DEAR DR. DONOHUE: I have a question about Valtrex and genital herpes.

I had a few outbreaks of herpes in a year and was advised to take this medicine daily to suppress them. I have been taking it for two years. It gives me peace of mind, but I worry about permanent side effects. Can you take it less often? Once a week? What happens if I stop taking it completely? — Anon.

ANSWER: The herpes virus lives in an affected person for life. Those who suffer frequent recurrences or painful outbreaks have the option of suppressing those outbreaks by taking Valtrex (valacyclovir), Famvir (famciclovir) or Zovirax (acyclovir).

One method is episodic treatment, taking the medicine only at the first signs or symptoms of an outbreak. A second method is chronic suppressive therapy, the daily use of medicine to prevent outbreaks. The safe length of time for this therapy hasn’t been established. A third option is to take no medicine if the outbreaks are not terribly painful or if they do not occur frequently.

Psychologic distress and lessening the chance for spreading the virus are two other reasons for suppressive treatment.

No one can predict what will happen if you stop completely. You might have a few yearly occurrences, as you did in the past. Side effects from these drugs include headache, nausea and stomach pain. Serious side effects, which are quite rare, are blood clots, a decrease in blood platelets and kidney damage. Taking the drugs once a week doesn’t work.

You and your doctor have to decide if daily medication is appropriate for you.

The booklet on herpes explains this common infection and its treatment. Readers can order a copy by writing: Dr. Donohue — No. 1202, Box 536475, Orlando, FL 32853-5475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: After two days of sinus headaches, I awoke with double vision. Doctors admitted me to a stroke ward. Then they determined that I had damage to cranial nerve III (3) and partial damage to IV (4). Can you shed some light on what happened? — D.D.

ANSWER: The eyes view objects from slightly different positions. To fuse the images they get into a single picture, the six eye muscles of each eye and the three nerves that control them have to align the eyes in exact positions. If one or more muscles or one or more nerves are out of whack, people see two images.

Diabetes, high blood pressure, small strokes, multiple sclerosis and myasthenia gravis (a nerve illness) are the major causes of double vision. A less-serious cause is a temporary disruption of blood supply to one of the eye nerves or eye muscles. In that instance, the visual disturbance clears in a matter of weeks or months. This sounds like what happened to you. The sinus headaches are not likely responsible.

In the meantime, glasses fitted with a prism can restore single images.

DEAR DR. DONOHUE: I sent you a warning about garlic and how it can thin the blood.

Enclosed is the article that cites this effect. I’m sure you’d rather have printed evidence. — D.S.

ANSWER: Garlic, when eaten in large amounts, can interfere with the clumping of platelets. That action is needed to form a clot.

But you really have to eat quite a bit, and you have to do so on a regular basis.

Thank you for your kindness in alerting all to this possible side effect. It is especially important to people who take blood thinners.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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