Chickenpox Medication

Updated: Jun 03, 2022
  • Author: Anthony J Papadopoulos, MD; Chief Editor: Dirk M Elston, MD  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications, especially in individuals who are immunocompromised/immunosuppressed. [46]


Immune globulins

Class Summary

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

Varicella zoster immune globulin, human (VariZIG)

When given within 10 days (ideally within 96 hours) of exposure, this agent modifies the course of disease but does not prevent it. Maximal effectiveness is seen with administration as soon as possible after exposure. It provides passive immunization to exposed individuals at high risk of complications from varicella. High-risk groups include immunocompromised children and adults, newborns of mothers with varicella shortly before or after delivery, premature infants, infants younger than 1 year, adults without evidence of immunity, and pregnant women. Administer by deep intramuscular injection in the deltoid muscle or in another large muscle mass. For neonates or infants, administer intramuscularly in anterolateral aspect of the thigh.


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.

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.

Famciclovir (Famvir)

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

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.



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).

Diphenhydramine (Benadryl)

Diphenhydramine is a 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.

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.