What is the cost of acyclovir (antiviral medication) 400 mg, 35 pills?

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Cost of Acyclovir 400 mg, 35 Pills

Based on the most recent guideline data available, acyclovir 400 mg taken twice daily costs approximately $1,300 annually, which translates to roughly $125 for a 35-day supply (35 pills at once daily dosing, or 70 pills for twice-daily dosing). 1

Pricing Context from Guidelines

The 2000 CDC/IDSA guidelines provide wholesale acquisition cost data for herpes simplex virus suppression therapy:

  • Acyclovir 400 mg twice daily: $1,300 per year 1
  • This equates to approximately $3.56 per day or $1.78 per 400 mg dose 1

Cost Calculation for 35 Pills

For a prescription of 35 pills of acyclovir 400 mg:

  • Once-daily dosing (35 days): Approximately $125 1
  • Twice-daily dosing (17.5 days): Approximately $62 1
  • Three times daily dosing (11.7 days): Approximately $42 1

Important Pricing Considerations

These are wholesale acquisition costs from 2000 and represent baseline pricing. 1 Actual patient costs will vary significantly based on:

  • Insurance coverage and copayments
  • Pharmacy dispensing fees
  • Generic vs. brand formulations (generic acyclovir is now widely available and typically much less expensive)
  • Retail pharmacy markup
  • Geographic location

Modern generic acyclovir is substantially less expensive than the 2000 pricing data suggests. 1 Current retail prices for generic acyclovir 400 mg typically range from $10-30 for 30 tablets at major pharmacy chains, making 35 pills approximately $12-35 out-of-pocket for cash-paying patients.

Clinical Context

The typical prescribing patterns for acyclovir 400 mg include:

  • Recurrent genital herpes treatment: 400 mg three times daily for 5 days (15 pills total) 1
  • Suppressive therapy: 400 mg twice daily continuously (60 pills per month) 1, 2
  • 35 pills would provide: 11-12 days of treatment dosing or 17-18 days of suppressive therapy 1, 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Aciclovir Dosage for HSV and VZV Infections

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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