Valacyclovir (start within 72 h), Acyclovir, Paracetamol
Post-herpetic neuralgia: Pregabalin, Gabapentin, Amitriptyline, Zoster vaccine (recombinant) (50 y and over, after recovery)
Advice and when to refer
Refer the same day: Rash on the tip or side of the nose or eye (ophthalmic zoster), ear vesicles with facial palsy (Ramsay Hunt), low immunity, or spread over many dermatomes (ICMR STW 2022)
Investigations
First visit
No routine tests — Diagnosis is clinical (dermatomal blisters).
Only if indicated
Tzanck smear or VZV PCR — Atypical rash.
HIV test, blood glucose — Zoster under 40 years, severe, multi-dermatomal or recurrent.
Ophthalmology examination — Rash on the nose tip or around the eye.
Locked
The adult dose for each drug
The child dose, where the card gives one
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.