what is this rash?

[Calluna]

This rash popped up a few days ago and is just getting worse.
It is itchy and hurts like heck if I scratch it.
Under the rash feels kind of bruised/ achy and that side of my chest is a bit sore.
I also have a bit if a rash on my back. It feels the same but the spots are more spread out.
I have had nausea for 2 days and a headache that started this morning that I put down to stress.
I am tired. But that's fairly normal for me.
My eyes are dry but I thought that's because I'm tired.
My body is a bit achey. Nothing unusual there either.

[willow5]

Is it to one side of your body, blistery? If you're stressed it could be shingles, if you had chicken pox when you were younger. That can flare if you're run down and stressed and can make you feel very gross

Hope you feel better soon, hopefully it's just a contact rash and will be easy and quick to clear up.

[Calluna]

Noo that's exactly what a friend on fb said. I came looking for happier answer lol!

[willow5]

Oh I'm sorry!! I'm sure it's something much less sinister. Have you changed your washing powder recently? Or soap/body wash? Could be an allergy...

[Calluna]

Nope I can't get to the doctor until Monday either. The only bulk billing surgery near us it's not accessible by bus and it's too far to walk.

[willow5]

Can you get to a chemist? Sometimes pharmacist are good at recognising rashes. They might be able to give you some advice on how to make it more comfortable until Monday.

[NicNac]

Bummer it's shingles Calluna. I didn't realise you were BF- maybe you could ask Barb about it through one of the bf forums.
Hope you find at least a temporary solution to your dilemma.

[willow5]

Bummer it's shingles Calluna. I didn't realise you were BF- maybe you could ask Barb about it through one of the bf forums.

Good idea and is it MadB who's up with BF too? or is it someone else grrr I hate it when I can't remember

[Calluna]

Yep, MadB is very knowledgeable. I'll do that now.
I couldn't find the aba list. :/

I've never been able to express. Maybe I'll just hand express to take the edge off and keep it moving.

[Calluna]

Would apo-valaciclovir be the same as valacyclovir?

[Little Chicken]

from the manufacturer's product info, from MIMs online

Use in Lactation
Lactating rats given a 25 mg/kg PO dose of 14C-valaciclovir showed peak milk radioactivity levels of 26
μg/eq/g, 2 hours post dose. The milk radioactivity levels declined slower than in plasma, and were
undetectable at 12 hours. Suckling pups had radioactivity in the stomach and intestinal contents up to 7
hours post dose, but not in tissues.
Limited data show that aciclovir does pass into human breast milk. In a study conducted on 5 women,
following oral administration of a 500 mg dose of valaciclovir, peak aciclovir concentrations (Cmax) in
breast milk ranged from 0.5 to 2.3 (median 1.4) times the corresponding maternal aciclovir serum
concentrations. The aciclovir AUC was 2.2 times (range 1.4 to 2.6) higher in breast milk compared to
maternal serum. In other studies, conducted with oral aciclovir administration, aciclovir had been detected
in breast milk at concentrations ranging from 0.6 to 4.1 times the corresponding aciclovir plasma
concentration. Caution is therefore advised if Valaciclovir is to be administered to a breast-feeding
mother. Valaciclovir should only be administered to breast-feeding mothers if the benefits to the mother
outweigh the potential risks to the baby

and from lactmed

Summary of Use during Lactation:
The dosage of acyclovir in milk after valacyclovir is less than 1% of a typical infant dosage and would not be expected to cause any adverse effects in breastfed infants. In one study, administration of valacyclovir to mothers with concurrent herpes simplex type 2 and HIV infections reduced breastmilk shedding of the HIV virus in breastmilk at 6 and 14 weeks postpartum, but not later.[1] No special precautions are required when using valacyclovir during breastfeeding.


Drug Levels:
Valacyclovir is a prodrug that is rapidly converted to acyclovir in the body.

Maternal Levels. Five mothers who were nursing neonates were given valacyclovir 500 mg orally every 12 hours for 5 days. Valacyclovir was not detected in milk. Median peak acyclovir concentrations in milk of 4.2 mg/L occurred at 2 to 4 hours after the first dose and was similar after the last dose. The authors calculated the median milk concentration at steady-state to be 2.24 mg/L. The median half-life in milk was 2.1 hours (range 1.3 to 12.2 hours).[2] Using the median milk levels from this study, an exclusively breastfed infant would receive 0.34 mg/kg daily by mouth with this regimen, which is less than 1% of dosage given to neonates.

In a study of pregnant women with concurrent HIV and Herpes simplex infections, mothers received zidovudine 300 mg daily from week of pregnancy until 12 months postpartum and nevirapine at delivery. Half of the women (n = 74) also received valacyclovir 500 mg orally twice daily from 34 weeks gestation until 12 months postpartum. Milk samples (timing not stated) from 44 women obtained at 2 weeks postpartum found detectable acyclovir in 35 samples, with a median concentration of 2.6 mg/L (range 0.15 to 10.15 mg/L) Three of the 9 women with undetectable milk acyclovir levels had missed one or more doses of valacyclovir in the previous 2 days.[3]

Infant Levels. The urine of 5 infants whose mothers were taking valacyclovir 500 mg every 12 hours orally was collected. Valacyclovir was not detected in any of the infant's urine. The median infant urine acyclovir concentration on day 5 of therapy was 0.74 mg/L.[2]


Effects in Breastfed Infants:
In a study of pregnant women with concurrent HIV and Herpes simplex infections, mothers received zidovudine 300 mg daily from week of pregnancy until 12 months postpartum and nevirapine at delivery. Half of the women (n = 74) also received valacyclovir 500 mg orally twice daily from 34 weeks gestation until 12 months postpartum. At 6 weeks postpartum, all infants who received acyclovir in breastmilk had normal serum creatinine (<0.83 mg/dL). Their median serum creatinine and alanine aminotransferase (ALT) values, and growth were no different from those of unexposed infants, with the exception of one infant with an ALT level of 70.1 units/L. Infants whose mothers received valacyclovir generally had adverse effects that were similar to the placebo group, except that treated infants had a lower risk of eczema and oral thrush than infants in the placebo arm.[1][3]


Possible Effects on Lactation:
Relevant published information was not found as of the revision date.


Alternate Drugs to Consider:
Acyclovir