Many people see their elderly parents suffer with this condition, and it is painful to watch
According to the Centers for Disease Control and Prevention (CDC), about 1 in 3 people will develop shingles in their lifetime. About half of the people who live to be 85 will experience shingles, and they can get it more than once.
Anyone who has had chickenpox is at risk of getting shingles, therefore, it is important to get the vaccine so you can potentially spare yourself the pain of this virus. The older you are, the higher the risk of developing shingles. If you are under stress or ill, your immune system may be weaker and that can additionally increase your risk.
“The virus that causes chickenpox is also what causes shingles. It’s called varicella zoster. It can lie quietly in your nerves for decades after causing chickenpox but suddenly wake up and become active.”
– WebMD Medical Reference, Reviewed by Ratini, 2020
Shingles is known to be an extremely painful experience and is described as pain or tingling, burning, or itching sensation usually on one side of the face or body in a small area, followed by a red rash with small, fluid-filled blisters. The course of a shingles outbreak usually lasts from 3–5 weeks. Even once the blisters clear up, there is often excruciating pain that continues in the area where the rash and blisters had been. This is called postherpetic neuralgia (PHN). According to the CDC, about 10–18% of people with shingles experience PHN. The nerve pain from shingles may be the worst part of shingles for some people, lasting indefinitely. Older adults are more likely to have problems with PHN.
Options for Shingles
Shingles is a virus and, if oral therapy with an antiviral is started within 72 hours, it can possibly cut down on the length or severity of it. Acyclovir oral tablets or other oral antivirals are commonly prescribed, however, it may or may not help with the immediate pain.
The commercial price of topical acyclovir, an antiviral active pharmaceutical ingredient often used in patients with herpes virus infections, including shingles, genital herpes, and cold sores, has drastically increased in the past few years. Patients are often unable to afford their prescription because of rejections by the insurance company or copays that are too high.
For example, one commercial drug that combines acyclovir and hydrocortisone is listed on Good Rx for over $1200 for a very small 5-gram tube! This example drug is intended for use on cold sores on the lip, not the body, but it shows that the price is astronomical for the antiviral/steroid combination.
Commercially available (not compounded) acyclovir cream by itself (without the steroid) is also very expensive and comes in small quantities. Acyclovir ointment is less expensive but still expensive for a small amount of ointment. This does not help with the immediate pain either so something else is usually needed.
At Town & Country Compounding we do our best to work with the patient and the practitioner to offer alternative options.
Compounded Medication
There are not great options available for patients to help with the terrible pain caused by shingles.
This is where a compounding pharmacist may be of extreme help to you for shingles. They can compound a customized combination of topical gel or cream with the antiviral PLUS multiple ingredients for pain that will help with the rash/blister pain and extreme nerve pain.
Common Requested Compounded Prescription for Shingles:
- Acyclovir 5%/Lidocaine 2%/Hydrocortisone 2.5% Topical
- Acyclovir 5%/Lidocaine 2% Topical
- Acyclovir/Gabapentin/Ketoprofen/Amitriptyline HCl/Tetracaine Topical Gel
- Acyclovir/Amitriptyline HCl/Ketoprofen/Bupivacaine HCl/Gabapentin Topical
