Antivirals: Because of the suspected causative viral etiology of HSV-1, antivirals such as acyclovir, valacyclovir, and famciclovir theoretically should be of benefit. 2,13 Antivirals work by inhibiting viral DNA polymerase, ultimately leading to inhibition of viral DNA synthesis. 13 The use of these medications as monotherapy is not recommended, according to the Cochrane Review: “High quality evidence from randomized controlled trials of herpes simplex antivirals for the treatment of Bell’s palsy showed no significant benefit from antivirals compared to placebo.” 8 The Cochrane Review also noted that when antivirals and placebo were compared, participants showed little difference in recovery. A plausible answer for the lack of efficacy is that an immunologic reaction occurs that produces increased local inflammation and exacerbation of symptoms due to the antiviral medication itself, even though the drug is active against the causative virus. This is known as Jarisch-Herxheimer reaction . 8
Prednisone is a drug that belongs to the corticosteroid drug class, and is an
anti-inflammatory and immune system suppressant. It's used to treat a variety of diseases and conditions, for example: inflammatory bowel disease (Crohn's
disease and ulcerative colitis ), lupus , asthma , cancers , and several types of
Common side effects are weight gain , headache , fluid retention, and muscle weakness . Other effects and adverse events include glaucoma , cataracts , obesity , facial hair growth, moon face, and growth retardation in children. This medicine also causes psychiatric problems, for example: depression , insomnia , mood swings , personality changes, and psychotic behavior. Serious side effects include reactions to diabetes drugs , infections, and necrosis of the hips and joints.
Corticosteroids like prednisone, have many drug interactions ; examples include: estrogens , phenytoin ( Dilantin ), diuretics, warfarin ( Coumadin , Jantoven ), and diabetes drugs . Prednisone is available as tablets of 1, , 10, 20, and 50 mg; extended release tablets of 1, 2, and 5mg; and oral solution of 5mg/5ml. It's use during the first trimester of pregnancy may cause cleft palate . This medicine is secreted in breast milk and can cause side effects in infants who are nursing . You should not stop taking prednisone abruptly because it can cause withdrawal symptoms and adrenal failure. Talk with your doctor, pharmacist, or other medical professional if you have questions about beta-blockers. Talk with your doctor, pharmacist, or other medical professional if you have questions about prednisone.
If you notice other effects not listed above, contact your doctor or pharmacist. In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
There is no single treatment for Bell's palsy. The approach should vary from patient to patient depending on the severity of their condition. For mild cases, a therapy can be helpful and no further medication is needed. However, in more severe cases, medical intervention is needed to prevent further damage to the nerves and for faster recovery of the patient. The common medication or treatment for this disorder is the use of antiviral drugs such as acyclovir which is used to fight viral infections. The treatment is commonly combined with an anti-inflammatory drug such as the steroid prednisone which is used to reduce inflammation and swelling. It is noted that these combination is effective in improving facial function by limiting or reducing damage to the nerve. Analgesics such as aspirin, acetaminophen, or ibuprofen may also be used to relieve pain. A study conducted by University of Alexandria in Egypt validated the efficacy of using steroids in the treatment of patients with Bell's palsy. The rate of satisfactory recovery in all steroid treated patients was higher (79 of 93 patients) which is 85%. There was also evidence that steroid treatment of Bell's palsy is effective more than 24 hours after the onset of facial paralysis. With these development, more doctors are now using steroids to help patient recover from this disorder.