.
4. Additional Management:
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Pain Control: NSAIDs, acetaminophen, or opioids if severe.
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Neuropathic Pain: Gabapentin, pregabalin, or amitriptyline for PHN.
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Topical Therapy: Calamine lotion or lidocaine patches for symptomatic relief.
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Corticosteroids: May be considered in severe cases to reduce inflammation.
5. When to Start Treatment:
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Best initiated within 72 hours of rash onset for optimal efficacy.
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Still beneficial beyond 72 hours in immunocompromised patients or those with ongoing new lesion formation.
Would you like details on special populations (e.g., pregnancy, elderly)?
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