Introduction - What is Zostex®?

Zostex® is a drug that inhibits the multiplication of viruses. So it is used for antiviral therapy for shingles. The tablets contain the active ingredient brivudine.

It is important that it is never used in combination with drugs that contain 5-fluoropyrimidines or 5-fluorouracil. That would lead to life-threatening interactions.

When is Zostex® used?

In general, Zostex® is prescribed for shingles, a disease with the varicella zoster virus.
When the immune system is weakened, the viruses spread along nerve tracts. The typical painful rashes occur. What is particularly feared is the so-called post-zoster pain, which remains even after the shingles has subsided. Zostex® can prevent this.

But not every shingles outbreak needs to be treated with antiviral drugs. The use of Zostex is recommended for

  • Patients over 50

  • Facial rose (= shingles on the face)

  • very severe clinical picture

  • Patients with a reduced immune system (after organ transplantation, HIV, chemotherapy, etc.)

  • Patients who also suffer from severe neurodermatitis

  • Children and adolescents who take cortisone or salicylates continuously

Learn more at: Treat shingles

How does Zostex® work?

The active ingredient in Zostex® is called brivudine. It is a nucleoside analog. This means that the viruses can no longer multiply because a wrong building block has been smuggled into their genome (DNA).

The special thing about brivudine is that it is a prudrug with a long residence time. It only takes effect in the infected cells. In this way, healthy body cells are not affected. Compared to other antiviral drugs, Zostex appears to be more effective.
Post-zoster pain in particular occurs around 25% less frequently with Zostex®.

Read also below: Brivudine

How quickly does Zostex® work?

Zostex® is taken in tablet form, which means that the active ingredient only reaches its destination after digestion and absorption.

The earlier treatment with Zostex® is started, the faster the symptoms will be relieved. Overall, Zostex works quite quickly. After about half a day you can see improvement.It usually takes several days for the symptoms to subside completely.

Dosage of Zostex®

As a rule, Zostex ® is dosed as follows:
Daily intake of one tablet (125mg) for one week.

The intake can be taken regardless of meals. However, it is recommended to swallow Zostex with plenty of water at the same time of day.

Contraindications - When should Zostex® not be given?

Warning: Zostex® must never be taken if medication containing 5-fluoropyrimidine or 5-fluorouracil has been taken in the last 4 weeks. This also applies to ointments or creams with the ingredients mentioned.

Zostex® must not be taken by children and adolescents under 18 years of age.

It must not be taken during pregnancy and breastfeeding and if you are hypersensitive to the active ingredient brivudine or other ingredients of Zostex®.

Can you take Zostex® during pregnancy and breastfeeding?

Zostex® must not be taken during pregnancy or breastfeeding.

Side effects of Zostex®

Nausea is reported as the most common side effect of Zostex®.

Occasionally it happens to

  • Changes in blood count,
  • Impairment of the liver,
  • allergic reactions,
  • Gastrointestinal complaints,
  • Fatigue,
  • Loss of appetite,
  • Dizziness,
  • Fear,
  • Insomnia and
  • Paresthesia.

If you notice any side effects while taking Zostex, you should inform your doctor.

Fatigue from Zostex®

Occasionally, tiredness occurs when taking Zostex®. About 1 in 100 people who take the drug will experience this side effect.

Interaction of Zostex®

Zostex® and 5-fluoropyrimidine as well as 5-fluorouracil (often abbreviated as 5-FU) enter into a life-threatening interaction.

Patients receiving chemotherapy should never be treated with Zostex®. At least 4 weeks must have passed between the last administration of the chemotherapeutic agent and the intake of Zostex®.
External preparations (ointments, creams, eye drops, etc.) that contain 5-FU must not be used in combination with Zostex®. The 5-fluoropyrimidine-containing drugs also include capecitabine (Xeloda®), tegafur (UFT® hard capsules), flucytosine (Ancotil®).

It is therefore necessary to tell the attending physician all medications that are taken regularly or have been prescribed in the last six months.

Is Zostex® compatible with alcohol?

There are no known interactions between Zostex® and food.

However, since there are occasional side effects on the liver and the breakdown of alcohol also takes place in the liver, as a precaution, alcohol consumption should be avoided while taking Zostex®.

Find out more at: Zostex and alcohol

Does Zostex® affect the effectiveness of the pill?

At the moment there are no known interactions between the contraceptive pill and Zostex®. However, since there are different active ingredients in the pill, you should consult your doctor and pharmacist.

also read: Which drugs affect the effect of the pill?

Zostex® and antibiotics - are they compatible?

There are currently no known interactions between Zostex® and antibiotics.
However, if other medications are taken in addition to Zostex®, the attending physician must be informed.

Alternatives to Zostex®

The classic drugs for shingles are

  • Acyclovir,
  • Valaciclovir or
  • Foscarnet.

They represent an alternative to Zostex®.

Price - what does Zostex® cost?

A pack of Zostex® with 7 tablets costs between 90 and 100 €. As a rule, the health insurance company contributes to the costs, so that the patient only has to pay a small part himself.

Is there Zostex® available without a prescription?

No, Zostex® is only available from a pharmacy and requires a prescription. It must be prescribed by the doctor.

Recommendations from the response

You might also be interested in these topics:

  • Antiviral drugs
  • Pencivir
  • Acicliovir
  • Brivudine
  • Treat shingles

Exclusion of liability / disclaimer

We would like to point out that medication must never be discontinued, applied or changed independently without consulting your doctor.
Please note that we cannot claim that our texts are complete or correct. The information may be out of date due to current developments.