Chickenpox Medication

  • Author: Anthony J Papadopoulos, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jun 20, 2011
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications, especially in individuals who are immunocompromised/immunosuppressed.[31]

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Immune globulins

Class Summary

For passive immunization, use varicella-zoster immune globulin, human (VZIG), a human immunoglobulin preparation. This agent is indicated for use in highly susceptible, VZV-exposed immunocompromised or immunosuppressed populations.

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Varicella zoster immune globulin, human (VZIG)

 

When given within 96 hours of exposure, VZIG can modify the course of disease but does not prevent it. Maximal effectiveness is seen with administration as soon as possible after exposure. Administer by deep intramuscular injection in the gluteal muscle or in another large muscle mass.

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Antiviral agents

Class Summary

Nucleoside analogues are initially phosphorylated by viral thymidine kinase to eventually form a nucleoside triphosphate. These molecules inhibit herpes virus polymerase 30-50 times more than the human host cells alpha-DNA polymerase.

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Acyclovir (Zovirax)

 

Acyclovir inhibits activity of both herpes simplex virus (HSV)-1 and HSV-2. It has affinity for viral thymidine kinase and, once phosphorylated, causes deoxyribonucleic acid (DNA) chain termination when acted on by DNA polymerase. Patients experience less pain and faster resolution of cutaneous lesions when acyclovir is given within 48 hours from rash onset. It may prevent recurrent outbreaks. Early initiation of therapy is imperative.

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Famciclovir (Famvir)

 

Famciclovir is a prodrug that, when biotransformed into the active metabolite, penciclovir, may inhibit viral deoxyribonucleic acid synthesis/replication.

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Valacyclovir (Valtrex)

 

Valacyclovir is a prodrug that is rapidly converted to the active drug acyclovir. It is more expensive than acyclovir but has a more convenient dosing regimen.

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Antihistamines

Class Summary

The symptoms of chickenpox such as pruritus in the pediatric population can be treated with oral antihistamines. Examples of antihistamines are diphenhydramine (Benadryl) and loratadine (Claritin, Alavert).

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Diphenhydramine (Benadryl)

 

First-generation antihistamine with anticholinergic effects that binds to H1 receptors in the CNS and the body. It is often used for symptomatic relief of pruritus caused by the release of histamine in inflammatory reactions. Diphenhydramine may cause drowsiness.

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Loratadine (Claritin, Alavert)

 

Loratadine selectively inhibits peripheral histamine H1-receptors. It provides relief of pruritus and has a decreased incidence of sedation compared with first-generation antihistamines.

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Contributor Information and Disclosures
Author

Anthony J Papadopoulos, MD  Private Practice

Anthony J Papadopoulos, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, Medical Society of New Jersey, and Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

Camila K Janniger, MD  Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Susan M Swetter, MD  Director, Pigmented Lesion and Melanoma Program, Professor, Department of Dermatology, Stanford University Medical Center and Cancer Institute, Veterans Affairs Palo Alto Health Care System

Susan M Swetter, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Clinical Oncology, Eastern Cooperative Oncology Group, Pacific Dermatologic Association, Society for Investigative Dermatology, Society for Melanoma Research, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Van Perry, MD  Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas School of Medicine at San Antonio

Van Perry, MD is a member of the following medical societies: American Academy of Dermatology and American Society for Laser Medicine and Surgery

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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Dewdrop on rose petal characteristic vesicle of chickenpox. Reprinted with permission from Cutis 65: 355, 2000.
Vesicular eruption on the trunk demonstrating papules, vesicles, and crusts. Reprinted with permission from Cutis 65: 355, 2000.
 
 
 
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