Oral Herpes

Oral Herpes Questions?

• How does oral herpes (cold sore) treatment with Nurx work?

  
  If you have been diagnosed with herpes in the past, visit the Nurx website or download the Nurx app and answer a few questions about your health, including how frequently you experience oral herpes outbreaks. Our medical provider team will review your health history and write a prescription for the medication valacyclovir if they decide that it’s an appropriate treatment option for you. Our pharmacy will fill your prescription and you’ll receive the medication in the mail in 3-5 days. We’ll bill your insurance if you have it, and offer affordable pricing if you pay directly.

• How much does oral herpes treatment cost through Nurx?

  Here is a breakdown of the cost of oral herpes treatment through Nurx:

  Medical consultation: After you answer questions about your health you pay $15 for a medical consultation, during which a member of our healthcare team reviews your health profile and (if appropriate) writes you a prescription. The price of the medical consultation includes unlimited follow-up with the Nurx provider team for a year, so you can ask questions about herpes or your prescription.

  If you pay with insurance: We will bill your insurance directly for your medication and the price you pay will depend on the specifics of your plan. Because valacyclovir is a generic medication your copay (if you have one) should be quite affordable.

  If you do not pay with insurance: When you pay directly for the medication it costs $45 for a 3-month supply of outbreak treatment (meaning you only take the medication when you experience an outbreak or feel one coming on). It costs $75 for a 3-month supply of preventive therapy (meaning that you take a pill every day to prevent outbreaks*). If you have both oral and genital herpes and need outbreak treatment the price will be $60 for a 3-month supply.

  Shipping is always free.

  *A Nurx medical provider may prescribe valacyclovir with instructions to take it every day to prevent oral herpes outbreaks. This is called “suppressive” treatment and the Food and Drug Administration (FDA) has not yet approved valacyclovir as a suppressive treatment for oral herpes, which means this is an “off label” use of the medication. It is legal and not uncommon for physicians to prescribe FDA-approved medications for off-label uses if they conclude that it is the ideal course of treatment for their patients. Please message your Nurx provider if you have questions about taking valacyclovir daily for oral herpes prevention.

• What type of oral herpes treatment does Nurx prescribe?

  We prescribe valacyclovir (the generic version of Valtrex), a pill which is the most effective medication for treating or preventing herpes outbreaks. When taken at the start of an oral herpes outbreak, valacyclovir will decrease the intensity of symptoms, decrease the duration of the outbreak, and reduce the risk of spreading herpes.

  Valacyclovir may also be prescribed to be taken daily to prevent outbreaks. Taking valacyclovir daily for oral herpes prevention is an “off label” prescription, meaning the FDA has not approved the medication for this purpose, though it has approved this use for the prevention of genital herpes. It is entirely legal for healthcare providers to write off-label prescriptions if they conclude that it is safe and appropriate.

  Valacyclovir is quite safe and generally has few side effects, but possible side effects include headaches, dizziness, depression, nausea, fatigue, vomiting, stomach pain, and joint pain.

• Who can use the oral herpes service from Nurx?

  We offer treatment to patients who have already been diagnosed with herpes by a healthcare provider or lab test. If you haven’t had a diagnosis but believe you may have herpes, we recommend that you see a local healthcare provider for evaluation the next time you have an outbreak. If you are diagnosed with oral herpes, our medical team would be more than happy to help manage your herpes treatment moving forward.

  Nurx provides oral herpes treatment to patients in the states we are currently available in, except Washington where there are additional regulations.

  We prescribe herpes treatment to patients age 13 and up, with the exception of patients in South Carolina, where we prescribe to patients 16 and up.

• What’s the difference between preventative and outbreak treatments?

  For outbreak treatment, patients take a valacyclovir pill at the first sign of an outbreak (when you experience tingling, itching, burning, or whatever your typical first symptoms are), then take a second pill later in the same day. When taken at the start of an oral herpes outbreak, valacyclovir will decrease the intensity of symptoms, decrease the duration of the outbreak, and reduce the chances of spreading herpes to others.

  Patients who experience more frequent outbreaks (usually more than six per year) may choose to take valacyclovir daily as preventive treatment, which can suppress oral herpes outbreaks by up to 80%. Taking valacyclovir daily also decreases the chances that you will transmit herpes to others. Daily valacyclovir therapy is an FDA-approved treatment for genital herpes, but prescribing valacyclovir to be taken daily for oral herpes prevention is an “off label” prescription. It is legal for medical providers to write off-label prescriptions if they conclude that it is safe and appropriate.

• Why is the medication the same for oral and genital herpes?

  
  The oral medication valacyclovir is an antiviral treatment for both types of herpes. Oral and genital herpes are caused by the two types of herpes virus: HSV-1 and HSV-2. Oral herpes is more often caused by HSV-1 infection, and genital herpes is associated with HSV-2 infection, but it is possible to have an oral infection with HSV-2 or a genital infection with HSV-1. In any of these cases, valacyclovir is very effective at preventing or treating outbreaks.

• Do you prescribe oral herpes treatment to pregnant women?

  
  Although Nurx does not replace comprehensive prenatal care, we do prescribe and deliver oral herpes medication to pregnant women. Valacyclovir is safe for pregnant women and their unborn children. Both oral and genital herpes can pose serious risks for a newborn baby, so if you are infected with herpes it is important that you discuss these risks with your OB-GYN or midwife, who can advise you on the best way to protect your infant.