|Anthony L. Komaroff, M.D.|
Q. I’ve been diagnosed with shingles. Is there anything I can take for the pain?
A. If you’re over age 50 and you’ve had the shingles pain for less than three days, the current recommendation is that you take a medicine that kills the virus that causes shingles—varicella-zoster virus. The two medicines recommended most often are famciclovir and valacyclovir.
The reason that the recommendation is made only for people over age 50 is that this is the age group most often affected by shingles, and most of the studies of antiviral treatments have been conducted in that age group. Still, if a patient younger than 50 is having lots of discomfort from shingles that began in the last three days, I will often prescribe antiviral therapy. If the antiviral medicine is not giving enough pain relief, pain medicines can be added. Doctors start with nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, and if necessary will then add more potent pain medicines.
Glucocorticoid medicines (often referred to as “steroids,” although not of the muscle-building kind) were used for many years. In my opinion, recent studies challenge their value.
—Anthony L. Komaroff, M.D.
Editor in Chief
Harvard Health Letter