Herpes Outbreak & Cold Sore Management - Episodic Treatment

This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains the full information on interactions, side effects, and other important information you should know about the medicine before you start.

Instructions

You have stated that you wish to take a medication for your herpes outbreaks only when you are feeling an outbreak coming on. This is known as “episodic treatment.”  The medication you have been prescribed is Valacyclovir, which you are to take 1 tablet 1 time each day for 5 days, immediately upon noticing the initial signs of an outbreak.* Signs include pain, burning and/or tingling in your genital and/or mouth area, or any sores, blisters and/or ulcers.

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. Please read the information in the following links for further information: 

*Initial outbreak: If this is your first outbreak, which is always the most severe, you are to take 1 tablets 2 times each day (morning and evening) for 10 days.

Refills

You will automatically be sent a refill every 90 days (subject to a refill visit to help screen for side effects). However, you may request a refill early by logging into your Account (Subscriptions > Next Refill).

If your symptoms aren't getting better after you start taking the medicine or if you develop new or worsening symptoms such as fever, chills, nausea, vomiting, or pain, you should see a doctor in-person and call or message us immediately.

Active Ingredients

This medicine contains the following active ingredients. If you are allergic to any of these components, similar components, or any of the others components listed in the manufacturer's pamphlet do not take it and call or message us immediately.

  • Valacyclovir

Allergies

This medicine 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 call or message us or see your doctor in-person.

  • Acyclovir

  • Antiviral medicines

  • Valacyclovir

Conditions

We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop or discover that one of these conditions applies to you please stop taking this medicine and call or message us immediately.

  • HIV

  • Immunocompromised

  • Kidney problems

  • Liver problems

  • Seizure disorder

Pregnancy and Breastfeeding

While Acyclovir is safe to take during pregnancy and breastfeeding, if you become pregnant or are breastfeeding you should stop taking this medicine, call or message us immediately, and talk to a doctor in-person.

Emergency Side Effects

This medicine 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

This medicine 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 call or message us or see your doctor in-person.

  • Abdominal pain

  • Abnormal heart rhythm

  • Change in vision

  • Changes in behavior

  • Depression

  • Dizziness

  • Easy bruising or bleeding

  • Fatigue

  • Hair loss

  • Hallucination

  • Headache

  • High blood pressure

  • Joint pain

  • Lightheadedness or passing out

  • Nausea or vomiting

  • Painful periods

  • Pale skin

  • Runny nose

Medicines, Supplements, and Foods

We have evaluated your health history and the specific health information you provided us, however if anything changes and you start or discover that you are taking any of the medicines, foods, or supplements listed below call or message us 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

Risks

Accurate Information

We have evaluated the specific health information you provided and are making our recommendations based on it. If you forgot to provide or incorrectly provided that information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.

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 the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency call 911 or seek immediate medical help in-person. You may need to seek alternative treatment such as those listed below or in the follow-up plan.

Misdiagnosis or 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 the evidence based practice and guidelines as well as clinical decision support to try to minimize these risks. Here are some other diagnoses that we attempt to rule out:

  • Acne

  • Other rash

  • Perioral dermatitis

Accepting or Declining Our Recommendation

We are recommending this treatment for you because the potential benefits outweigh the risks in our estimation. You should evaluate this information as well as the manufacturer's pamphlet, any input from your in-person healthcare team, and any other relevant information to decide if this treatment plan is appropriate for you. You are free to not follow our recommendations although there may also be risks associated with no treatment.

Alternative Treatment

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. Message us or talk to your doctor in-person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:

  • Alternate antiviral medicines

  • In-person lab testing

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.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.

Related Links

  1. CDC 2015 STD Treatment Guidelines, Genital Herpes. At https://www.cdc.gov/std/tg2015/herpes.htm.

  2. WebMD. Drugs and Medications. Acyclovir. https://www.webmd.com/drugs/2/drug-941/Acyclovir-oral/details