From the Guidelines
The best medicine for treating cold sores is antiviral medication, with oral valacyclovir (Valtrex) being the most effective option. The recommended dosage is 2 grams taken twice daily for one day, ideally started at the first sign of symptoms like tingling or burning 1. Alternatives include oral acyclovir (400mg five times daily for 5 days) or famciclovir (1500mg as a single dose) 1. For topical treatment, prescription penciclovir cream (Denavir) applied every 2 hours while awake for 4 days or over-the-counter docosanol cream (Abreva) applied 5 times daily until healing occurs can help. These medications work by inhibiting viral DNA replication, preventing the herpes simplex virus from multiplying. Some key points to consider when treating cold sores include:
- Starting treatment during the prodromal phase before blisters appear for maximum effectiveness
- Avoiding touching the sores to prevent spreading the infection
- Using pain relief options like acetaminophen or ibuprofen alongside cold compresses
- Considering suppressive therapy with daily valacyclovir for people with frequent outbreaks (more than 6 per year) 1. It's worth noting that while there are various treatment options available, oral valacyclovir remains the most effective option due to its high oral bioavailability and efficacy in reducing the duration and severity of symptoms 1.
From the FDA Drug Label
1 INDICATIONS AND USAGE 1.1 Adult Patients Cold Sores (Herpes Labialis) VALTREX is indicated for treatment of cold sores (herpes labialis).
INDICATIONS AND USAGE Denavir (penciclovir cream) is indicated for the treatment of recurrent herpes labialis (cold sores) in adults and children 12 years of age and older.
The best medicines for treating cold sores (Herpes Simplex Labialis) are valacyclovir (PO) and penciclovir (TOP), as indicated by their respective drug labels 2 and 3.
- Valacyclovir (PO) is indicated for the treatment of cold sores in adult patients and pediatric patients aged greater than or equal to 12 years.
- Penciclovir (TOP) is indicated for the treatment of recurrent herpes labialis (cold sores) in adults and children 12 years of age and older.
From the Research
Treatment Options for Cold Sores
The treatment of cold sores, also known as herpes labialis, can be managed through various antiviral medications. Some of the most effective treatments include:
- Valacyclovir: A highly bioavailable prodrug of acyclovir, which has been shown to be effective in reducing the duration and severity of cold sore episodes 4, 5, 6.
- Acyclovir: An antiviral medication that can be used topically or orally to treat cold sores, with studies demonstrating its efficacy in reducing episode length and healing time 7, 5.
- Famciclovir: Another antiviral medication that has been shown to be effective in treating herpes zoster and may also be useful in treating cold sores 8, 6.
Dosage and Administration
The dosage and administration of these medications can vary depending on the specific treatment regimen. For example:
- Valacyclovir can be taken orally at a dose of 2g twice daily for 1 day, or 1g twice daily for 3-5 days 4, 6.
- Acyclovir can be taken orally at a dose of 400mg three times daily, or applied topically as a 5% cream 7, 5.
- Famciclovir can be taken orally at a dose of 750mg once daily, 500mg twice daily, or 250mg three times daily 8.
Efficacy and Safety
These medications have been shown to be safe and effective in treating cold sores, with studies demonstrating significant reductions in episode length, healing time, and pain 4, 7, 5, 8, 6. However, it is essential to consult with a healthcare professional to determine the best treatment option for individual cases.