💊 Acyclovir (Acyclovir)
Acyclovir Cream 5% is a topical antiviral for the treatment of recurrent herpes labialis (cold sores) in immunocompetent adults and adolescents 12 years of age and older. It is applied only to the external skin of the lips and face.
In Arabic: أسيكلوفير (كريم موضعي)
🏷️ Brand names & manufacturers
Zovirax🏭 Bausch Health US, LLCDailyMed
Avaclyr🏭 Fera Pharmaceuticals, LLCDailyMed
Acyclovir Suspension🏭 Novadoz Pharmaceuticals LLCDailyMed
Acyclovir🏭 Camber Pharmaceuticals, Inc.DailyMed
Acyclovir🏭 Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.DailyMed
Acyclovir🏭 Teva Pharmaceuticals USA, Inc.DailyMed✅ What it is used for
- Treatment of recurrent herpes labialis (cold sores) in immunocompetent adults and adolescents 12 years and older
🧪 Active ingredient
Acyclovir: a synthetic deoxynucleoside analogue active against herpes viruses; it inhibits the DNA polymerase of herpes simplex virus types 1 and 2.
🌿 Benefits
- Treats recurrent cold sore episodes when started early
- Very little is absorbed into the body through the skin
📝 How to use
- The dose is set by your doctor or pharmacist; do not change it on your own
- Per the label: apply the cream 5 times per day for 4 days
- Start as early as possible after the first signs or symptoms (prodrome) or when lesions appear
- For use on the external skin of the lips and face only; for topical (skin) use only
💊 Dosage forms
- Cream, 50 mg acyclovir per gram (5% w/w), supplied in 5 g tubes
⚠️ Common side effects
- Local reactions at the application site (5% of patients vs 4% with placebo)
- Dry lips or dry skin
- Skin flaking (desquamation) or cracked lips
- Burning or stinging of the skin
- Itching (pruritus)
🚨 Serious — seek medical help
- Angioedema (swelling) and anaphylaxis, reported after marketing; seek medical help immediately
- Contact dermatitis and eczema
⛔ Do not use if
- Known hypersensitivity to acyclovir, valacyclovir, or any component of the formulation
❗ Warnings & precautions
- For topical use only on the external skin of the lips and face
- Do not apply to mucous membranes, in the eye, or inside the mouth or nose
- Potential for irritation and contact sensitization
- Effect has not been established in immunocompromised patients
🔄 Drug interactions
- No interactions have been identified with topical or systemic use of other drugs together with the cream
- Systemic drug interactions are unlikely because of minimal systemic absorption
🤰 Pregnancy
Systemic absorption is minimal and maternal use is not expected to result in fetal exposure. Decades of experience with topical acyclovir have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Consult your doctor before use.
🍼 Breastfeeding
Systemic absorption is minimal and breastfeeding is not expected to result in exposure of the child. There are no data on effects on the breastfed infant or milk production. The benefits of breastfeeding should be weighed against the mother's need for the drug; consult your doctor.
🧒 Children
Adolescents 12 years and older use the same dose as adults, with a safety profile similar to adults. Safety and effectiveness in children under 12 years have not been established.
👴 Older adults
Studies did not include enough subjects aged 65 and over to determine whether they respond differently; other clinical experience has not identified differences. Systemic absorption is minimal.
🌡️ Storage
Store at or below 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F).
⏰ Missed dose
The label does not provide information on a missed dose. Ask your doctor or pharmacist.
🆘 Overdose
Overdose by topical application is unlikely because of minimal systemic exposure. No information is available on overdose.
💰 Price & brands in your area
🏛️ Official price in Palestine — Ministry of Health price list:
| Product | Company | Pack | Price |
|---|---|---|---|
| VIRAX SUSPENSION ACYCLOVIR | BPC | 60 ml | 25 ₪ |
| VIRAX HC Acyclovir & HC | BPC | 5 gr. | 30 ₪ |
| Zovirax Cream 5% 2g DMC acyclovir Cream 5% 2g DMC | GSK | 2g tube | 34 ₪ |
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Mechanism of action
Acyclovir is a synthetic purine deoxynucleoside analogue. Viral thymidine kinase converts it to acyclovir monophosphate, which cellular enzymes convert to the diphosphate and then the triphosphate. The triphosphate inhibits viral DNA replication by competitive inhibition of viral DNA polymerase, incorporation into and termination of the growing viral DNA chain, and inactivation of the viral DNA polymerase. Systemic absorption is minimal (urinary excretion about 0.04% of the daily applied dose).
Labeled dosing
Adults and adolescents 12 years and older: apply the cream 5 times per day for 4 days, initiated as early as possible at the prodrome or when lesions appear. The dose is determined by the physician or pharmacist.
- Strength: 50 mg/g (5% w/w)
- Contraindicated in hypersensitivity to acyclovir, valacyclovir, or any component
- Not for mucous membranes, eye, or inside the mouth or nose
- Potential for irritation and contact sensitization; the sensitizing ingredient has not been identified
- Postmarketing reports: angioedema, anaphylaxis, contact dermatitis, eczema
🎓 Key points for students
- Antiviral nucleoside analogue targeting herpes simplex virus
- Selectivity depends on activation by viral thymidine kinase
- Converted to the active triphosphate through three phosphorylation steps
- Inhibits viral DNA polymerase and terminates the growing viral DNA chain
- Minimal systemic absorption through skin, so systemic interactions are unlikely
- Indication: recurrent herpes labialis in immunocompetent patients
- Dosing: 5 times daily for 4 days with early initiation
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What is acyclovir cream used for?
It treats recurrent herpes labialis (cold sores) in immunocompetent adults and adolescents 12 years and older.
How often is the cream applied and for how long?
Per the label: 5 times per day for 4 days, starting at the first signs. However, your doctor or pharmacist sets the dose.
Can it be used in the mouth, nose, or eyes?
No. It is for the external skin of the lips and face only, not for mucous membranes, the eye, or inside the mouth or nose.
What are the main side effects?
Mostly local reactions such as dryness, flaking, burning, and itching. Rarely, severe allergy and swelling can occur and need immediate medical attention.
Is it safe during pregnancy and breastfeeding?
Systemic absorption is minimal and experience has not shown a drug-associated risk, but consult your doctor before use.
Can children use it?
Adolescents 12 years and older use the same dose as adults. Safety and effectiveness in children under 12 have not been established.
⚕️ For education only — not a substitute for advice from your doctor or pharmacist. Do not start or stop any medicine without advice. Source: official FDA drug label via openFDA (2025-10), simplified. Updated: 2026-11-10.