I had two scary vertigo episodes last weekend. Brief, but very intense, followed by unpleasant increase in symptoms. I was on 2 gm/day of Valtrex (Valacyclovir brand name, which works better for me than generics I've tried). I think some stress and migraine triggers set it off. I'd felt good for a long while. It is so easy to forget that even when I feel good I have to be careful. Thankfully after a day and a half back on 3 gm of Valtrex/day, I felt much better. But I've never been able to get below 2 gm/day of Valtrex, so I think I will talk with my doctor about trying Famvir. I already bounced it off Dr. Gacek in an email, and he was positive about the idea, but very brief (which is fine, he is so great to even answer my emails). A couple questions: * Is there a journal article I can show my doctor that has the dosages for Famvir? * Any advice from those who have made the switch? If you do it while feeling good is it pretty smooth?
I just made the switch and haven't had any issues. I don't know the max dose, but I'm taking maintenance of 500 mg.
BTB- I showed my GP the Gavek email and she wrote the script. The one where he told me about Famvir and he doses. I did really well on it, moved to a maintenance dose and have since had a flare up. I moved to max dose again and have started feeling better. Hope this helps.
I made the switch from VAL to FAM on Sept 21, also after emailing Dr Gacek. He recommended I take 1gm 3x daily of FAM for three weeks, then go to 500mg 3x daily. He didnt advise a decrease after that, but I plan to sending him an update after I initially decrease from 3gms to get his thoughts (also very happy he is willing to engage thru emails). I still have my moments where a wave of uneasiness is present and I have to lay down, but fortunately these waves dont last hours on end. I've been able to do gardening, play golf and have a bit of a social life. I was hesitant to make the switch, but I wanted to do anything that would possibly help me continue to improve. Pls keep us posted on your progress
Thanks very much everyone. Are you taking the brand name or generics? Have you heard if that seems to make a difference?
Not sure if this helps, but this site suggests that Famvir doses are about half that of Valtrex. http://www.emedexpert.com/compare/herpes-antivirals.shtml
Forever grateful- our doses don't match up. I wonder why? He told me famvir 500mg 3x/day then 500mg 2x/day then 1 per day.
I decided to email and ask him myself, so that I will have something to show my doctor. I'll let you know what I learn. That's interesting that the doses are varying. Are folks taking generics or brand name?
Generic here. I imagine the doses differ depending on the severity of symptoms and prior response or non-response to other AVs.
yeah, forevergrateful, are you sure that you took 1g Fam 3x per day? for 3 weeks? If you truly stood that I may try it. Can you copy the email from Gazek and paste it here?
I just rewrote to Dr G for further clarification on the dosage he suggested for me. Like I mentioned in my email to him, it must be difficult sometimes when your "the best" and people are constantly seeking your advice. Suffice to say, I will let you know if/when I hear from him. As a side note, I had a terrible "attack" last night (nystagmus) which awakened me from my sleep, sending me to the bathroom for over an hour of vomiting and diarrhea. I checked for BPPV this am and there was no indication that was the causal factor. I"m bewildered by it all. My hopes have been high that the FAM and betahistine (along with JOH etc etc) would be the mechanisms that got me back in control of this beast.
All - I switched from Valtrex to Famvir when Valtrex stopped working. Per Dr. Gacek, this was the dose he recommended: Famvir 500mg 3x per day for 3 weeks, then down to 500mg twice daily for 3-4 weeks .Finally stay on 500mg daily. I've never gotten back to where I was before, but hope this dosing helps anyone looking to switch.
Thanks very much, TLB! You've never gotten back to where you were on Valtrex when it worked or where you were before MM?
Bythebay- I’ve never gotten back to where I was on Valtrex. That being said, I had a fabulous 5 months and I’m not 100% that was because of the AV - I just assumed. I went to Europe for 2 weeks in the beginning of April, had a major flare up and have never gotten back to where I was no matter what I’ve tried. I’m thinking about trying the really look into the TMJ connection next. I don’t think I have anything left to try!
Dr G finally got back to me this morning. He corrected the dosage to 500mg 3x daily for three weeks then 500mg 2x daily for one to two months. He didnt respond to me query about his previous email being incorrect, but I will chalk that up to his leaving on vacation that day and his busy schedule. Given my setback last weekend, I took it upon myself to lower the dosage starting last Saturday. Now I am planning to take the 500mg 2x daily for the foreseeable future. I still am not "quite right" (if ever I was ) but I"m hopeful that I will improve now that I'm on a more normal dose of FAM. Not sure how long it takes the body to adjust to the lower dosage, but there isnt much I can do to control that anyway. Sorry for the previous confusion about dosage, but I was only repeating what he had told me previously.....In any event, I stand corrected and keeping my fingers crossed. ps Dwayne, I tried again to send you a PM, but your in box is still full.
TLB--Have you tried doing a max dose of the AVs and at the same time taking 1000 mg of lysine on a empty stomach 2-3 times per day? That (albeit with Valtrex) is what finally got me back after a major flare up at the end of last year.