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Answer
: Hello Alfred. Antiviral medications do not treat the pain, so you should start with Acetaminophen (Tylenol) or Ibuprofen (Advil, Motrin) for the pain. The addition of narcotic pain medication, such as Codeine, Hydrocodone (Vicodin) or Oxycodone (Percocet), is sometimes required. Unfortunately, narcotic medications can cause sedation and constipation; you cannot drive a car when taking this kind of pain medication. Amitryptiline (Elavil), an old antidepressant medication, is used at lower doses to treat chronic nerve pain and insomnia. Side effects include sedation, feeling hungover the next morning, and dry mouth. Capsaicin cream (Capsin, Zostrix), available over-the-counter, is derived from chili peppers. Capsaicin is the chemical in hot peppers that causes the tingling, burning sensation. Used on the skin, it can help with chronic nerve pain. Make sure the skin is healed with no open or scabbed wounds - otherwise the cream can cause discomfort. The cream is applied at least three to four times a day and may not improve pain until several weeks of use. It is recommended that you wear latex gloves to apply the cream and hand washing after use in order to avoid getting the chemical in the eye that causes severe irritation and pain. Neurontin (Gabapentin), a seizure medication, is commonly used for chronic pain and is often helpful with postherpetic neuralgia. The medication is well tolerated but is expensive and requires taking three times daily. Other pain treatments include lidocaine skin patches (which temporarily numb the skin) and, rarely, nerve block injections.
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