ANTI-VIRAL DRUGS

There are far fewer antiviral drugs with clinically proven effectiveness than antibiotics. Based on the characteristics of their primary use, antiviral drugs can be divided into several groups: antiherpetic, anticytomegalovirus, anti-influenza and those with an extended spectrum of activity (). The group of antiretroviral drugs used for HIV infection is not covered in this guideline.

Viruses, like bacteria, can become resistant to antiviral drugs.

Table 13. Classification of antiviral drugs*

*Except for antiretroviral drugs.

ANTIHERPETIC DRUGS

This group includes acyclovir, , and.

ACICLOVIR

Zovirax, Virolex

He is the founder of the group of viral DNA polymerase inhibitors.

Pharmacodynamics

The active metabolite of acyclovir, acyclovir triphosphate, which is formed in cells infected with herpes viruses, has an antiviral effect. By inhibiting viral DNA polymerase, acyclovir triphosphate blocks viral DNA synthesis. In healthy cells, the concentration of acyclovir triphosphate is 40-100 times lower than in cells affected by viruses, so the cytotoxicity of the drug is minimal.

Activity spectrum

The most sensitive viruses are herpes simplex ( Herpes simplex) types I and II. Virus Varicella-Zoster 10 times less sensitive. Cytomegalovirus is insensitive.

There are acyclovir-resistant strains of herpes viruses, the prevalence of which in moderate immunodeficiency can reach 6-8%, and in patients who have received immunosuppressive therapy for a long time and in AIDS patients - up to 17%.

Pharmacokinetics

Bioavailability when taken orally is low (15-20%). Plasma concentrations are unstable. Acyclovir is well distributed in the body. Penetrates into saliva, intraocular fluid, vaginal secretions, and the fluid of herpetic vesicles. Passes through the BBB. When applied topically, it is slightly absorbed through the skin and mucous membranes.

It is excreted mainly by the kidneys, 60-90% unchanged. T 1/2 - 2-3 hours, in young children - up to 4 hours, in case of renal failure it can increase to 20 hours.

Adverse reactions

Acyclovir is generally very well tolerated, and adverse reactions are rare.

• Local - sometimes burning when applied to mucous membranes; phlebitis with intravenous administration.
• Gastrointestinal tract - dyspeptic and dyspeptic disorders.
• Neurotoxicity (more often with intravenous administration, in 1-4% of patients) - lethargy, tremor, convulsions, hallucinations, delirium, extrapyramidal disorders. Symptoms usually appear in the first 3 days of treatment, but then gradually disappear.
  Risk factors: renal failure, use of other neurotoxic drugs, interferon, methotrexate.
• Nephrotoxicity (in 5% of patients with intravenous administration, more often in children) - crystalluria; obstructive nephropathy, manifested by nausea, vomiting, lower back pain, azotemia.
  Risk factors: rapid administration, high doses, dehydration, kidney disease, use of other nephrotoxic drugs, such as cyclosporine.
  Prevention measures: drinking plenty of fluids.
  Help measures: drug withdrawal, infusion therapy.

Indications

• Infections caused by H.simplex:
• genital herpes;
• mucocutaneous herpes;
• herpetic encephalitis;
• neonatal herpes.
• Infections caused by a virus Varicella-Zoster:
• shingles;
• chicken pox;
• pneumonia;
• encephalitis.

Dosage

Adults and children

Orally - 0.2 g 5 times a day or 0.4 g 3 times a day for 5-10 days; in patients with immunodeficiency - 0.4 g 5 times a day for 10 days; for infections Varicella-Zoster- 0.8 g 5 times a day for 7 days. When prescribed 5 times a day, the drug is taken every 4 hours regardless of food, with a night break of 8 hours.

Intravenously (for severe lesions) - 5 mg/kg every 8 hours for 7 days; for infections Varicella-Zoster in patients with immunodeficiency - 10 mg/kg every 8 hours for 7-10 days; for herpetic encephalitis - 10-15 mg/kg every 8 hours for 2-3 weeks.

Locally - cream or eye ointment is applied to the affected areas of the skin and mucous membranes 5-6 times a day for 7 days.

Newborns

Intravenously - 10-15 mg/kg every 8 hours for 14 days.

Warnings

When applied topically, acyclovir is less effective than when used systemically; it does not prevent the development of relapses, therefore it is not used for recurrent infections.

Cream for cutaneous use (5%) should not be used if the eyes are affected.

Intravenous administration of the drug should be carried out slowly, over at least 1 hour.

In case of renal failure, dosage regimens must be adjusted.

Release forms

Tablets of 0.2 g, 0.4 g and 0.8 g; capsules 0.2 g; suspension, 0.2 g/5 ml; ampoules of 0.25 g, 0.5 g and 1.0 g of powder for preparing a solution for infusion; cream, 5%; eye ointment, 3%.

VALACICLOVIR

Valtrex

It is acyclovir valine ester, intended for oral administration. During absorption in the gastrointestinal tract and liver it is converted into acyclovir.

Differences from acyclovir:

• has higher bioavailability (more than 50%);
• sometimes causes thrombotic microangiopathy in immunosuppressed patients.

Indications

• Infections caused by H.simplex: genital herpes, mucocutaneous herpes.
• Herpes zoster ( H.zoster) in patients with preserved immunity.
• Prevention of cytomegalovirus infection after kidney transplantation.

Dosage

Adults

Orally - for genital herpes, 1.0 g every 12 hours for 7-10 days (first episode), for relapses, 0.5 g every 12 hours for 3 days; for mucocutaneous herpes and herpes zoster, 1.0 g every 8 hours for 7 days. For long-term suppressive therapy of recurrent forms - 0.5 g every 24 hours for 2-3 months. For the prevention of cytomegalovirus infection - 0.5 g every 6 hours for 3 months.

In children does not apply.

Release form

Tablets 0.5 g.

PENCICLOVIR

Vectavir

In chemical structure and activity spectrum it is close to. In cells affected by the virus, it is activated, turning into penciclovir triphosphate, and disrupts the synthesis of viral DNA.

Differences from acyclovir:

• active against some acyclovir-resistant strains of viruses;
• more effective in later stages Herpes labialis(papule, vesicle);
• has a longer intracellular T1/2 (7-20 hours), which provides a more durable antiviral effect;
• applied only topically.

Indications

• Herpetic lesions of the skin and mucous membranes caused by H.simplex, in patients with preserved immunity.

Release form and dosage

Cream, 1%, is applied to the affected areas every 2 hours (during the day) for 4 days.

Herpesvirus infection is a common viral disease, which in terms of frequency of infection is second only to influenza. To improve the patient's well-being and reduce the frequency of relapses, antiviral and immunomodulatory drugs are widely used for external and systemic use. In advanced cases, injections for herpes are indicated, which can delay the exacerbation of the infection for several years with proper treatment.

When are injections prescribed?

Injection of drugs as part of the treatment of herpes allows you to quickly eliminate the symptoms of the disease, prevent the development and infection of healthy people. Therapy is indicated in the following cases:

• the development of an extensive herpes virus infection, which leads to damage to the skin, mucous membranes, liver, eyes, brain tissue, esophagus and lungs;
• relapses of the disease more than several times a month;
• possibility of infection of a sexual partner;
• the occurrence of neuropathy, which occurs against the background of impaired urination;
• simultaneous progression of herpes and human papillomavirus, which significantly increases the risk of developing cervical cancer.

Features of prescribing antiviral drugs

This group of medications not only prevents further proliferation of viral particles, but also alleviates the course of the disease (relieves pain and accelerates regeneration processes).

Modern pharmacology suggests the use of the following antiviral agents in the form of injections for herpes:

• . The drug is used to treat simplex virus, Epstein-Barr virus. The drug is used when the first signs of exacerbation develop (itching, redness, burning), which helps prevent the formation of blisters;
• . The medicine belongs to a new generation of antiviral drugs. The injections will help cope with damage to the skin and mucous membranes by the herpes simplex virus, and are effective for;
• . This is an original Russian drug that is created from potato shoots. The drug is widely prescribed for herpes types 1 and 2, papilloma virus, cytomegalovirus. Panavir has a pronounced anti-inflammatory, analgesic and immunomodulatory effect.

The listed drugs are administered intravenously; the dosage and treatment regimen should be determined exclusively by the doctor.

Medicines have contraindications and can lead to complications. The action of antiviral drugs is based on the ability of active metabolites to be included in the DNA of herpes, which leads to a decrease in the activity of viral particles and makes the process of their reproduction impossible.

Use of immunomodulators

The use of antiviral drugs can eliminate unpleasant symptoms, alleviate the course of the disease, and accelerate reparative processes. However, drugs can only stop the infection for a short period of time. To increase the duration of the remission period and increase the functionality of the immune system, injections of immunomodulators are recommended.

Doctors widely prescribe injections of the following drugs:

1. . The medicine allows you to activate immunity and reduce the risk of activation of the herpes virus. Depending on the severity of the herpesvirus infection, injections are given intramuscularly or intravenously. The course of therapy is 23 days, involves the administration of 2.5 to 5 g of the drug;
2. Leukinferon. The drug is based on interferon, helps activate the body's immune defense, and minimizes the risk of relapses. The duration of the course should not exceed 2-3 weeks. At the initial stage of the disease, injections are given every day, diluting the prescribed dosage in saline. After eliminating the symptoms, injections are given once every 2-3 days;
3. . The drug is prescribed to patients during acute herpes virus infection. Administration of 250-500 mg of medication per day for 3 days is indicated. The next 3 injections are given at intervals of 2 days. In case of severe immunodeficiency, 1 injection of 250 mg of the drug is given per week for a month. Then a break of 4 weeks will be required;
4. Polyoxidonium. This unique Russian drug has no analogues. It helps alleviate the condition in patients who have a form of herpes that is resistant to Acyclovir. The medicine is administered intramuscularly or drip at a dose of 6 mg for 3 days, then up to 7 injections every other day. If recurrent herpes is diagnosed, then 10 injections are given every other day.

Immunization against herpes

Vaccination against herpesvirus infections involves injecting weakened viral particles to increase the body's resistance to herpes. Vaccination allows you to form stable immunity to the virus, therefore reducing the frequency of relapses of the disease and the risk of complications. The Vitagerpevac vaccine is widely used in Russia.

The vaccine is prescribed in the following situations:

• exacerbation of recurrent herpes more than 3 times a year;
• elderly patients;
• people with severe immunodeficiency (HIV stages 1 and 2).

Immunization involves 5 injections with an interval of 6-10 days. If the patient does not tolerate the vaccine well or an exacerbation of the infection develops, then the interval between injections may be increased.

Injections for herpes are indicated for the chronic form of the disease. Prescribing drugs for parenteral administration in the treatment of herpesvirus infection helps prevent the development of relapses and complications, and quickly relieve unpleasant symptoms.

Antiviral drugs are increasingly prescribed by doctors for certain conditions and are used in home practice for self-treatment by people. What kind of drugs are these, how effective and harmless are they, is it worth using them? Maybe it’s still better to return to traditional folk antiviral remedies - onions, milk and honey? After all, they have long been used to effectively treat “colds”, infectious and viral diseases, accompanied by a decrease? This will be discussed in our article.

Antiviral drugs are separated from anti-infective drugs into a separate group. This was done due to the fact that no other antibacterial drugs (including the well-known ones) can have an effective effect on the development of viruses. This invulnerability of the virus is due to their small size and structural features. For comparison, let's try to compare, say, the sizes of our planet and an apple. So, the planet in our example is a medium-sized microbe, and the apple we are used to is a virus.

Viruses consist of nucleic acids - sources of self-reproduction information and capsules surrounding them. In the “host” body, under favorable conditions, they can multiply very quickly, including by “embedding” their information into the cells of the diseased organism, which themselves begin to reproduce these pathogenic forms. The usual defenses of the human immune system (blood cells) are often powerless against them. The number of pathogenic viruses found is more than 500.

The first drug with antiviral properties was obtained back in 1946, it was called Thiosemicarbazone. As the main component, it was part of Faringosept, and for many years it was used in clinical medicine to combat inflammatory diseases of the throat. Then Idoxuridine was discovered, which is used against the virus.

Please note:A breakthrough in virology was the discovery of human interferon, a protein that suppresses the activity of viruses.

Since the early 80s of the last century, active work began on the creation of drugs that stimulate the body’s ability to synthesize interferon.

Scientific work continues in our time. Unfortunately, the cost of antiviral drugs is quite high.

Alas, a large number of counterfeits have appeared on the pharmaceutical market these days - drugs that do not have protective or stimulating properties, essentially “placebos - dummies.”

Types of antiviral drugs

All available antiviral drugs can be divided into 2 groups:

1. Immunostimulants- medications that can dramatically increase the production of interferons in a short-term manner.
2. Antiviral– medications that can have a direct inhibitory effect on the virus and block its reproduction.

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Based on their effect on different types of viruses, they are distinguished:

• antiviral drugs that act on;
• medications directed against the herpes virus;
• agents that suppress the activity of retroviruses;

Please note: A separate group of drugs intended for the treatment of (immunodeficiency viruses) can be distinguished.

An effective antiviral drug against influenza is Amantadine. Amantadine is an inexpensive and effective antiviral agent. In small doses, it is able to suppress the reproduction of influenza type A virus at a very early stage.

Amantadine blocks the entry of necessary substances through the membrane of the virus and delays its release into the cytoplasm of the host cell. This drug also disrupts the normal development process of a new synthesized virus. Unfortunately, with long-term use of this drug, resistance to influenza viruses can develop.

Another anti-influenza drug, Remantadine (Rimantadine), has a similar effect.

Both of these drugs are endowed with a number of undesirable (side) effects.

While taking them, the following may occur:

• stomach and intestinal problems - with vomiting and appetite disturbances;
• poor and nervous sleep, impaired concentration and attention;
• large doses can contribute to the appearance of altered consciousness, convulsive attacks, illusory phenomena, even hallucinations;

Important: Caution is required when taken by pregnant women. They can be prescribed to children no earlier than seven years of age.

According to clinical statistics, preventive use of drugs during an influenza A epidemic allows one to avoid the development of the disease in 70-90% of cases of infection.

When influenza has developed, the use of Amantadine or Rimantadine shortens the duration of the disease, facilitates the course and reduces the period of virus excretion in patients.

Anti-flu drug Arbidol

Arbidol is another drug that is one of the best antiviral drugs used against influenza . It has both a direct effect on the suppression of the reproductive qualities of the virus and on the activation of the body’s immune systems, in particular T-lymphocytes and macrophages that can fight influenza. In addition, Arbidol increases the activity and number of NK cells, specific “killer” viruses. In addition to these properties, it is a pronounced antioxidant. It has a preventive effect due to penetration into both infected cells and healthy ones. Has a broader antiviral effect. The range of its therapeutic action also includes influenza B and C viruses, as well as the causative agent of avian influenza.

Important:the antiviral drug has the properties of an allergen, which is a manifestation of a side effect. Recommended as an antiviral agent for children over 3 years old.

Taking this medicine also has a positive effect on complications of influenza, ARVI, viral origin, etc.

Features of the use of the antiviral drug Oseltamivir

– in the body of a sick person it is converted into an active carboxylate, which has an inhibitory effect on the enzymes of influenza A and B viruses.

Its main distinguishing feature is that it acts on strains resistant to Amantadine. Against the background of the action of Oseltamivir, viruses lose the ability to actively spread. The number of influenza A viruses resistant to it is much lower than with previous drugs. Most effective against influenza B viruses. Excreted unchanged by the kidneys.

This anti-influenza drug may cause gastrointestinal discomfort, which is significantly reduced if the drug is taken with food. Recommended for the treatment of all age categories. In particular, it is used as part of antiviral drugs for children. Oseltamivir during the acute period of influenza significantly reduces the possibility of bacterial complications - by about 40-50%.

Please note:The drugs discussed are effective antiviral drugs for colds.

Medicines with antiherpetic properties

The most common is type 1 of the herpes virus, which manifests itself on the skin, oral mucosa, in the esophagus, and in the membranes of the brain.

Type 2 causes pathological problems most often in the genital area, buttocks and rectum.

The very first drug of this group was Vidarabine, obtained in 1977. However, along with its effectiveness, it had serious side effects and contraindications. Therefore, its use was justified only in very severe cases and was used for health reasons.

In the early 80s, Acyclovir appeared. The main effect of this drug is to suppress the synthesis of viral DNA by incorporating acyclovirtiphosphate into the pathological DNA, which stops the growth of the virus. Valacyclovir works in a similar way. . However, herpes viruses often develop resistance to these drugs.

When used internally, acyclovir penetrates well into all tissues of the body. The medication is usually well tolerated, but intestinal disorders may occur with,. Sometimes headaches and disturbances of consciousness appear. Cases of the development of renal failure have been described.

It is used both internally and externally in the form of ointments.

Much less frequently, resistance to herpes viruses develops with the use of Famciclovir and Penciclovir. The mechanism of action on viruses for these drugs is similar to that of Acyclovir. Side effects are the same as with Acyclovir.

Ganciclovir is also similar in action to Acyclovir. Used to treat all types of herpes virus.

Please note:Ganciclovir is a specific drug for the treatment of cytomegalovirus.

Important: When using the drug, constant monitoring of blood tests is necessary, since this drug can cause inhibition of hematopoietic function and cause damage to the central nervous system. Use during pregnancy is prohibited due to the damaging effects on the fetus.

Valaciclovir is indicated for herpes zoster.

The mechanism of the antiviral action of Idoxuridine is under study. This drug is used topically to treat herpetic eruptions. But, in addition to its antiviral effectiveness, it produces frequent side effects in the form of pain, itching and swelling.

Interferon group drugs

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Interferons are proteins secreted by body cells infected with viruses. Their main effect is the transmission of information about the need to activate the body’s protective properties against the introduction of pathological organisms.

Antiviral drugs in this group include:

• – the antiviral agent, produced in the form of suppositories and ointments, has been used since 1996. It has not undergone scientific evidence or clinical trials, but in practical medicine it has shown itself to be an effective drug in the treatment of herpetic rashes in adults and children.

Please note: Contraindicated for pregnant women and women during breastfeeding. Research into its effects is ongoing. It has a high cost.

Work to find new inexpensive antiviral agents does not stop. Positive progress in this area indicates the need to develop this area of ​​pharmacology further.

In conclusion, it is worth noting that the group of antiviral drugs is still in the development stage, and not all issues of interest to physicians have been clarified. The mechanism of action, effectiveness and side effects of existing drugs are not always clearly known; the search for new effective ways to combat viruses continues.

When faced with a viral disease, it is important not to resort to self-medication. It is necessary to use drugs with proven effectiveness and safety, only on the recommendation of a doctor.

Please note: Parents of young children need to be especially careful. Antiviral drugs are not always needed to treat a baby.

Dr. Komarovsky talks about the specifics of prescribing and using antiviral drugs for children in a video review:

Lotin Alexander, radiologist

Many people are accustomed to treating herpetic diseases with ointments and tablets, but not everyone knows that there are also injections for herpes. As a rule, this type of treatment is resorted to if the infection begins to recur frequently and spread to large areas of the body.

It is necessary to select injectable medications taking into account the general condition of the patient and his individual characteristics. Not in all situations, the same injections help patients with similar diagnoses equally well, even if their clinical symptoms are largely similar.

In what cases are they prescribed?

The use of injections against herpes may be required in the following cases:

• when adequate treatment was not used at the acute stage of the disease;
• with severe immunodeficiency;
• when the patient is undergoing surgery;
• when there are extensive infectious processes that affect the skin, mucous membranes, respiratory tract, digestive organs, brain and hepatobiliary area;
• cases of relapse of the disease are increasingly repeated;
• in cases of infection of a sexual partner;
• with degenerative-destructive lesions of peripheral nerves;
• in case of disturbances or delays in urination processes;
• in women with herpes virus in combination with HPV.

Injections for herpes infection have a serious effect on the body. Therapy can be carried out using immunostimulating or antiviral drugs, and can also be combined with the use of several pharmacological agents simultaneously. Properly organized therapy is the key to a long period when the virus will remain in a “dormant” state and will not manifest itself in the form of pathological symptoms.

So, what injections are effective for herpes?

Antiviral medications

All antiviral agents for injection use are divided into two categories:

• plant-based, which can eliminate signs of the disease and transfer the virus into a long-term inactive state;
• inorganic, produced on the basis of acyclovir, which penetrate the structures of damaged cells, exhibiting functionality at the DNA level, depriving viruses of the ability to multiply.

Injections against herpetic infections successfully stop and prevent relapses, accelerate the regeneration processes of the skin and mucous membranes, reduce the frequency and severity of pathological manifestations of the disease and prevent the spread of the virus to surrounding people.

Injections for herpes must be selected taking into account the resistance of a particular type of virus to them. These medications do not affect healthy cells.

Titles

Popular drugs:

• "Panavir";
• "Zovirak";
• "Acyclovir";
• "Medovir";
• "Gerpevir".

These names of injections for herpes are known to many.

"Panavir"

This antiviral medicine contains a biologically active element - hexose glycoside, extracted from Solanum tuberosum. It is a high-molecular polysaccharide that increases the level of general resistance of the body to a variety of viral pathogens and increases the production of its own interferon by white blood cells. In addition, it has a slight anti-inflammatory and analgesic effect.

When this medication is administered parenterally, its active substance in high concentration is detected in the plasma after 5 minutes. Removal of the medication begins after about half an hour. It leaves the body through the urinary system and respiratory tract. The drug "Panavir" is recommended for use in the following situations:

1. With the development of pathologies caused by herpesvirus (including oral, ocular and genital), HPV (including the occurrence of genital warts), as well as other DNA and RNA enteroviruses.
2. For cytomegalovirus infection in women.
3. When the functions of the immune system are impaired against the background of infectious diseases or after them.
4. For local defects in the mucous membrane of the gastroduodenal zone, natural focal viral infections transmitted by ticks, inflammatory processes in the prostate of bacterial origin and autoimmune diseases of the joints and adjacent tissues in combination with recurrent herpesvirus.

When infected with herpesviruses of the first and second types, as a rule, 2 injections of Panavir solution (5 ml) are prescribed with an interval of 24 hours or two days. If such a need arises, the therapy is repeated after another month.

The pharmacological agent "Panavir" is administered intravenously. This medicine cannot be taken into the same syringe with others. The administration of the medication should be a stream and very slow.

What other injections for herpes are used?

"Acyclovir"

This medication is actively used against type 2 herpes. It is used to treat herpes infections on the genitals, as well as in the form of herpes zoster. The parenteral form is a lyophilisate with an active element, from which solutions for infusion are prepared. Each vial contains 250 mg of acyclovir in the form of sodium salt.

Adults and children are prescribed droppers with acyclovir or given an intravenous injection of this medication. The dosage is calculated individually, taking into account the body weight and age of the patient. The interval between administrations should be 8 hours. For parenteral use, the contents of the vial must be dissolved in 10 ml of injection water or saline.

If the drug is administered by jet injection, then such an event should be carried out very slowly (about 60 minutes in time). If the medicine is administered by drop, the medical solution is diluted additionally in a solvent (the total volume of the solution should be 50 ml).

If it is necessary to administer the drug in high dosages (up to 1000 mg), the volume of the injected solution increases proportionally. The duration of the therapeutic course depends on the patient’s condition and his response to the treatment. Injections are usually carried out over 7 days.

Immunomodulating medications are used as injections to treat herpes.

Immunomodulatory medications

Immunity protects the body from the aggressive influence of external pathogens and internal aggression (autoimmune processes). One of the ways to improve immunity is to use it in the body to reduce the level of T and B lymphocytes, their functional activity decreases, the work of mature monocytes and the processes of interferon production change.

In addition to antiviral therapy, treatment of pathology involves correction of antibody production and the process of phagocytosis. Immunoglobulin and interferon are widely used as injections for herpes.

The names of the drugs are as follows:

• "Vitagerpavak";
• "Tactivin";
• "Immunoglobulin";
• "Timogen";
• "Imunofan";
• "Galavit";
• "Polyoxidonium";
• "Cycloferon";
• "Ferrovir."

"Vitagerpavak"

This medication is an antiherpetic vaccine and is used in the treatment and prevention of exacerbation of herpes simplex.

Despite the fact that this medicine is not able to permanently eliminate this disease, it has many advantages:

• promotes cellular immunity;
• protects against relapses;
• has no toxic effect.

The drug is administered subcutaneously on the forearm in a volume of 0.2 ml. The course of injections for herpes should be 5 injections - once every 7 days.

"Immunoglobulin"

The active substances of the drug are antibodies to herpes antigens, which can neutralize its effect. In case of relapse or primary infection, the drug is administered intramuscularly at a dose of 1.5 ml every 3 days. For a full treatment course, seven injections must be given. To enhance the effect, this medicine is used topically - the solution is used to treat blistering rashes in the genital area.

Pregnant women are at risk, but this drug can only be used after the first trimester. The drug is administered intramuscularly according to the same scheme as for other patients, but six injections are sufficient for the therapeutic course of the expectant mother. After this, a break is taken and the course is repeated after 36 weeks of gestation.

Herpes injections are only required in cases of extensive or frequently recurring infections. Typically, this condition occurs in the absence of treatment for the disease in the acute stage or in sufficiently reduced immunity caused by an unhealthy rhythm of life, bone marrow transplantation or other viruses (for example, HIV).

Injection administration of antiherpetic drugs should be carried out exclusively as prescribed by a doctor who has studied the patient’s complete medical history. The choice of medications is based on the patient’s condition and other individual characteristics. Using such serious remedies without consulting a doctor can significantly worsen the situation.

Treatment of herpes with injections can be antiviral, immunomodulatory or combined. Adequate therapy will delay relapse for 3-5 years (taking into account the patient’s healthy lifestyle). To prolong the period of remission, annual prophylaxis with non-injectable agents is recommended.

Combination therapy is carried out according to the following scheme: For the first 5-10 days (during acute inflammation), antiviral drugs are prescribed; as soon as remission occurs, immunomodulatory drugs are prescribed.

Drugs in this group are divided into two types - herbal and acyclovir-based. Some act on the symptoms of the disease, dull it and put it into remission, others penetrate into infected cells and block their reproduction and activity at the DNA level (so-called chemotherapy).

The most commonly used drugs are:

• Acyclovir;
• Ganciclovir;
• Zovirax;
• Valaciclovir;
• Gerpevir;
• Panavir.

These drugs suppress the activity of herpes-infected cells by inserting themselves into their DNA. Healthy cells are not affected. The choice of a specific drug depends on the presence/absence of virus resistance to it and the patient’s medical history. All substances are available in the form of diluted powders for injection solution of 250 and 500 mg.

Rules for the use of Acyclovir and its analogues (Zovirax, Gerpevir):

1. Every 250 mg of powder is diluted in 10 ml of sterile water or a solution of 0.9% sodium chloride. Another 40 ml of solvent is added to the resulting solution.
2. Dosage for adults and children over 12 years of age – 5 mg/kg of patient weight. For young children, the dosage is halved. It is not recommended to use the drug for up to 3 months.
3. If the patient has meningoencephalitis caused by herpes, the dosage is increased to 10 mg/kg.
4. The maximum daily dosage is 30 mg/kg.
5. The frequency of injections is every 8 hours three times a day.
6. The medicine is administered drip-wise for at least an hour.
7. Typically, therapy lasts 5-7 days, sometimes it is extended for another 3 days.
8. If the patient has severe immunodeficiency, the therapeutic course lasts a month, after which they switch to tablets.

Use of Valaciclovir. The exact dosage is prescribed by the doctor, but usually it is 450 mg once or twice daily. The drug is contraindicated for children under 12. Treatment takes less time than with acyclovir.

Instructions for using Ganciclovir:

1. The required dose of the substance is taken from the bottle and mixed with 100 ml of infusion solution.
2. The drug is administered intravenously, similar to Acyclovir (slowly).
3. The dosage for an adult is 5 mg/kg, for those with renal failure – 2.5 mg/kg.
4. The medication is taken twice a day at equal time intervals (12 hours).
5. Duration of treatment is 2-3 weeks.
6. If Ganciclovir is prescribed as maintenance therapy (for severe immunodeficiency), it is taken 5 mg/kg daily or 6 mg/kg with two-day breaks every 5 days.
7. The patient needs to take a lot of water.

1. Panavir does not need to be diluted - it is sold in ampoules of 200 ml, which is the recommended adult dosage. The drug is administered slowly, intravenously.
2. The course consists of two injections, the interval between which is 1-2 days.
3. If necessary, therapy is repeated a month later.
4. Herpes infections in people with rheumatoid arthritis take longer to treat, requiring 5 injections at the same intervals. The course can be repeated after 2 months.
5. Patients 12-18 years old are prescribed a dosage halved. The drug is contraindicated for younger children.

Important! Any antiviral injections for herpes are contraindicated during the period of planned conception, during pregnancy and lactation. During treatment, adequate contraception should be observed.

Immunomodulators

Acyclovir and all its derivatives, as well as herbal preparations (Panavir), are not able to reliably suppress the herpes virus. They relieve symptoms and suppress the infection, but only temporarily. A relapse cannot be avoided, but its occurrence can be delayed if you give the immune system a boost to work.

Therefore, immunomodulators have been used in the treatment of herpes for the last 20 years. These drugs are prescribed after a course of antiviral drugs to restore the body’s natural defenses, thereby blocking the possibility of its activation.

In practice, the following injections of immunomodulators are most often used:

Also, for herpes, doctors prescribe other immunomodulators - Viferon, Amiksin, Ridostin, Larifan, Kamedon, Reaferon, Kagocel, Imunofan, Galavit, Likopid, Tamerid.