Help with shingles meds

Hello Eileen,

I am so sorry you are suffering so, but I'm afraid Shingles and pain go together, and you need to come to terms with that fact and do whatever you can to cope. The pain will eventually ease, but that could be weeks down the line - go back to your Dr and ask for a different pain killer as some people get more relief from one than another - also go online and check out self help advice, there are a fair few things you can try, some will help others won't its a bit of trial and error - I found the itchy pain was greatly helped by using Calamine lotion - the stingy hot pain by Aloe Vera gel and the teeth gritting pain by a strong mixture of Paracetamol and Codeine .

Wear loose clothing whenever possible - bathe with an oatmeal based product in your bath, I found this very soothing.

Rest as much as you can - i know sleeping can be difficult, but get as much as you can when you can, its very important. Eat a healthy diet, and supplement your diet with immune system boosting vitamins - this will greatly aid your recovery and help prevent further outbreaks.

I'm afraid there is no instant cure - outbreaks can last a varying amount if time, there are no set rules - but most if all be kind to yourself Eileen, plenty of rest - you cant powerhouse through Shingles I'm afraid, know you are not alone, there are plenty of people on here who are suffering with you, have suffered in the past and some unfortunately who continue to suffer repeated attacks - but all of us are here with you, and will help in any way we can - chin up

Babs xxx

Hello Eileen, I'm sorry to tell you that Barbara is correct. I also give her credit for telling you that. My shingles was in my back/chest over 2 years ago, but as I didn't have any rash, I didn't get the anti-virals in time. The gab may eventually dull the pain, as it also numbs you and your brain, but it will probably mean an increased dose. Gab and meds like these come with a long list of side effects and complications, some of them quite serious and life-altering. I've been slowly getting off gab for 2 years and the gab withdrawal is worse than the pain of my PHN, the condition you get if you get nerve damage from the shingles.

Think of the pain meds as short term, but in reality, not much helps in the first week or two. What can ease the discomfort is whatever helps you. Some people find ice helpful, others heat. I also use Tyelenol (the UK calls it something else) and a pain cream with Lidocaine. Rest, is VERY important. The rash or specific pain is only part if the issue. You have a virus which is making you ill, just like if you had the flu or any other condition. Take care of yourself, accept that you're sick and let others know that. Do NOT try and power through, that can extend the condition. Try to avoid aggravating the area with movement. Right now I know it all hurts and it may be hard to isolate it. But I learned to avoid lifting, bending, twisting etc. Anything that put pressure on the area or involved core movements, made it worse. You want to avoid firing up those nerves, which may speed up recovery.

It's very hard and emotional to see the changes shingles will have on you and your life the few weeks, but it will get better.

Dear Eileen,

I am so sorry you are going through this right now. I understand the agonizing, lancinating pain, sleepless nights, and suffering.

Please read this post carefully. You need to find a sympathetic physician who actually understands that shingles is excruciating, and knows how to treat it accordingly. A neurologist would be a better option. Codamol is useless.

I am a Nurse Practitioner in the States. I have had Herpes Zoster-Shingles in my right ear, mouth, and throat every three to five weeks for the past twenty-two years and twice in my right eye. It has now escalated to include my entire right scalp.

This is a summary of the stages, signs and symptoms of Herpes Zoster-Shingles, and medical management of the disease.

During the Pre-eruptive Phase, you may have some of the following symptoms:

The duration is one to ten days, but the rash occasionally takes much longer to appear

Headache

Photophobia

Generalized Aches and Pains

Fever, Chills, and Sweating

Enlarged Lymph Nodes near the pain and rash

Fatigue and Exhaustion

Pain usually preceding the rash, but not always

Itching

The pain can be described as a deep burning or aching pain, or electric shock–like pains.

Acute Eruptive Phase

Rash of grouped vesicle-blisters in a dermatomal pattern.

Occurs in waves or crops over a period of 5-7 days.

Vesicle-blisters look dissimilar and are of different sizes.

The rash is on a red base.

The pain may continue to increase into the second and third week.

The clear vesicle-blisters cloud over, look like pustules, scab over, and turn black. This process may take between 2-4 weeks. Once every vesicle-blister has scabbed over, you are no longer infectious!

You are considered infectious (contagious) if your rash is open to the air, ie not covered, to anyone who has not had chickenpox. This includes all pregnant women! Remember, not all women know they are pregnant!

Chronic Phase (Post Herpetic Neuralgia PHN)

30 days after onset of rash. Definition varies

Duration may last months or years after initial episode of Herpes Zoster-Shingles.

The resolution of the scars can take up to a year to heal.

Management and Medications

ANTIVIRALS ARE THE CORNERSTONE OF TREATMENT

Famciclovir 500 mg 3x daily 7-10 days, sometimes 14 days.

Smallest Tablet

Convenient dosing

Least Resistance

Valcyclovir 1000 mg 3x daily 7-10 days

Large Tablets difficult to swallow for some

Based on Acyclovir

Acyclovir 800 mg 5x daily 7-10 days

Inconvenient Dose Schedule

Growing Resistance to Varicella Virus

Acyclovir is the antiviral most often prescribed in the UK

What dosage of the medication are you on? Sometimes, the Physician places the patient on a lower dose, but needs to increase it to help with the pain-itching.

Sometimes, you need to be placed on a cocktail of medications, as they will work synergistically to help you. These are all by prescription. I have grouped them according to class. A clinician would start with one from the Anticonvulsant class, taper the dosage up, then one from the Antidepressant Class, etc. This list is by no means complete.

ANALGESICS

NSAIDS

Ibuprofen

Naprosyn

Acetominophen

OPIOIDS

Oxycodone

Hydrocodone

Codeine

CBD

ANTI-CONVULSANTS

Gabapentin-Neurontin

Pregabalin-Lyrica

ANTI-DEPRESSANTS

SNRIs

Cymbalta

Effexor-Venlafaxine

Heterocyclics

Nortriptyline

Amitriptyline

2. I would find 100% cotton knit clothing. Make sure there are no seams to irritate your skin. The cotton knit is the most breathable, least irritating cloth to most individuals.

3. Use Lidocaine Cream or Spray OTC topically to help with the pain- itching, eg, Solarcaine with Aloe or Bactine. Many on this forum feel either Lidocaine or Benzocaine help with the pain-itching. The cream might soothe the inflamed nerve endings better and last longer on the skin. You can only use Lidocaine 12 hours on and 12 hours off, as the usefulness will extinguish itself.

4. Use ice or cool compresses. Do not take hot showers, as it will only increase the pain-itching

5. You need to rest and sleep. You cannot power through this disease. Do not go back to work! This virus is way stronger than you are, and you will only get more pain, the more exertion you do.
6. Most Importantly, get the Shingrex Immunization. It is a two phase vaccine, two months apart. It is given intramuscularly. It is highly efficacious in stopping Post Herpetic Neuralgia PHN and recurrent episodes of Herpes Zoster-Shingles.

Shingrex is available in the US at the pharmacy and covered by insurance if you are over 50 years of age. If you are younger than 50, and have had a documented case of shingles, it is still covered.

If you are in the UK/Canada/Australia/NZ, I know it has been distributed there, but the national health insurance may not cover it until age 70, which is ridiculous. It is expensive, but I would have paid thousands not to have recurrent shingles.

Best Wishes,

Merry Juliana

hi, the Gabapentin only works for very short time on Shingles. I TRIED everything from nerve pain meds, Opioids, anti-depressants, cremes, anti-itch meds and NOTHING WORKED!!!! I had Shingles on the right side of my face (so awful and embarassing) back in OCT. 2018. The breakout was simple compared to post-shingles. I went to ER twice and Urgent CARE twice in one month. No one could help me with the pain and itching!!!! Its like no one taught this in Med School!!! It still itches to this day which is 3 months later and if I get stressed it starts itching and hurting worse. The best advice I received was "you must stop scratching when it itches or it will never stop itching"! It has proved to be true . I know this isnt much help and you MUST FIGHT THRU SHINGLES TO OVERCOME. IT can last months or longer, its very serious and nasty. I forgot to mention I WENT THROUGH 3 rounds of the Viral MEDICINE! It barely helped as far as I can tell.

Get the Shingles shot after your Shingles rash goes away and get the 2 shot one. You get first shot and then 2-6 months later you get the 2nd shot. Suppose to help in the future with your nagging post-shingles issues.

Shingles is not just an older person thing... I've known 3 people in early 50's this year to get shingles!!!! It's nasty!!!!

All the luck and love to anyone going thru all the issues caused by Shingles! It is caused by stress, weak immune system CHANCES ARE YOU DIDNT CONTACT IT FROM ANYONE ELSE ESPECIALLY IF YOU'VE ALREADY HAD CHICKEN-POX!!!!

I was on gabapentin for 4 months-started out with 1 /day along with a couple of opiods a day. I went off the opioids in a month, but found that taking 7 gabapentin (2/2/3) per day helped a lot. Had shingles for 4 months on my torso- I feel your pain and sleepless nights. As stated, get all the rest and stress free time you can. I have a pool and the cool water gave me a lot of relief. Good luck

did you try a Versatis Patch

You can ask doctor about Pregabalin that's also good for the back pain with shingles. I just got over my second dose of shingles and have PHN , but these keep pain away

Try Aspercreme-- 4% Lidocaine w/o a script.