QuestionDr. Rappaport,
I am hoping you can help me. I suffer from frequent herpes 2 outbreaks, especially starting from the 7 month on. Last time(3yrs ago) the Dr. I had at the time, put me on suppressive therapy the last 3 weeks of pregnancy. It was 400mg,tid of acyclovir. It worked for me, and I did not have any outbreaks while on the therapy.
My question is that now, I am at a midwife group. The midwife said she "rarely" prescribes this medication and had to look it up. She prescribed 400mg only 2x a day, instead of 3. She claimed this was the CDC protocol since 2 yrs ago. I have searched the web and have not found ANY certain protocol for pregnancy. That IS the protocol for "long term" suppressive therapy, or valtrex 500 mg. However, I have a difficult case and know for a fact the 3x a day worked for me. I want to take it the same way I did last time, as I also had no side effects. I sent her studies that listed it 3x a day, but she is still insisting on going by what her info said.
Do you have any information regarding this. She stated already that she "never" prescribes it. (which I found strange because 4 of my girlfriends also have it , so I believe it is a common concern>) I really need some info to refer her to.
Thank you very much
ps All info I saw also showed either acyclovir 400mg bid or t.i.d., or valtrex 500mg bid.
Thank you much for your help
Pam
AnswerCurrently, we are using Valtrex 500mg twice a day. It has really replaced acyclovir and works much better. If you do not have any herpetic lesions while you are in labor, you can safely deliver vaginally. However, if you notice any lesions at the time that you are in labor, a cesarean section is recommended. You might ask your midwife if you could speak to her covering obstetrician. She cannot practice without a covering obstetrician and you certainly have the right to speak to the doctor. Personally, I believe that acylovir twice a day is as effective as three times a day. Don't worry.
