Shingles vaccine and antiviral meds
Dear Dr. Roach: I am a 60year-old woman who has been taking a 200-mg tablet of acyclovir (Zovirax) every day for HSV-2 suppression. I may have an outbreak every few years, and they are pretty mild. When I do have an outbreak, I increase my dosage to 1,000 mg per day. What is the procedure when I want to get the shingles vaccine (Shingrix)? Would I need to stop taking the acyclovir for two weeks before getting the vaccine and then be able to continue after? Does taking acyclovir help to suppress shingles in any way?
B.S.
Answer: Acyclovir, as well as the related valacyclovir (Valtrex) and famciclovir (Famvir), is an antiviral drug that is used for treatment and sometimes suppression of herpesviruses.
Shingrix is a new, twodose vaccine for shingles. It is a subunit vaccine, meaning it is made from a viral protein, not from the live virus. You do not need to stop taking the acyclovir before getting the two doses of the vaccine. With the live vaccine (Zostavax), you did need to stop acyclovir, in just the way you suggested.
Dear Dr. Roach: I took a sleep study and slept on my back all night because I was wired up and couldn’t sleep on my side. After a couple of hours, I was told that I have moderate sleep apnea. I snore when I’m on my back, but not when I’m on my side. Do you think I really have sleep apnea?
T.M.
Answer: Obstructive sleep apnea very often goes unrecognized. It is caused by the soft tissue in the neck obstructing the airway; the muscles relax while you are asleep, closing the airway. This is indeed much more likely to happen when lying on the back, and generations of spouses have learned that turning a snorer on the side is a good way to get him or her to quit snoring. Snoring is caused by the very same process that leads to sleep apnea; in fact, snoring is a significant risk factor, with up to a third of snorers having the condition.
I believe the sleep study. While I am sure you would have demonstrated less obstruction if you could sleep on your side, you still are likely to have some obstruction during the night.