Shingles
Commonly treated with Valacyclovir, Famciclovir & Acyclovir
Shingles (herpes zoster) is a painful, blistering rash caused by reactivation of the same virus that causes chickenpox. Prescription antiviral medication works best when started within 72 hours of the rash appearing. After an online review by a licensed provider, appropriate treatment can be prescribed and shipped from our licensed U.S. pharmacy.
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Medically reviewed by David Paul Mackarey, RPh, Pharmacist-in-Charge — Last updated July 15, 2026
Choosing and Using Your Treatment
| Treatment | Choose this if… | How to Take |
|---|---|---|
| Valacyclovir 1000mg | A common first choice for most adults because of its convenient three-times-daily dosing. | Take 1 tablet by mouth 3 times daily for 7 days. Start within 72 hours of the rash. Complete the full course. |
| Famciclovir 500mg | A good alternative for adults who prefer or previously did well on famciclovir. | Take 1 tablet by mouth every 8 hours for 7 days. Start within 72 hours of the rash. Complete the full course. |
| Acyclovir 800mg | An effective, lower-cost option for those who can manage five doses per day. | Take 1 tablet by mouth 5 times daily, about every 4 hours while awake, for 7 to 10 days. Start within 72 hours of the rash. Complete the full course. |
| Lidocaine 5% Patches | Suits those with lingering nerve pain (postherpetic neuralgia) after the rash has fully healed. | Apply 1 patch topically to intact skin over the painful area once daily for up to 12 hours for 30 days. |
About Shingles (Herpes Zoster)
Shingles is caused by the varicella-zoster virus — the virus responsible for chickenpox. After a person recovers from chickenpox, the virus stays dormant in nerve tissue and can reactivate years or decades later as shingles. It typically appears as a painful, blistering rash in a band or stripe on one side of the body or face. Many people feel burning, tingling, or itching in the area days before the rash shows up. Most cases clear in two to four weeks, but some people develop lingering nerve pain called postherpetic neuralgia. Starting antiviral medication early can shorten the outbreak and may lower the risk of complications.
Signs & symptoms
- Burning, tingling, or shooting pain, usually on one side of the body
- A red rash that appears a few days after the pain begins
- Fluid-filled blisters that break open and crust over
- Itching or heightened skin sensitivity in the affected area
- Fever, headache, or chills
- Fatigue or a general feeling of being unwell
- Lingering nerve pain after the rash heals (postherpetic neuralgia)
Causes & risk factors
- Reactivation of the varicella-zoster virus after a past chickenpox infection
- Age — risk rises significantly after age 50
- A weakened immune system from illness or immunosuppressive medications
- Significant physical or emotional stress
- Certain cancers or cancer treatments such as chemotherapy
- Recent illness or major surgery that lowers immune defenses
Prevention
- Get the shingles vaccine (Shingrix) if you are 50 or older, or 19+ with a weakened immune system
- Keep the rash covered until it crusts over to avoid spreading the virus to others
- Avoid contact with pregnant women, newborns, and immunocompromised people during an outbreak
- Wash your hands often while you have active blisters
- Avoid scratching or picking at the blisters
- Manage stress and get adequate sleep to support immune health
When to see a doctor
Online treatment is a good fit for adults with a typical shingles rash on the trunk, arm, or leg who can start antiviral medication within about 72 hours of the rash appearing. Seek in-person or urgent care right away if the rash involves your eye, nose tip, ear, or face, if you have severe pain, a widespread rash, a high fever, confusion, or if you are pregnant or have a significantly weakened immune system — shingles near the eye can threaten vision and needs prompt hands-on evaluation. If you develop signs of infection such as spreading redness, warmth, or pus, see a provider in person.
Why Timing Matters With Shingles
Antiviral medications work by slowing the virus while it is actively multiplying. They are most effective when started within 72 hours of the rash first appearing. Starting treatment early can shorten the outbreak, ease pain, and may reduce the chance of long-term nerve pain. If more than 72 hours have passed but new blisters are still forming, treatment may still offer benefit — a provider can help you decide.
Comparing Common Shingles Antivirals
| Medication | Typical Dosing Frequency | Notes |
|---|---|---|
| Valacyclovir | 3 times daily | Convenient dosing; often the first choice for adults |
| Famciclovir | 3 times daily | Similar effectiveness; useful alternative option |
| Acyclovir | 5 times daily | Effective and often lower cost, but requires more frequent dosing |
All three antivirals are considered standard treatment for shingles in the U.S. Your provider will recommend the option that best fits your health history and preferences.
Sources & References
Frequently Asked Questions
Is shingles contagious?
You cannot give someone shingles, but a person with active blisters can spread the varicella-zoster virus to someone who has never had chickenpox or the chickenpox vaccine — that person could develop chickenpox. The virus spreads through direct contact with fluid from the blisters. Once the rash crusts over, the risk of spreading it drops significantly.
How long does shingles last?
Most shingles outbreaks clear within two to four weeks. Pain and tingling often start a few days before the rash, and blisters typically crust over within 7 to 10 days. Some people experience nerve pain that lasts weeks or months after the rash heals, known as postherpetic neuralgia.
How quickly do I need to start antiviral medication?
Antiviral treatment works best when started within 72 hours of the rash first appearing. Early treatment can shorten the outbreak, reduce the severity of pain, and may lower the risk of long-lasting nerve pain. If you think you have shingles, seek evaluation as soon as possible.
Can you get shingles more than once?
Yes. While most people only have one episode, shingles can recur, especially in people with weakened immune systems. The shingles vaccine is recommended even for people who have already had shingles to help prevent future episodes.
What is postherpetic neuralgia?
Postherpetic neuralgia (PHN) is nerve pain that persists in the area of the rash after the skin has healed, sometimes for months or longer. It is the most common complication of shingles and is more likely in older adults. Starting antiviral treatment early and getting vaccinated can help reduce the risk.
Should I get the shingles vaccine if I have already had shingles?
Yes. The CDC recommends the Shingrix vaccine for adults 50 and older, including those who have had shingles before, since the condition can come back. Talk with your provider about the right timing after an outbreak has resolved.
Can shingles affect my eyes?
Yes. Shingles on the face, forehead, or around the eye can involve the eye itself, which can lead to vision loss if untreated. Any rash near the eye or on the tip of the nose needs prompt in-person evaluation, often including an eye specialist.
Treatments for Shingles
Find out more information about each treatment.