Is oral antiviral therapy for localized herpes zoster safe and effective for preventing postherpetic neuralgia?
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Oral acyclovir reduces the incidence of subacute postherpetic neuralgia (PHN) at 1 month, but does not reduce the incidence of PHN at 4 or 6 months after onset of rash (SOR: A, systematic review of RCTs). Famciclovir speeds relief of zoster pain, but does not decrease the incidence of PHN (SOR: B, single RCT). Valacyclovir may reduce PHN at 6 months compared with acyclovir (SOR: B, single comparative RCT).
Evidence Based Practice 16(7): 08-09.