Acyclovir is an antiviral medication for the treatment and suppression of infections caused by the herpes virus. It can be applied topically or can be taken orally in the form of tablets or a liquid suspension. But not all options are available over-the-counter.
What is Acyclovir?
Acyclovir (aciclovir) is used to treat infections caused by the herpes simplex virus (HSV) type 1 (HSV-1) and type 2 (HSV-2), which can cause cold sores (HSV-1 only) and genital herpes. It is also prescribed to individuals infected by herpes zoster (shingles), varicella zoster virus (chickenpox) and sometimes for the treatment of Bell’s palsy.
Acyclovir does not cure HSV, but it will stop the virus from spreading in your body.
The medication has been extensively tested and produces little to no side effects for most patients. But you should talk to your doctor before taking acyclovir if you suffer from one of the following:
- You have or have had kidney complications
- You are allergic to medications
- You are pregnant or breastfeeding
- You have a weak immune system
Acyclovir for cold sores
To treat cold sores (fever blisters), your doctor may prescribe acyclovir cream (Zovirax) or an ointment containing the active ingredient.
Make sure you wash your hands before touching the infected area. Apply a thin layer of the cream up to 5 times a day, 4 hours apart. In most cases, topical treatment will last 5 to 7 days.
You should begin treatment as soon as symptoms occur. The earliest symptoms of cold sores include tingling and an itching sensation surrounding the lip. Symptoms should begin to improve within 48 hours, but it could take longer depending on the severity of the infection and when you started treatment.
Side effects of acyclovir cream (Zovirax) include:
- Dry or chapped lips
- Flaky skin
- Burning, redness or swelling
If you notice any severe side effects, get urgent medical help:
- Rash, hives
- Difficulty breathing
- Swelling of the face, lips, throat, eyes
Most people who are HSV carriers may never notice any symptoms at all, whilst others may experience frequent breakouts. Recurrence of cold sores is usually once a year, but if you get them very often, your doctor can prescribe oral acyclovir to help suppress the symptoms and avoid future outbreaks.
Acyclovir for genital herpes
Your healthcare provider will usually prescribe acyclovir tablets (200mg or 400mg) or an oral suspension (200mg) to treat genital herpes.
Genital herpes causes blisters, itching and discomfort in the genital and anal areas. It is spread via sexual contact and bodily fluids. It can be caused by both HSV-1 (via oral sex) and HSV-2.
It is recommended that you begin treatment as soon as symptoms occur (within 48 hours) to speed up recovery. In most cases, patients are prescribed 200 mg of acyclovir to be taken 5 times a day, at 4-hour intervals for 5 days.
Genital herpes has a fairly high recurrence rate. One study found that 38% of patients had at least 6 outbreaks a year. Suppression therapy is usually recommended for people who suffer from genital herpes frequently.
To suppress herpes outbreaks, your doctor may ask you to take 200 mg of acyclovir up to 4 times a day, or 400 mg 2 times a day at 12 hours apart.
Common side effects of oral acyclovir include:
Serious side effects that require urgent medical attention include:
- Shortness of breath
- Chest tightness
- Rash or hives
- Swelling of the face, mouth, tongue, throat, eyes
If your immune system is very weak or this is your first genital herpes outbreak, your doctor may prescribe acyclovir cream in addition to tablets to treat the blisters.
Can you buy Acyclovir over the counter?
When you’ve got a herpes breakout, you want to heal as quickly as possible. And whilst some treatments are available over-the-counter, others require a prescription.
In the U.S., however, you cannot buy acyclovir cream (5%) or ointments (5%) over-the-counter. The only topical treatment approved for over-the-counter sales is Abreva which contains docosanal (10%) as its active ingredient.
You need a prescription from a doctor or a consultation with an online pharmacist to buy:
- Acyclovir cream/ointments (5%)
- Acyclovir tablets/capsules (200mg, 400mg)
- Acyclovir suspension (200mg)
Acyclovir cream (Zovirax) is freely available to purchase over-the-counter in the European Union.
How can I get an Acyclovir prescription?
You can make an appointment with a doctor or healthcare provider to get a prescription for acyclovir. If it is your first herpes breakout, you should see a doctor to ensure the right diagnosis.
Alternatively, you can book an online health assessment with a medical advisor at an online pharmacy. This is a convenient way to buy acyclovir to manage recurring symptoms or suppress symptoms in the long-term. Your online pharmacist will help you determine the best course of treatment.
You won’t need a prescription from a doctor to buy acyclovir online. Acyclovir tablets (400mg) start at $8.50 for 15 tablets.
- Aciclovir 200 mg Tablets - Summary of Product Characteristics (SmPC) - (eMC). (2018). Retrieved from Medicines.org.uk website: https://www.medicines.org.uk/emc/product/4334/smpc
- Acyclovir - DrugBank. (2010). Retrieved from Drugbank.ca website: https://www.drugbank.ca/drugs/DB00787
- Benedetti, J. (1994). Recurrence Rates in Genital Herpes after Symptomatic First-Episode Infection. Annals of Internal Medicine, 121(11), 847. https://doi.org/10.7326/0003-4819-121-11-199412010-00004
- Uchoa, U. B. C. (2003). Long-term Acyclovir Use to Prevent Recurrent Ocular Herpes Simplex Virus Infection. Archives of Ophthalmology, 121(12), 1702. https://doi.org/10.1001/archopht.121.12.1702
- Johnston, C., Saracino, M., Kuntz, S., Magaret, A., Selke, S., Huang, M., … Wald, A. (2012). Standard-dose and high-dose daily antiviral therapy for short episodes of genital HSV-2 reactivation: three randomised, open-label, cross-over trials. The Lancet, 379(9816), 641–647. https://doi.org/10.1016/s0140-6736(11)61750-9