An older study found zoster immune globulin single early infusion could reduce shingles symptoms by 50% at day 42 but this appears to be forgotten. It appears in Canada to be readily available through public health as Varizig – manufactured in Winnipeg by Cangene.
Eur J Pain. 2002;6(6):435-45.
Prevention of postherpetic neuralgia with varicella-zoster hyperimmune globulin.
Hügler P, Siebrecht P, Hoffmann K, Stücker M, Windeler J, Altmeyer P, Laubenthal H.
- 40 cases of early herpes zoster – half given zoster immune globulin 2 ml/kg body weight on day 1(Varizig is given as “a single intramuscular dose of 125 IU/10 kg body
weight to a maximum dose of 625 IU of VARIZIG” – comparison found it worked as well as IV and would be safer). Varizig comes in a vial reconsituted to 6 mls of 625 IU – they suggest only 3 mls for each injection site IM – so needs to be divided in two).
- Varizig monogram here:
- Control group received a single infusion of human albumin 5% in a dose of 2mL/kg body weight.
- All patients got IV acyclovir intravenously 15mg/kg body weight per 24h for 5 days
Comments – I loathe the one shot wonder treatments but imagine serum is incredibly expensive so not likely available for free more than one dose. Public health has Varizig available primarily for pregnant varicella cases but its compassionate use in severe shingles cases should be do-able. I recently heard of a younger man developing ophthalmic shingles and is still in considerable pain month later – If this can cut this chance in half – people need to know and use it very early. Better yet, I had a case with neuralgic level pain over his left TMJ that suddenly appeared. I put him on Valtrex; his neurologist agreed it could likely be “viral”. He never developed a rash and the pain dissipated in 3 days…