Herpetic Whitlow Medication

Updated: Nov 11, 2022
  • Author: Michael S Omori, MD; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Medication Summary

The main goals of treatment are to prevent oral inoculation or transmission of infection and to provide symptomatic relief. [7]


Antiviral agents

Class Summary

These agents are used to shorten the clinical course, prevent complications, prevent the development of latency and/or subsequent recurrences, decrease transmission, and eliminate established latency.

Acyclovir (Zovirax)

Topical form shortens duration of symptoms in primary infections; acts by interfering with DNA replication within the virions.

Oral acyclovir may abort recurrences if treatment is initiated immediately upon onset of symptoms; inhibits HSV-1 and HSV-2.

Famciclovir (Famvir)

After ingestion, the drug is rapidly biotransformed into the active compound penciclovir and phosphorylated by viral thymidine kinase. By competition with deoxyguanosine triphosphate, penciclovir triphosphate inhibits viral polymerase, subsequently inhibiting viral DNA synthesis/replication.

Adjust dose in patients with renal insufficiency or hepatic disease.

Used against herpes simplex and varicella-zoster viruses.

Valacyclovir (Valtrex)

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


Antiviral Agent, Topical

Class Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

Penciclovir (Denavir)

Inhibitor of DNA polymerase in HSV-1 and HSV-2 strains, inhibiting viral replication.