We talk about a cold that has popped up on our lips and immediately remember Acyclovir. This is an immunomodulator belonging to the group of antiviral drugs used to treat herpes types 1 and 2, genital herpes and chickenpox. It contains no toxic elements, it acts selectively - only on the cells of the virus itself, suppressing their reproduction.
Acyclovir-Acri ointment
So, let's start with the fact that herpes does not only occur on the lip; viral diseases affect various parts of the human body. Therefore, Acyclovir is sold in the following forms, each of which has its own indications for use: cream and ointment for topical use 5%, tablets (200 mg, 400 mg, 500 mg), solution for intravenous injection Lyophilisate 250 mg, ophthalmic ointment 3%.
What is acyclovir?
Acyclovir is a selective, antiviral drug, a nucleoside analogue, related to cytarabine, idoxuridine, trifluridine and vidarabine, active against 4 types of herpes virus (herpes simplex types 1 and 2, chickenpox (type 3), cytomegalovirus (type 4)). It slows down the growth and spread of the herpes virus in the body by affecting their viral cells at the DNA level. This drug does not completely cure herpes, but it reduces the symptoms of the infection and its acute course.
Acyclovir is used both for therapeutic treatment and for the prevention of relapses. It effectively eliminates skin rashes and foci of inflammation around it, prevents the spread of the viral pathogen (contamination), and reduces the complications of herpes.
The effect of acyclovir therapy is greatest when treatment is started early, especially for non-primary infections, which usually have a shorter course than the primary episode. Long-term prophylactic oral acyclovir in patients with frequent episodes of genital herpes simplex completely suppresses relapses in most patients; As with other acyclovir-responsive infections, the viral latency period is not eradicated and the pre-treatment relapse rate returns after treatment is stopped.
Caution should be exercised when using acyclovir prophylactically in the general population due to the theoretical risk of the emergence of viral strains that are resistant to acyclovir and other agents whose mechanism of action is dependent on viral thymidine kinase (viral protein).
Intravenous acyclovir is the drug of choice for biopsy-proven herpetic encephalitis (damage to the nervous system by herpes) in adults, and has also been successfully used in the treatment of disseminated herpes simplex in pregnant women and herpes in newborns. Intravenous and oral acyclovir protects against the spread and progression of varicella zoster virus infection, but does not protect against postherpetic neuralgia (a complication of herpes zoster, manifested by the appearance of serous rashes in the area of innervation of individual branches of the trigeminal nerve).
In immunocompromised patients, intravenous, oral, and topical acyclovir reduces the clinical course of herpes simplex infections, while prophylaxis with oral or intravenous dosage forms suppresses reactivation (recurrence) of the infection while taking the drug.
Ophthalmic use of 3% acyclovir ointment quickly cures herpetic corneal ulcers and superficial herpetic keratitis. Thus, despite its failure to eradicate latent virus, acyclovir, administered therapeutically or prophylactically, is now standard antiviral therapy for some manifestations of herpes simplex virus infection and does represent a major advance in this regard.
Indications for use
Acyclovir is indicated for the following diseases:
- infectious lesions of the skin and mucous membranes caused by the herpes simplex virus (primary and recurrent genital);
- chicken pox;
- shingles;
- herpetic lesions in children in the first month of life (including intrauterine infection);
- prevention of cytomegalovirus infection in patients who have undergone bone marrow transplantation;
- herpetic lesions of the cornea of the eyes (for eye ointment);
- Epstein-Barr virus infection.
Symptoms of acyclovir overdose
You should stop taking acyclovir if you experience these symptoms:
- easy bruising or bleeding, purple or red dotted spots under the skin;
- changes in behavior (motor restlessness and emotional agitation, confusion, hallucinations);
- disorders of the urinary system (anuria (lack of urination), painful or difficult urination), swelling of the lower extremities;
- feeling tired, shortness of breath.
Uncomplicated side effects of acyclovir include:
- skin allergic manifestations (itching, soreness of the skin when touched, rashes);
- nausea, which may be accompanied by vomiting, stomach upset (diarrhea);
- headaches and/or dizziness;
- pain in the mouth when taking acyclovir tablets buccally (by the cheek).
Typically, cases of acyclovir overdose have been recorded extremely rarely, but common manifestations are allergic reactions, which entail a number of symptoms:
- hives, blisters, itching;
- difficulty breathing and swallowing;
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or legs;
- hoarseness;
- cardiopalmus;
- general weakness;
- pale skin;
- confusion and/or loss of consciousness;
- the appearance of unusual bruises on the body;
- blood in urine and stool;
- numbness, burning or tingling in the upper and lower extremities;
- temporary inability to move parts of the body.
If you experience any of the above symptoms, you should contact your doctor immediately.
Recommend some remedy for cold sore lips for a pregnant woman
Unfortunately, first-line drugs for the treatment of exacerbations of orolabial herpes are indicated for use during pregnancy only if the benefit to the mother outweighs the risk to the fetus and child [2]. Expectant mothers can be encouraged to use a lip balm or cream with a UV filter - it protects the skin of the lips from the negative effects of ultraviolet radiation, which is considered one of the triggers for relapses of herpes. Additionally, I would recommend lip moisturizers to prevent dry skin.
What you need to know before you start taking acyclovir
You should not take this medication if you are allergic to acyclovir or valacyclovir (Valtrex). The use of Sitavig buccal tablets is not recommended if you have an allergic reaction to milk proteins.
To make sure this medication is safe for you, check with your doctor before taking it if you have a history of the following conditions:
- kidney disease;
- weakened immunity (as a result of taking some medications or caused by any disease).
It is especially important to consult a specialist if you are pregnant or planning a pregnancy, or if you are breastfeeding a child. Because herpes can be passed on to your baby during birth if you develop genital lesions at birth. If you have genital herpes, it is very important to prevent herpes during pregnancy.
During lactation, this medication may be unsafe. You should consult with your doctor to identify and determine any possible risks to your newborn baby.
Acyclovir can be used in children from 2 years of age.
Dosage forms
Products containing the active substance are produced by the following companies:
- in tablets;
- in powders intended for the preparation of solutions used for intravenous drip administration of the drug;
- in a thick cream or ointment consistency.
The use of the product, regardless of the release form, does not impose any age restrictions and is generally recommended based on the indications in each individual case. However, the use of compositions used to prepare solutions for drip administration implies hospital treatment, as it requires compliance with certain precautions.
Drugs produced in the form of creams, ointments and tablets are recommended for outpatient treatment.
How to take acyclovir?
You must take acyclovir exactly as indicated in the instructions or as individually prescribed by your doctor. Do not use the drug in doses that do not comply with the instructions and do not exceed the permissible duration of use.
To use this medication in children, be sure to consult a doctor and carefully study the official instructions for the drug.
To use buccal acyclovir, do not crush, chew, suck, or swallow the tablet; simply place the flat side of the tablet on the herpes-affected area.
Note!
Giving buccal tablets to children is strictly prohibited, as this can lead to suffocation.
If you take acyclovir in the form of a suspension, be sure to use a special dosing measuring cup to measure the dosage. It is not recommended to use ordinary cutlery (a kitchen spoon) for this purpose.
The calculation of the dose of acyclovir used depends on the weight category (especially important for children). When losing or gaining body weight, the dose may vary.
During treatment with acyclovir, it is important to drink as much fluid (drinking water) as possible to maintain normal kidney function.
When prescribed a course of treatment with this drug, it is necessary to strictly follow it, even if your symptoms improve after the first days of using acyclovir, since interrupting treatment or skipping doses may increase the risk that the virus will become resistant to acyclovir, and there is also a high likelihood of frequent relapses.
The drug should be stored out of the reach of children, away from moisture and heat.
Acyclovir: price for 2022
The price of the drug acyclovir in 2022 has not increased compared to previous years, which is most likely due to high competition between manufacturers, as well as the appearance in pharmacies of a large number of more modern and effective analogues of acyclovir. The highest price is the original Acyclovir from GlaxoSmithKline (UK), sold under the Zovirax brand.
Ointment and cream Acyclovir 5% –
- Acyclovir-Acri ointment, 5 g – from 35 rubles,
- Acyclovir-Belupo cream, 5 g – from 70 rubles,
- Acyclovir-Sandoz cream, 5 g – from 150 rubles (2 g tube – from 75 rubles),
- Zovirax cream, 5 g – from 190 rub.
- Zovirax Duo-Active cream, 2 g – from 350 to 400 rubles.
Please note that all of the above products contain propylene glycol (to enhance the penetration of acyclovir into tissues). However, despite this, the ointment will in any case be inferior in effectiveness to the cream. The second point is that only Acyclovir-Sandoz cream and both Zovirax creams contain dimethicone, which will allow you to easily apply cosmetics over the absorbed cream.
Eye ointment Acyclovir 3% –
- Acyclovir-Sintez (Russia) – from 150 rubles,
- Acyclovir-Akos (Russia) – from 150 rubles,
- Zovirax 3% (UK) – from 240 rubles.
Acyclovir tablets: price
- Zovirax 200 mg (25 tablets) – from 250 rubles,
- Acyclovir Acri 200 mg (20 tablets) – from 70 rubles,
- Acyclovir Acri 400 mg (20 tablets) – from 220 rubles.
Consequences of an overdose of acyclovir
Cases of overdose with acyclovir have not been recorded, but if a dose of acyclovir is taken too high, the following symptoms may occur:
- nausea, vomiting, diarrhea;
- headache, dizziness, clouding of consciousness;
- dyspnea;
- anaphylaxis (immediate allergic reaction);
- febrile symptom (increased body temperature);
- swelling;
- visual impairment;
- general malaise;
- myalgia (muscle pain).
If you have taken a high dose of acyclovir and experience any of the above symptoms, you should seek emergency medical help as soon as possible.
What should you not do while taking acyclovir?
When using buccal acyclovir until it is completely dissolved in the mouth, you should avoid brushing your teeth, chewing gum, and wearing dentures. You can rinse your mouth with caution. It is recommended to drink plenty of water to prevent dry mouth.
It is worth remembering that herpes infections are contagious, even if you are treated with acyclovir you can still infect other people, so avoid contact of infected areas with other people. When touching the infected area, do not touch the mucous membranes of the eyes with your hands. Wash your hands with soap as often as possible to prevent the spread of infection.
With genital herpes, even during treatment with acyclovir, the risk of infecting a sexual partner does not decrease. It may still be contagious even if you don't have any symptoms.
All medicines against herpes on the lips are the same, give me something cheaper
Indeed, many drugs intended for the treatment of orolabial herpes contain the same active substance. Most often this antiviral drug is acyclovir, less often - penciclovir. However, there are means that have characteristic differences. For example, one of the creams, along with acyclovir, contains hydrocortisone. This remedy, unlike single drugs, simultaneously prevents the formation of new rash components and shortens the healing time of existing rashes, reducing the severity of the inflammatory reaction and itching [2].
What are the side effects of acyclovir?
Common side effects after taking acyclovir may include:
- headaches and dizziness;
- pain in the gastrointestinal tract, feeling of nausea;
- hives (itchy skin with large red rashes);
- fast fatiguability.
If you observe the following symptoms, you should contact an ambulance as soon as possible:
- skin hemorrhages on the body;
- vomit;
- problems with urination;
- behavioral changes;
- pain in the mouth when using the buccal form of acyclovir.
I caught a cold, and lo and behold, my lips were covered. Give me some tea for colds
You are confusing two completely different infections - respiratory and herpes. A cold, or ARVI, develops when the body is infected with respiratory viruses. But a “cold on the lips,” or a relapse of orolabial herpes, appears when the herpes simplex viruses, which live in the body constantly, are activated. Therefore, when itching or rash appears on the lips, traditional cold remedies are not effective: they only act on the symptoms of acute respiratory viral infections or respiratory viruses. In the case of “cold lips,” it is advisable to use antiviral drugs that are active against herpes simplex pathogens.
Directions for use and dosage of acyclovir
For the treatment of herpes virus types 1 and 2:
Adults: 1 tablet at a dose of 200 mg 5 times a day with an interval of 4 hours between doses. The course of treatment lasts up to 10 days on average.
The maximum dose taken per day is 1000 mg (5 tablets).
Children: used for children from 3 years of age: from 3-6 years - 400 mg (2 tablets) per day.
For children from 6 years of age, it is used in the same dosage as for adults. The course of treatment is determined by the doctor. On average, it is used up to 5 days.
For the treatment of herpes virus types 3 and 4:
Adults: prescribed at a dose of 800 mg up to 5 times a day (dosing interval 4 hours). The duration of treatment is determined by the doctor, but on average the course is about 10 days.
Children: from 3 to 6 years, 400 mg (2 tablets) 4 times a day.
Children over 6 years of age are prescribed in the same dosage as for adults.
In old age, the process of removing the drug from the body (clearance) slows down, so it is necessary to take care of drinking plenty of fluids during treatment with acyclovir, and if renal function is impaired, the dose of the drug should be reduced.
It is worth remembering that for each person, based on the state of health and the specific type of herpes virus, the dose may vary, so acyclovir should be prescribed by a doctor.
Acyclovir ointment: instructions for use
Let's now figure out what Acyclovir ointment or cream helps with. This drug can only be used externally, and indications for its use:
- infections of the skin and mucous membranes caused by the herpes simplex virus (types HSV-1 and HSV-2), i.e. First of all, this is herpes on the lips and skin around the mouth, as well as as part of complex therapy for the treatment of genital herpes.
We have already said above that the key to the effectiveness of treatment with acyclovir is the earliest possible start of using the drug (24stoma.ru). For example, in the prodromal period (when the feeling of itching and bloating is just beginning to appear), or during the first 12 hours from the moment herpetic blisters erupt. If acyclovir ointment or cream is started to be used only after 48 hours or even after the herpetic blisters have opened, this will not reduce the duration of symptoms at all.
Application regimen - the effective concentration of acyclovir for the treatment of herpes of the lips and facial skin is 5%. It is very important to strictly follow the application regimen. For acyclovir ointment, the instructions for use state that the drug should be applied to the skin and red border of the lips 5-8 times a day (i.e., preferably every 2 hours while you are awake). The cream is applied in a thin layer to the areas of herpetic rashes and the adjacent skin - with careful massaging movements. The usual course of use is 5-6 days, but with severe clinical manifestations - up to 10 days.
How to choose ointment or cream with acyclovir –
Please note that acyclovir ointment and acyclovir cream differ in their properties. The ointment is absorbed much less well, which means the acyclovir contained in it will penetrate much worse into the skin cells affected by herpes, which reduces the effectiveness of the drug. The ointment is much cheaper to produce (than cream), and therefore 5% acyclovir ointment - the price starts from only 35 rubles.
The disadvantage of Acyclovir is also its rather poor penetration through the stratum corneum of the epidermis of the skin. To increase skin permeability to acyclovir, a number of manufacturers add propylene glycol to the composition. This component is added to the original acyclovir preparations - Zovirax cream and Zovirax Duo-Active cream, as well as to generics - Acyclovir-Belupo, Acyclovir-Sandoz and the Russian ointment Acyclovir-Acri.
If we compare the effectiveness of cream and ointment with the same 5% concentration of acyclovir, then the effectiveness of the cream will be higher. The cream tends to be absorbed faster, which means that acyclovir will better penetrate from the cream into the skin cells affected by the virus. Zovirax cream also contains dimethicone (silicone), which allows even cosmetics to be applied immediately after the cream is absorbed. On the other hand, Acyclovir-Acri 5% ointment will cost you only 40 rubles, and Zovirax cream will cost you 190 rubles. By the way, dimethicone is also included in the Acyclovir-Sandoz cream, which costs from 150 rubles.
Zovirax or Acyclovir: which is better? So, Zovirax cream is certainly better - when compared with Acyclovir Acri or similar drugs from other manufacturers. In addition to the classic Zovirax cream, which contains 5% acyclovir, propylene glycol and dimethicone, there is also Zovirax Duo-Active cream (it additionally contains 1% hydrocortisone). For example, if you start using this cream early in the prodromal period, due to hydrocortisone it can reduce the number and size of herpetic blisters that form, and sometimes even prevent their formation.
In our opinion, Zovirax Duo-Active cream is the best option for ointment or cream with acyclovir for herpes on the lips or facial skin. This cream has only 2 disadvantages - the price starts from 350 rubles (only 2 g per tube) and the age limit is up to 12 years. But, if we consider good herpes creams not only based on acyclovir, then Fenistil-Pentsivir (based on penciclovir) is also a very good cream. But the latter is currently temporarily unavailable in pharmacies - most likely due to the re-registration of the drug in Russia.
Interaction of acyclovir with other drugs and substances
If you are using medications to treat tumors, osteoporosis (low bone density), gastrointestinal disorders, or rheumatoid diseases, then taking them together with acyclovir may increase the negative effect on the kidneys (nephrotoxicity). Therefore, you should be careful and when using any medications, you should consult your doctor.
Be careful!
When taking acyclovir simultaneously with Probenecid (a drug for gout), the half-life of acyclovir increases and its biotransformation (redistribution in the body) decreases. This is especially important for those who have impaired kidney function.
This is not an exhaustive list of drugs that may interact with acyclovir. You should tell your doctor about any medications you start or stop using.
Give me some kind of alcohol tincture for colds on the lips - maybe calendula or boric alcohol
Applying alcohol solutions to lesions is a very controversial method. On the one hand, they, of course, dry and have an antiseptic effect. However, not a single tincture, as well as boric or salicylic alcohols, are active against the causative agents of “colds on the lips” - herpes simplex viruses. Moreover: these drugs contain ethyl alcohol in a fairly high concentration - up to 70%. When applied to damaged skin, irritation and even burns may occur, which will only worsen the situation. The pharmacy's assortment today includes products that act directly on herpes viral particles, preventing their reproduction and accelerating recovery. It is these drugs that are considered the “first line” for the treatment of herpes on the lips.
What you need to know about acyclovir
Do not forget that acyclovir, like all other medications, must be stored out of the reach of children. Never share your medications with other people, so as not to harm their health. Remember that acyclovir should be used only for its intended purpose.
Always consult your doctor to make sure the information on this page applies to your individual situation.
Sources
Acyclovir / Drugs.com (English)
Acyclovir / State register of medicinal products (ukr.)
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