pronounced as (ay sye' kloe veer)
Acyclovir is used to decrease pain and speed the healing of sores or blisters in people who have varicella (chickenpox), herpes zoster (shingles; a rash that can occur in people who have had chickenpox in the past), and first-time or repeat outbreaks of genital herpes (a herpes virus infection that causes sores to form around the genitals and rectum from time to time). Acyclovir is also sometimes used to prevent outbreaks of genital herpes in people who are infected with the virus. Acyclovir is in a class of antiviral medications called synthetic nucleoside analogues. It works by stopping the spread of the herpes virus in the body. Acyclovir will not cure genital herpes and may not stop the spread of genital herpes to other people.
Acyclovir comes as a tablet, a capsule, and a suspension (liquid) to take by mouth. It also comes as a delayed-release buccal tablet to apply to the upper gum of the mouth. The tablets, capsules, and suspension are usually taken with or without food two to five times a day for 5 to 10 days, starting as soon as possible after your symptoms begin. When acyclovir is used to prevent outbreaks of genital herpes, it is usually taken two to five times a day for up to 12 months. The delayed-release buccal tablet is usually applied with a dry finger as a one-time dose within 1 hour after itching, redness, burning or tingling cold sore symptoms begin but before the cold sore appears. Take or use acyclovir at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take or use acyclovir exactly as directed. Do not take or use more or less of it or take it more often or for a longer time than prescribed by your doctor.
Do not chew, crush, suck, or swallow the delayed-release buccal tablets. Drink plenty of liquids, if you have a dry mouth while using the delayed-release buccal tablets.
To use buccal acyclovir, follow these steps:
- Find the area on the upper gum above your left and right incisor teeth (the teeth just to the left and right of your two front teeth).
- With dry hands, remove one delayed-release tablet from the container.
- Gently apply the tablet to the upper gum area as high as it will go on your gum above one of your incisor teeth on the side of your mouth with the cold sore. Do not apply it to the inside of the lip or cheek.
- Hold the tablet in place for 30 seconds.
- If the tablet does not stick to your gum or if it sticks to your cheek or the inside of your lip, reposition it to stick to your gum. Leave the tablet in place until it dissolves.
- Do not interfere with the placement of the tablet. Check to see if the tablet is still in place after eating, drinking, or rinsing your mouth.
If the delayed-release buccal tablet comes off within the first 6 hours of application, reapply the same tablet. If it still will not stick, then apply a new tablet. If you accidentally swallow the tablet within the first 6 hours of application, drink a glass of water and place a new tablet on your gum. If the tablet falls off or is swallowed 6 or more hours after application, do not apply a new tablet until your next regular time.
Avoid the following while you are using acyclovir buccal delayed-release tablet:
- Do not chew gum, touch, or press the buccal tablet after it has been applied.
- Do not wear upper dentures.
- Do not brush your teeth until it dissolves. If your teeth need to be cleaned while the tablet is in place, rinse the mouth gently.
Shake the suspension well before each use to mix the medication evenly.
Your symptoms should improve during your treatment with acyclovir. Call your doctor if your symptoms do not improve or if they get worse.
Take or use acyclovir until you finish the prescription, even if you feel better. If you stop taking acyclovir too soon or skip doses, your infection may not be completely treated or may become more difficult to treat. The delayed-release buccal tablet is applied as a one-time dose.
Acyclovir is also sometimes used to treat eczema herpeticum (a skin infection caused by the herpes virus) to treat and prevent herpes infections of the skin, eyes, nose, and mouth in patients with human immunodeficiency virus (HIV), and to treat oral hairy leukoplakia (condition that causes hairy white or gray-colored patches on the tongue or inside of the cheek).
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Before taking acyclovir,
- tell your doctor and pharmacist if you are allergic to acyclovir, valacyclovir (Valtrex), any other medications, milk proteins, or any of the ingredients in acyclovir products. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amphotericin B (Fungizone); aminoglycoside antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Nes-RX, Neo-Fradin), paramomycin (Humatin), streptomycin, and tobramycin (Tobi, Nebcin); aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn); cyclosporine (Gengraf, Neoral, Sandimmune); medications to treat HIV or AIDS such as zidovudine (Retrovir, AZT); pentamidine (NebuPent); probenecid (Benemid); sulfonamides such as sulfamethoxazole and trimethoprim (Bactrim); tacrolimus (Prograf); and vancomycin. Many other medications may also interact with acyclovir, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if there is a possibility you may be dehydrated from a recent illness or activity, or if you have or have ever had problems with your immune system; human immunodeficiency virus infection (HIV); acquired immunodeficiency syndrome (AIDS); or kidney disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking acyclovir, call your doctor.
- if you are taking acyclovir to treat genital herpes, you should know that genital herpes can be spread through sexual contact even if you don't have blisters or other symptoms and possibly even if you are taking acyclovir. Talk to your doctor about ways to stop the spread of genital herpes and about whether your partner(s) should receive treatment.
Drink plenty of fluids while you are taking or using acyclovir.
Take the missed dose as soon as you remember it and take any remaining doses for that day at evenly spaced intervals. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- extreme tiredness
- loss of consciousness
- swelling of the hands, feet, ankles, or lower legs
- decreased urination
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to acyclovir.
Do not let anyone else take or use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
- Zovirax® Capsules
- Zovirax® Tablets
Browse Drugs and Medicines
Genital Herpes Treatment and Care
There is no cure for herpes, but medication is available to reduce symptoms and make it less likely that you will spread herpes to a sex partner.
Is there a cure or treatment for herpes?
There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy (i.e. daily use of antiviral medication) for herpes can reduce the likelihood of transmission to partners.
Several clinical trials have tested vaccines against genital herpes infection, but there is currently no commercially available vaccine that is protective against genital herpes infection. One vaccine trial showed efficacy among women whose partners were HSV-2 infected, but only among women who were not infected with HSV-1. No efficacy was observed among men whose partners were HSV-2 infected. A subsequent trial testing the same vaccine showed some protection from genital HSV-1 infection, but no protection from HSV-2 infection.
Treatment Guidelines and Updates
Resources for Clinicians
Herpes Treatments and Medications
We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.
Herpes, also known as herpes simplex virus (HSV), is an infection that can appear in various parts of your body, though it mainly affects your mouth and genitals.
According to the , an estimated 3.7 billion people under 50 years old (67 percent) have HSV-1 infection and 491 million who are 15 to 49 years old (13 percent) have HSV-2 infection worldwide.
Herpes symptoms are mainly treated by three major drugs taken in pill form: acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). In severe cases, treatment may include the intravenous (IV) drug acyclovir.
There is no cure for the herpes virus yet. A herpes vaccine does not currently exist because the herpes virus has more complicated DNA than most infections, creating challenges for researchers.
However, medication can help with symptoms like sores and outbreaks. Medication also reduces the risk of transmission to others. Most medications for herpes are taken orally, though they may also be applied as a cream or administered by injection.
When you are first diagnosed with herpes and have symptoms of an active infection, a brief 7- to 10-day course of antiviral therapy is usually prescribed. This may help alleviate your symptoms and prevent them from worsening. If your symptoms don’t improve in that time, you may continue with the antiviral course for a longer duration.
After the initial treatment, your doctor may recommend one of two options depending on how frequently you experience a flare-up: intermittent or suppressive treatment.
Once your symptoms subside from the initial treatment, your doctor may recommend intermittent therapy. This is when you keep medication on hand to treat a flare-up. Since herpes is a virus that stays in your body and may cause recurrent outbreaks, having an antiviral drug for when you feel an outbreak coming on can reduce the severity of the symptoms and make them heal faster.
Taking the antiviral drug daily is a type of suppressive therapy, which may be recommended for people who experience very frequent outbreaks. This is a preventative measure as taking herpes medication daily may significantly reduce the number of outbreaks.
Daily medication is also associated with reduced risk of transmission. A 2004 study concluded that once-daily suppressive therapy with valacyclovir significantly reduces transmission of HSV-2 (genital herpes) among couples.
Treatment options for herpes symptoms include prescription medication, over-the-counter (OTC) medication, and home remedies. The best herpes treatment for you may depend on the type and severity of the infection.
Acyclovir is a prescription antiviral drug taken orally or applied topically that treats the symptoms of genital herpes. It can decrease the pain of outbreaks and help them heal faster. In people with weakened immune systems, acyclovir can also help prevent the risk of the virus spreading to other parts of your body, causing further infections. In severe cases, the intravenous (IV) form of acyclovir can be administered by a healthcare professional.
Famciclovir, taken orally in the form of a tablet, is a prescription drug for oral and genital herpes. It is recommended for people with strong immune systems, though it should not be the first course of treatment for people experiencing their first episode of genital herpes. It is also not recommended for people with weakened immune systems. Famciclovir works by decreasing the severity and length of herpes outbreaks.
Valacyclovir comes in tablet form taken by mouth. It is a prescription antiviral drug that can treat the symptoms of and prevent flare-ups of oral and genital herpes. People with frequent outbreaks can take valacyclovir daily as part of their suppressive therapy to prevent future infections and reduce the risk of transmission to sexual partners.
Docosanol is the active ingredient in the OTC topical medication Abreva, which is FDA-approved for the treatment of recurrent herpes simplex labialis (HSL), the most recognized recurring infection of your lips and perioral tissue caused by HSV-1. A 2001 study concluded that docosanol is safe and effective for treating recurrent HSL.
Like prescription and OTC medications for herpes, home remedies do not cure the virus. However, they may provide relief for symptoms like pain, cold sores, and blisters.
Some home remedies for herpes include:
- applying a warm or cold compress
- applying cornstarch or baking soda paste
- making dietary changes
- applying garlic or apple cider vinegar
- incorporating supplements like lysine and zinc
- applying herbs and essential oils
Risks and side effects
The three main treatments for herpes — acyclovir, famciclovir, and valacyclovir — are all FDA-approved drugs, though there are side effects and interactions to be aware of.
Common side effects of these antiviral drugs include headaches and nausea. Famciclovir can cause dizziness, confusion, or sleepiness.
Acyclovir and valacyclovir, which are very similar to each other, can cause your kidneys to stop working. If you have kidney problems, your doctor may prescribe a lower dose. These medications may interact with other drugs such as nonsteroidal anti-inflammatory drugs like ibuprofen, which may weaken kidney function.
Frequently asked questions
What happens if herpes is left untreated?
Without treatment, sores and outbreaks usually heal on their own. Oral herpes is usually considered a mild infection, but complications may appear in people with weakened immune systems.
The risk of complications with genital herpes is also low, though these include inflammation, swelling, and pain. Passing HSV-2 to a newborn can be dangerous, however. Doctors may recommend a cesarean delivery to mothers with genital herpes, according to the .
Can herpes go away permanently?
Symptoms may go away, but the herpes virus does not. It stays in your body even after all the symptoms of infection are gone. Since herpes remains dormant until reactivated, symptoms may not show at all, show rarely, or show frequently in recurrent outbreaks.
Can you test for herpes at home?
Yes, there are at-home sexually transmitted infection (STI) tests for herpes. LetsGetChecked is a health and diagnostic company that offers home laboratory testing services. The home Herpes Test checks for HSV-1 and HSV-2 by taking a blood sample from your finger.
Herpes is a virus that, while not curable yet, is considered mild to manage. The symptoms, mainly cold sores on your mouth and blisters on your genitals, are usually temporary and can go away with treatment.
There are home remedies, OTC medications, and prescription medication for herpes. If you think you might have herpes, talk with your doctor about getting tested and treatment options right away.
Lacey Bourassa is a health, wellness, and beauty writer based in Southern California. She holds a BA in English. Her work has appeared in digital publications like Livestrong, Verywell, Business Insider, Eat This Not That, and others. When she’s not writing, Lacey is likely pursuing her other interests: skin care, plant-based cooking, pilates, and traveling. You can keep up with her by visiting her website or her blog.
Aciclovir (including Zovirax)
1. About aciclovir
Aciclovir (or acyclovir) is an antiviral medicine.
It treats infections caused by the herpes virus (herpes simplex), including:
Your doctor may prescribe aciclovir to prevent you getting these infections if you have had them before or you have a weak immune system.
It's also used to treat chickenpox and shingles.
Aciclovir is available on prescription. It comes as tablets, a liquid that you drink and a cream.
It's sometimes given by injection, but this is usually only done in hospital.
You can buy aciclovir cold sore cream at most pharmacies and supermarkets without a prescription.
2. Key facts
- Start taking aciclovir as soon as you get the first signs of infection.
- For most infections, you should start to feel better after taking aciclovir for a few days.
- Common side effects include headaches, dizziness, and feeling or being sick.
- Wash your hands before and after using the cream.
- Brand names include Zovirax, Cymex Ultra and Virasorb.
3. Who can and cannot take aciclovir
Aciclovir can be taken by most adults and children.
Aciclovir is not suitable for some people.
To make sure aciclovir is safe for you, tell your doctor if you:
- have had an allergic reaction to aciclovir or any other medicine in the past
- have kidney problems
- are over 65 years old
- are pregnant, trying to get pregnant or breastfeeding
If your immune system is weakened (for example, if you have HIV or AIDS, or you have had a bone marrow transplant), talk to your doctor about the best type of aciclovir for you.
They may recommend tablets rather than the cream.
4. How and when to take it
It's important to start taking (or using) this medicine as soon as you get the first signs of infection.
A cold sore usually starts with a tingling, itching or burning feeling.
Aciclovir tablets and liquid
Doses will vary, depending on why you're taking aciclovir. Your doctor will tell you how much to take and how often.
A single dose is generally between 200mg and 800mg, and may be lower for children.
You'll usually take aciclovir 2 to 5 times a day. Try to space the doses evenly throughout the day.
If you take aciclovir:
- 4 times a day – you could take it first thing in the morning, at midday, in the late afternoon and at bedtime
- 5 times a day – for example, you could take it at 7am, 11am, 3pm, 7pm and 11pm
You can take aciclovir with or without food. Drink plenty of water while taking this medicine to help keep your kidneys working well.
Keep taking the medicine until it's all finished or until your doctor or pharmacist tells you to stop taking it.
For treating a viral infection, you'll usually take aciclovir for 5 to 10 days. For prevention, you may need to take it for a long time.
Tablets: swallow the tablets whole with some water. If you find tablets difficult to swallow, you can dissolve them in water. Add a tablet to a small glass of water and stir. Drink all the liquid to make sure you get the full dose.
Liquid: use the measuring spoon or plastic syringe that came with your medicine. If you do not have a measuring spoon or syringe, ask your pharmacist for one. Do not use a kitchen teaspoon as you will not get the right amount of medicine.
Cream for cold sores
Wash your hands before and after using the cream.
Put a thin layer of cream on the cold sore 5 times a day. Do this every 4 hours – for example, at 7am, 11am, 3pm, 7pm and 11pm.
Do not put aciclovir cream in your mouth, eyes or vagina.
Use the cream for at least 4 days. If the cold sore has not healed by then, you can carry on using the cream for another 6 days.
If the sore still has not healed after a total of 10 days, stop using the cream and tell your doctor.
Cream for genital herpes
Wash your hands before and after using the cream.
Put a thin layer of cream on the affected area 5 times a day. Do this every 4 hours – for example, at 7am, 11am, 3pm, 7pm and 11pm.
Use the cream for at least 5 days. If the genital herpes sore has not healed by then, you can carry on using the cream for another 5 days.
If the affected area has still not healed after a total of 10 days, stop using the cream and tell your doctor.
What if I forget a dose of aciclovir?
If you forget a dose of aciclovir, take it (or use the cream) as soon as you remember, unless it's nearly time for your next dose. In this case, just skip the missed dose and continue with your next one as normal.
Never have 2 doses at the same time. Never have an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you.
You could also ask your pharmacist for advice on other ways to remember your medicines.
What if I take or use too much?
Taking too much aciclovir by accident is unlikely to harm you, unless you take too much over several days.
Talk to your doctor or pharmacist if you're worried that you have had too much aciclovir.
7. Pregnancy and breastfeeding
It's usually safe to use the cream or take aciclovir during pregnancy.
Speak to your doctor, who'll be able to explain the benefits and the risks of taking aciclovir when pregnant.
They can help you decide on the best treatment for you and your baby.
For more information about how aciclovir can affect you and your baby during pregnancy, read this leaflet on the best use of medicines in pregnancy (bumps) website.
Aciclovir and breastfeeding
It's usually safe to breastfeed while taking aciclovir.
If you're taking the tablets or liquid, some of the medicine passes into your breast milk.
This is in small amounts and is unlikely to harm your baby.
Talk to your doctor if you want to breastfeed while taking aciclovir. They can advise you on what's best for you and your baby.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
8. Cautions with other medicines
Some medicines can affect the way aciclovir tablets or liquid work. They can also make you more likely to get side effects.
If you're using aciclovir cream on your skin, this is less likely to react with other medicines.
It's important to tell your doctor if you take any of the following medicines before taking aciclovir:
- cimetidine, a medicine for stomach ulcers
- mycophenolate mofetil, a medicine given after organ transplants
- probenecid, a medicine for gout
- aminophylline or theophylline, medicines for asthma
Mixing aciclovir with herbal remedies and supplements
There's very little information about taking herbal remedies and supplements while taking or using aciclovir.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
9. Common questions
Prescription medication herpes
Treatment for Genital Herpes
There are three antiviral medications that are FDA-approved for the treatment of genital herpes:
- Acyclovir: The oldest antiviral medication for herpes is acyclovir. It has been available since 1982 in a topical form (as an ointment) and sold since 1985 in pill form. Acyclovir has been shown to be safe in persons who have used it continuously (every day) for as long as 10 years.
- Valacyclovir: A newer drug, valacyclovir, actually uses acyclovir as its active ingredient. This medication delivers acyclovir more efficiently so that the body absorbs much of the drug, which has the advantage of taking the medication fewer times during the day.
- Famciclovir: Famciclovir uses penciclovir as its active ingredient to stop HSV from replicating. Like valacyclovir, it is well absorbed, persists for a longer time in the body, and can be taken less frequently than acyclovir.
Antiviral medication is commonly prescribed for patients having a first episode of genital herpes, but they can be used for recurrent episodes as well. There are two kinds of treatment regimens: episodic therapy and suppressive therapy.
In this approach, a person begins taking medication at the first sign of an outbreak (or ideally at first signs of prodrome) and continues taking medication for several days, in order to speed healing or even prevent an outbreak from fully occurring. All three of the antiviral treatments mentioned above have been proven to help shorten the amount of time that a person may experience symptoms of herpes. However, keep in mind that results may vary from person to person.
Many people feel the advantages of using medication for recurrent episodes are marginal compared with use in a primary episode. But for others, episodic therapy offers a useful way to manage outbreaks by cutting the length of an outbreak by a day or two, on average. The benefits may be greater for those whose outbreaks tend to last longer.
Also, episodic therapy has its best results when treatment begins at the very first sign of prodrome. If lesions are already present, therapy may offer little benefit. Because the medications differ in their absorption rate and duration of effectiveness, dosages vary with episodic therapy treatment ranging from one to five pills every day for three to five days during an outbreak.
People with genital herpes who want to eliminate (suppress) outbreaks can take antiviral medication daily to hold HSV in check so that it’s less likely to flare up and cause symptoms. For individuals who have frequent recurrences (six or more per year), studies have shown that suppressive therapy can reduce the number of outbreaks by at least 75% while the medication is being taken. Also, for some, taking an antiviral on a daily basis can prevent outbreaks altogether.
While antivirals can be successful in controlling herpes symptoms, researchers also have turned their attention to the important issue of antiviral therapy and asymptomatic shedding. Does suppressive therapy lower the risk of unrecognized herpes reactivation as well as curb recognized outbreaks? One study addressing this question found that women on suppressive acyclovir (400 mg, twice daily) had a 94% reduction in subclinical shedding while taking daily therapy. This type of study has also been done with famciclovir and valacyclovir, with similar reductions seen in both men and women.
Suppressive therapy has been studied in thousands of patients and it appears to be both safe and effective. Because the medications differ in their absorption rate and duration of effectiveness, dosages vary with suppressive therapy treatment ranging from one to two pills every day.
Treatment for Oral Herpes
The antiviral medications available in pill form (acyclovir, valacyclovir, famciclovir) have been specifically developed for the treatment of genital herpes. However, it is not uncommon for healthcare providers to prescribe the antiviral drugs to those who have frequent or severe outbreaks of oral herpes.
A recent study found valacyclovir to be effective for treating oral herpes in a one-day treatment of 2 grams taken at the first sign of a cold sore, and then again about 12 hours later.
There are two topical antiviral medications prescribed for the treatment of oral HSV symptoms: acyclovir ointment and penciclovir cream. Both work to speed up the healing process and reduce the viral activity. These topical drugs are put directly on the lesions themselves, but can also be used at the onset of prodrome.
Other topical treatments for oral herpes are available over-the-counter (OTC), but are not antiviral compounds like acyclovir and penciclovir. Some also contain ingredients that numb the area and induce temporary relief from the discomfort of an outbreak. Unfortunately, some OTC treatments may actually delay the healing time of symptoms because they can further irritate the area with repeated applications. There is only one OTC FDA-approved cream, called Abreva®, which has been clinically proven to help speed the healing process.
Over-the-counter creams and/or ointments are not recommended for genital herpes, since they can interfere with the healing process in a number of ways, causing genital outbreaks to last longer. Keeping the area clean and as dry as possible and allowing the area to get air can help to speed the healing process.
Many people find that outbreaks tend to lessen in severity and frequency with time. What triggers an outbreak is highly individual, but with time, many people learn to recognize, and sometimes avoid, factors that seem to reactivate HSV in their own bodies. For example, illness, poor diet, emotional or physical stress, friction in the genital area, prolonged exposure to ultraviolet light (commonly for oral herpes, such as a beach trip or skiing weekend), surgical trauma, or steroidal medication (such as asthma treatment) may trigger a herpes outbreak.
The frequency of outbreaks can often be managed through effective stress management, and getting adequate rest, nutrition, and exercise.
People often ask about an amino acid by the name of lysine (L-lysine), because of Internet claims or claims from other people that it helps control outbreaks. While some studies have suggested that lysine supplements can reduce the frequency of recurrences or healing time, other trials have been unable to replicate those results. Therefore, there is not sufficient information to discern how effective it may be, in addition to what the effective dosages or frequency of L-lysine may be.
Lysine can be found with other nutrients and supplements at your local grocery or drug store, but people should only take the recommended dosage if it is taken and always check with their health care provider first before starting any new medication or supplement. Megadoses of lysine may throw other amino acids out of balance and interfere with the absorption of other nutrients such as vitamins and minerals.
In regard to possible foods to avoid, some people feel that foods that contain high amounts of the amino acid arginine may cause herpes outbreaks. Arginine is found in numerous foods that are eaten on a regular basis, so we don’t encourage not eating foods simply because they contain arginine. However, an individual may want to consider adjusting their diet if they are having frequent outbreaks and believes food is a contributing factor. Again, while some individuals believe arginine can trigger outbreaks, there is no clinical evidence to support these claims.
Valtrex for Cold Sores: Is It Right for You?
Cold sores are painful and oozing, and they always seem to appear before that wedding or class reunion. Also called fever blisters, the small, fluid-filled lesions typically form near or on your lips and can cause symptoms such as tingling, itching, or burning.
They’re caused by the herpes simplex virus. There are two types of herpes virus. Cold sores are typically caused by type 1 virus (HSV-1). But in some cases, HSV-1 can cause sores on the genitals and type 2 virus (HSV-2) can cause sores on the mouth.
There’s no cure for cold sores. But, because they’re caused by a virus, they can be treated with antiviral medications. These include the prescription medication Valtrex.
Valtrex, which contains the active ingredient valacyclovir, can help your cold sores clear up faster. It can also reduce the number of cold sores you get. Read on to learn how Valtrex works and how to use it to treat your cold sores.
Treating cold sores with Valtrex
Cold sores typically start to heal on their own within about four to six days. Although, the first cold sore you get will likely last longer.
Most people don’t require treatment for their cold sores, but, in some cases, a doctor may prescribe an antiviral medication such as Valtrex. This may be because you get cold sores often or if you’re at high risk of serious complications, such as from a weakened immune system.
To treat a cold sore, you take Valtrex on the day you notice a cold sore forming. Valtrex works by preventing the herpes virus from growing and spreading.
Your doctor may also prescribe Valtrex to help prevent future cold sores, which is an off-label use. In that case, you and your doctor would work together to create the best treatment plan for you.
Valtrex is an oral caplet. It comes in 500-milligram and 1-gram strengths. It’s available as a brand-name product as well as a generic medication (valacyclovir). The generic product is an oral tablet which comes in the same strengths.
For adults and children 12 years and older
The recommended dosage is 2 grams twice daily, taken 12 hours apart, for one day. Valtrex should be started at the earliest signs of a cold sore.
For children 11 years and younger
Valtrex is not recommended for treating cold sores in children of this age group. But it can be used to treat chickenpox in children ages 2 years and older.
In one , people who took Valtrex had shorter cold sore episodes by about one day compared to people who didn’t take Valtrex at all. Most people in the study took Valtrex within two hours of noticing their first cold sore symptoms.
Tips for taking Valtrex
- Take Valtrex at the first sign of a cold sore.
- You can take it with or without food.
- Don’t take more than the prescribed number of caplets each day.
- If your child can’t swallow caplets, ask your pharmacist to make the caplets into an oral suspension (liquid).
- Be sure to drink lots of water. Since your kidneys help remove the metabolized drug from your body, it’s important to stay hydrated to lower the risk of serious side effects, such as kidney damage.
Side effects of Valtrex
The more common side effects of Valtrex include:
- stomach pain
The serious side effects of Valtrex can include:
Valtrex may not be the best choice for certain people.
People with kidney damage or kidney failure may need a lower dosage of Valtrex. Be sure to tell your doctor if you have kidney problems before you start taking the drug.
If you’ve ever had an allergic or other serious reaction to Valtrex, Zovirax (acyclovir), or the ingredients in them, do not take Valtrex without talking to your doctor first.
Other Treatment Options
Valtrex is not the only medication used to treat cold sores. Other medications include:
- Zovirax (acyclovir)
- Denavir (penciclovir)
Zovirax is an oral medication and it also comes in cream form. Denavir is a topical cream.
There are also natural treatments that may help ease symptoms of a cold sore during an outbreak.
Talk with your doctor
For more information about Valtrex, talk with your doctor. Feel free to review this article with them and ask any questions you have, like:
- Is it important that I take medication to prevent cold sores?
- Are there drug-free ways to help avoid cold sores?
- Are there over-the-counter drug options that I could consider?
Together, you and your doctor can decide if Valtrex or another medication or treatment is a good choice to treat your cold sores. For more information, read about the seven best cold sore remedies.
- Hempworx cbd reviews
- Ed sheeran tatuajes
- Bayshore used trucks
- Club type beats
- Gameflip sign in
- Concrete lamp shades
- Evolution variation
- Topeka tripadvisor
- Tecsun pl
- Dr sharkey dentist
- Amazon prada candy
Effective Treatments for Herpes
Herpes simplex virus (HSV) types 1 and 2 are not curable, but they are treatable. Herpes treatments relieve symptoms, shorten the duration of outbreaks, and prevent recurrences. Treatments also help to reduce the risk of spreading herpes to others.
Treatments for herpes involve home remedies, pain relievers, and other options that can help ease discomfort. It may also include antiviral medications that can reduce the severity and duration of herpes flare-ups.
This article discusses treatment options for HSV-1, which causes oral herpes (cold sores), and HSV-2, which causes genital herpes.
Home Remedies and Lifestyle
At-home treatments for a cold sore or genital herpes can relieve symptoms, but not the infection. To ease the pain and prevent sores from getting worse, try the following:
- Apply cold compresses. Place a well-insulated ice pack on your lesions for as long as it makes you feel better. The cold will not worsen or improve the lesion, but it can lessen the pain.
- Don't scratch. Avoid touching and scratching lesions caused by herpes, as this can spread the infection to other areas of your own skin.
- Keep the sores clean. Cold sores and genital herpes infections can become infected with bacteria from your hands or, in the latter case, from urine or feces. Keep the sores and blisters, and the areas around them, clean and dry to avoid an additional infection.
- Reduce stress. Stress can affect how well your immune system can keep your herpes infection in check. Reducing your stress may help prevent excessive herpes recurrences.
Over-the-counter antiviral therapy creams may help speed recovery from oral or genital herpes infections, and other options can help reduce pain.
Some to consider include:
- Abreva (docosanol): This is the only FDA-approved antiviral medication for herpes infection that you can get without a prescription. Antiviral medications inhibit the ability of a virus to multiply in the body, but they do not completely destroy or eliminate the virus. This medication comes as a cream that you apply directly to the affected area about every three to four hours. Take care to only apply it to the skin, not inside your mouth, eyes, or vagina. Wash your hands before and after use.
- Pain-relieving lotions and creams: Medicated pain creams or lotions can ease discomfort associated with sores. There are a number of over-the-counter options available. Be sure to confirm with your healthcare provider or pharmacist that the product you select is safe to use on herpes lesions, and wash your hands before and after you apply any product.
- Oral pain relievers: Oral medications such as Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen) can help relieve herpes-related pain for several hours.
The 6 Best Cold Sore Medicines of 2021
Prescription antiviral medication is often used to treat genital herpes infection. Like the OTC antiviral cream Abreva, they inhibit the proliferation of the virus, but they do not rid the body of it.
If you have a first episode or a recurrence, a short course of one of the three options available is recommended. Those with frequent episodes may need to take one of these drugs daily on an ongoing basis, which is known as suppressive therapy.
Taking herpes medication when you do not have symptoms has been shown to reduce the risk of sexual transmission to a partner.
The following recommendations for adults with genital herpes are from the Centers for Disease Control (CDC) herpes treatment guidelines, but your healthcare provider will decide which of these options is best for you.
|Drug||First Outbreak Treatment||Recurrent Outbreak Prevention||Recurrent Outbreak Treatment|
|Zovirax, Sitavig (acyclovir)||400 mg three times a day for seven to 10 days||400 mg twice a day||800 mg twice a day for five days —OR— 800 mg three times a day for two days|
|Famvir (famciclovir)||250 mg three times a day for seven to 10 days||250 mg twice a day||125 mg twice a day for five days —OR— 1 g twice a day for one day —OR— 500 mg once, followed by 250 mg twice a day for two days|
|Valtrex (valacyclovir)||1 g twice a day for seven to 10 days||500 mg or 1 g daily*||500 mg twice a day for three days —OR— 1 g once a day for five days|
Usually, treatment of cold sores is not needed unless the symptoms are severe and persistent, in which case acyclovir is generally used.
Complementary Medicine (CAM)
Alternative therapies for herpes with some supporting research include:
- Propolis: A sticky substance that bees produce from tree saps, propolis shows promise in the treatment of herpes. Studies have found that people who are treated with propolis experience faster healing of herpes lesions and a higher likelihood of fully healed lesions by day 10 of treatment when compared to people who receive a sham treatment (placebo).
- Algae extract: In a laboratory setting, algae extract has been shown to inhibit HSV-2 growth, so this may be considered a useful component in alternative treatments in the future. More research is needed.
- Acupuncture: Acupuncture has been used for the treatment of pain caused by herpes lesions with some beneficial results. This treatment method, while mildly helpful, has also rarely been associated with the transmission of HSV, so it is best to consider it with caution.
Several other alternative options have been investigated for the treatment or suppression of genital herpes, including lysine, zinc, echinacea, eleuthero, and bee products. There is no evidence to show that any of these options are beneficial for these purposes.
Resolve Herpes, an alternative therapy said to be a "detox therapy," is marketed for herpes. So far, there does not appear to be evidence that this product can cure or treat herpes infections.
A Word From Verywell
The key to successfully treating any herpes outbreak is a timely response. The sooner you recognize the signs and access treatment, the shorter and less severe the outbreak is likely to be. Treatment should be started within 48 hours of the first appearance of symptoms.
If your primary care provider is unable to see you, do not hesitate to access treatment through a telehealth provider. If you have health insurance, the visit may be partially or fully covered.
Frequently Asked Questions
Abreva (docosanol) 10% cream is the first and only over-the-counter antiviral drug approved for the treatment of the type of herpes that causes cold sores. If applied before a blister develops, it may reduce the duration of an outbreak to as few as two and a half days.
Herpes viruses are treated with antivirals. There are three commonly used to treat oral and genital herpes:
- Zovirax (acyclovir)
- Valtrex (valacyclovir)
- Famvir (famciclovir)
All three antivirals are effective in reducing the severity and duration of a herpes outbreak. However, some authorities recommend Valtrex over Zovirax for the treatment of genital herpes.
Studies have shown that, if started within 48 hours of the first appearance of lesions, antivirals can reduce the duration of oral herpes by one to two days. Antivirals can also shorten the duration of a first genital herpes outbreak by up to 50%.
Although evidence on the benefits of complementary and alternative medicines for treating herpes is scant, several natural compounds have shown promise, including:
- African rue (Peganum harmala) extract
- Green algae (Stypopodium zonale) extract
- Red seaweed (Hypnea musciformis) extract
- Verbena (Verbenaceae) essential oil
- Yu Xing Cao (a traditional Chinese medicine)
There is no cure for herpes. Once you are infected, the virus remains in your body forever.
There have been some promising trials of herpes vaccines. However, to date, no human trials have shown high enough efficacy to bring a herpes vaccine to market.
Can You Use Telehealth for STIs?
Thanks for your feedback!
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Pereira DB, Antoni MH, Danielson A, et al. Stress as a predictor of symptomatic genital herpes virus recurrence in women with human immunodeficiency virus. J Psychosom Res. 2003;54(3):237-44.
Modi S, Van L, Gewirtzman A, et al. Single-day treatment for orolabial and genital herpes: a brief review of pathogenesis and pharmacology. Ther Clin Risk Manag. 2008;4(2):409-17. doi:10.2147/tcrm.s1664
Sauerbrei A. Optimal management of genital herpes: current perspectives. Infect Drug Resist. 2016;9:129-41. doi:10.2147/IDR.S96164
U.S. Department of Health and Human Services. Sexually Transmitted Infections. Summary of CDC Treatment Guidelines—2021.
Sung SH, Choi GH, Lee NW, Shin BC. External use of propolis for oral, skin, and genital diseases: a systematic review and meta-analysis.Evid Based Complement Alternat Med. 2017;2017:8025752. doi:10.1155/2017/8025752
Deethae A, Peerapornpisal Y, Pekkoh J, Sangthong P, Tragoolpua Y. Inhibitory effect of Spirogyra spp. algal extracts against herpes simplex virus type 1 and 2 infection. J Appl Microbiol. 2018;124(6):1441-1453. doi:10.1111/jam.13729
Ursini T, Tontodonati M, Manzoli L, et al. Acupuncture for the treatment of severe acute pain in herpes zoster: results of a nested, open-label, randomized trial in the VZV Pain Study. BMC Complement Altern Med. 2011;11:46. doi:10.1186/1472-6882-11-46
DailyMed. Label: Abreva - docosanol cream. Updated October 5, 2020.
Pinder M, Wright A. Valaciclovir versus aciclovir for the treatment of primary genital herpes simplex: a cost analysis. Int J STD AIDS. 2015 Nov;26(13):971-3. doi:10.1177/0956462414563628
Alvarez DM, Castillo E, Duarte LF, et al. Current antivirals and novel botanical molecules interfering with herpes simplex virus infection. Front Microbiol 2020;11:139. doi:10.3389/fmicb.2020.00139
Yip ST, Liu R, Warrington T, Webb CW, Hamilton A. Clinical inquiry: How well do antivirals shorten genital herpes pain duration?J Fam Pract. 2015;64(3):190-1.