Does Acyclovir Cause Stomach Ulcers? the Risks and Symptoms

Acyclovir and gastric ulcers?

Hi Doctor,
1.
I previously contracted herpes simplex virus type II from my girlfriend and have experienced frequent outbreaks, approximately seven times a year.
A doctor recommended that I take acyclovir 200 mg twice daily (one tablet after breakfast and one after dinner) for a long-term period.
I have been on this medication for six years without any recurrences.
However, I recently developed gastric ulcers and would like to know if acyclovir can harm the stomach.
2.
Can gastric ulcers be associated with gastroesophageal reflux disease (GERD)?
Thank you for your clarification.

P.S.
(I have been using acyclovir during the following periods) In July 2017, I underwent an endoscopy and was diagnosed with gastric ulcers, and I continued taking pantoprazole for five months.
In mid-December 2017, I stopped the medication for one week.
At the end of December 2017, I had another endoscopy, which revealed new lesions and bleeding (accompanied by worsening gastroesophageal reflux).
My diet during this time included bread at 10 AM, lunch at noon, a small cup of light black coffee after lunch, a snack of cookies at 4 PM, dinner at 6 PM, and some fruit between 8 and 9 PM.

votto, 30~39 year old female. Ask Date: 2018/01/05

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
There is no literature evidence to prove a correlation between the two.
Please consider a biopsy during the treatment of your gastric ulcer to check for other factors if necessary.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2018/01/05

More Info

Acyclovir is an antiviral medication primarily used to treat infections caused by certain types of viruses, including herpes simplex virus (HSV) and varicella-zoster virus (VZV). While it is generally well-tolerated, some patients may experience gastrointestinal side effects, including nausea, diarrhea, and abdominal pain. However, the direct association between acyclovir and the development of stomach ulcers is not well-established in the medical literature.

1. Acyclovir and Stomach Ulcers: Although acyclovir is not commonly known to cause stomach ulcers, it is important to consider that any medication can have side effects, and individual responses can vary. The gastrointestinal side effects of acyclovir may lead to discomfort, but they are typically mild. If you have been taking acyclovir for an extended period (as you mentioned, six years), it is advisable to discuss your symptoms with your healthcare provider. They may want to evaluate other potential causes of your stomach ulcers, such as the use of nonsteroidal anti-inflammatory drugs (NSAIDs), excessive alcohol consumption, or infection with Helicobacter pylori, which is a common cause of peptic ulcers.

2. Gastric Ulcers and Gastroesophageal Reflux Disease (GERD): It is also important to note that gastric ulcers can coexist with gastroesophageal reflux disease (GERD). GERD occurs when stomach acid frequently flows back into the esophagus, leading to symptoms such as heartburn and regurgitation. The presence of a gastric ulcer can exacerbate GERD symptoms, as the ulcer may cause increased acid production or changes in gastric motility. In your case, the worsening of GERD symptoms alongside the development of new ulcers may indicate that your stomach lining is compromised, leading to increased acid exposure in the esophagus.

Recommendations:
- Consult Your Healthcare Provider: Given your history of recurrent herpes simplex virus infections and the recent development of stomach ulcers, it is crucial to consult your healthcare provider. They may recommend further evaluation, such as an endoscopy, to assess the condition of your stomach and esophagus more thoroughly.

- Review Medications: Discuss all medications you are currently taking, including acyclovir, with your doctor. They may consider adjusting your treatment plan or prescribing medications to protect your stomach lining, such as proton pump inhibitors (PPIs) or H2 receptor antagonists, which can help reduce stomach acid production.

- Dietary Considerations: Your dietary habits may also play a role in your gastrointestinal health. It is advisable to avoid foods and beverages that can irritate the stomach lining, such as spicy foods, caffeine, and alcohol. Eating smaller, more frequent meals may also help reduce symptoms.

- Monitor Symptoms: Keep track of your symptoms, including any changes in pain, frequency of ulcers, or GERD symptoms. This information can be valuable for your healthcare provider in determining the best course of action.

In conclusion, while acyclovir is not directly linked to the development of stomach ulcers, it is essential to consider all factors that may contribute to your gastrointestinal symptoms. A thorough evaluation by your healthcare provider will help determine the underlying causes and appropriate treatment options for your condition.

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