Why does Dr. Gacek’s study recommend cutting back the antiviral after only three weeks? After a patient finally introduces Dr. Gacek’s article to the ENT, and after the ENT writes the scrip for the antiviral, the next thing that happens is the ENT wants the patient to start cutting back, right? My local ENT recommended I visit an area specialist in neurotology and otolaryngology. So they both thought I should cut back. (I had been on 3 a day for all of November and almost all of December.) In fact, I had gone about 2 weeks without dizzy spells twice during the two months. And the vertigo/vomiting was pretty much eliminated as soon as I got on the antivirals at the end of October. So I cut back to 2 a day on December 29. Everything was okay the first week. And I was really good about doing the John of Ohio regimen. Then things started to deteriorate with some dizzy spells and last night (Jan 10) I had a full-blown vertigo/vomiting attack for several hours. I’m resuming the 3 a day antiviral immediately. I’ve read here that most people take several months on antivirals before they can safely cut back. But it’s hard when the guys who write the scrips only want you to take 2 a day. I would appreciate some feedback on how people deal with this, especially when Dr. Gacek cuts back in 3 weeks or whatever. I'm guessing the solution is to get your family doc to write another scrip.
I had to stay on the load dose (3x day) for an extra month. Then tapered per normal guidelines and no further issues. I think some people need a little longer to respond, also the goal is to get everything in check then go to a lower ongoing maintenance dose.
IMO Dr Gacek's protocol is a guideline and he does say if you decrease to increase and try again in a certain period of time and also people need to find their maintenance dose. Not everyone's maintenance dose is 800 mg either. page 104 of his publication: effectiveness of new treatments for disorders of unknown etiology. T he antiviral treatment protocol for patients with recurrent vertigo is as indicated below. Discontinue all previous medical treatments; ensure that patients are cleared for normal renal and liver function; use acyclovir tabs 800 mg t.i.d. for 3 weeks and reexamine. If there is significant relief of vertigo, decrease to 800 mg b.i.d. for 3 weeks, then to 800 mg daily as a maintenance dose. If valacyclovir is selected (in those who fail to respond to acyclovir), use 1 g t.i.d. for 3 weeks with taper to b.i.d. for a further 3 weeks and then 1 g daily as a maintenance dose. The starting dose of acyclovir was given for a longer period (3 weeks) than that used for zoster because it was felt necessary to cross the blood-brain barrier to reach ganglion and satellite cells with virus. Most patients experienced relief from vertigo in the first 2 weeks but some required a longer period. The gradual lowering dose was then used to find the lowest level maintenance dose for a given patient
I meant to say: he does say if you decrease and symptoms return to increase and try again ..............
It has always confused me that the more potent antiviral drug, valtrex, is taken in larger doses than the original aciclovir. Irrespective, I do not follow what you are saying Vicki. It seems that the prescription is 3 weeks high dose, 3 weeks medium dose and then the maintenance dose in both cases. I had also read an article from him where the choice of drug was as much to do with costs/insurance as efficacy.
He says 3 weeks then re examine (it states that in the post I made pasting from his publication) re examine is the operative word. I have corresponded with him many times, and he says if you still have symptoms after the 3 weeks don't decrease, if you do not have symptoms then decrease but he has said if symptoms come back then increase again, for another few weeks until you have no symptoms then try decreasing again. valcylovir and acyclovir are both cheap meds, but valcylvoir from what I have read crosses the blood brain barrier quicker. He also states on page 104 The gradual lowering dose was then used to find the lowest level maintenance dose for a given patient. Most were controlled on a single dose daily but occasionally a patient required an adjustment to 1,200 mg of acyclovir or 1,500 mg of valacyclovir.
Clarification, I meant to type he says if you still have symptoms after the 3 weeks but show some kind of improvement don't decrease yet....
I just refilled my prescription for acyclovir and I got a pill that looks totally different, odd shaped, not round or any shape I ever saw a pill in, looks hard to swallow too and definitely not what I have been getting for 3 years. I called CVS and told them I do not want them I want the meds from the same manufacturer I have always gotten them from. She put in an order for me and I hope she can get them. I have no more left
I absolutely agree that you should get them to fill with what you are used to and successful with. Both of those appear to be MUCH smaller than the generic valtrex I take. But I have no issues swallowing and it is working.
They told me when they ordered the ones they always got they could not get them. I am so hoping they can and it comes today. I haven't gone 1 day w/o them in 3 years and I am getting so anxious about this, which we all know can't be good for Meniere's. Its my 3 year anniversary this month of no vertigo, whatta way to celebrate
I'm going nuts! thye got their order was same new manufacturer! I call the manufacturer that makses the one I want and thye have CVS listed as one of their retialers. I don't know why their supplier keeps sending CVS that new pill. I called several other pharmacies in and out of my insurance network. Walgreens is ordering it for me. hope they get the right one. I will have to pay out of pocket but I don't care. I feel frantic sorry I hijacked your thread.
All my sympathy, Vicki! I've had lots of problems with my scrips. In fact, it seems like I get a different generic every time. And I'm sticking with Valtrex because I don't need a bunch of side effects along with the problems I already have. But as soon as the doc doesn't write a big note to specify Valtrex, they send another generic and I have to get a new scrip. I hope you can find a source for the one you need pronto!
thanks Earwig. I will know tomorrow, I found 2 more acyclovirs in my purse in my pill case so took them today, but tomorrow I pray I get the ones I want or I will be w/o
That other pharmacy never called me back, but I asked CVS where I usually get mine if they have any 800 mg from the company I have been getting them from and they had 36, so one of my Drs called in a new script and I have 36 more pills YAY, hopefully I can sort this out by next time I need a refill. CVS told me they will keep trying to get the ones I want.