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Photography by Aya Brackett

Herpes is a common viral infection caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus: type 1 (HSV-1) and type 2 (HSV-2).

HSV-1 mainly affects the oral area and is called oral herpes or herpes simplex labialis. It can cause lesions or sores also commonly called cold sores or fever blisters around the lips, tongue, mouth, or gums. In rare cases, HSV-1 can also cause genital sores or blisters (genital herpes).

HSV-1 is a contagious virus that can be spread through direct oral contact such as kissing, or through sharing utensils with someone who has an infection.

HSV-2 mainly affects the genital areas. It can cause sores, or blisters in the genital or anal areas of the body. It is sexually transmitted through contact with genital herpes sores or blisters of an infected person.

Symptoms of either HSV-1 or HSV-2 may include:

  • blisters or sores that may be painful
  • itching
  • burning, tingling
  • tiredness
  • body aches
  • sore throat
  • fever

There is no cure for herpes simplex viral infection. After the first infection, the virus can lay dormant and return. Most people don’t have serious symptoms from herpes simplex, and symptoms such as sores or blisters resolve on their own. But some people with immune-related problems may experience more serious symptoms.

There are several medications available with proven effectiveness for symptom management.

Below we’ll discuss some of the most common medications used to treat oral and genital herpes.

Generic nameBrand nameDosage form and strengthPrescription/OTCApproved use for herpes
acyclovirZovirax, Sitavigtablet (400mg, 800mg), capsule (200mg), oral suspension (200mg/5ml), cream (5%), ointment (5%) Sitavig buccal tablet (50mg)prescriptionoral herpes, genital herpes
docosanolAbrevatopical cream (10%)

over the counteroral herpes (cold sores, fever blisters)
famciclovirFamvirtablet (125mg, 250mg, 500mg)prescriptionoral herpes (cold sores), genital herpes
penciclovirDenavirtopical cream (1%)prescriptionoral herpes
valacyclovirValtrextablet (500mg, 1 g)prescriptionoral herpes, genital herpes

There are various antiviral medications effective for managing a herpes simplex infection. They belong to the antiviral group of drugs and come in different dosage forms. Antiviral medications work to manage herpes simplex symptoms by blocking the virus from multiplying and growing in the body.

A healthcare professional can discuss the best choice for you based on:

  • your symptoms
  • your age
  • any other health conditions you may have
  • other medications you may be taking

The dosage of your antiviral medication depends on:

  • the dosage form (oral, buccal, or topical)
  • your condition (oral or genital herpes)
  • if it’s an initial or recurrent infection
  • your age

Common side effects of oral antiviral medications can include:

  • headache
  • nausea, vomiting
  • diarrhea
  • rash
  • weakness

Some serious side effects of oral antivirals can include:

Let your doctor know if you have

  • any health conditions such as liver or kidney problems or blood disorders
  • are pregnant or breastfeeding
  • are immunocompromised (weakened immune system)
  • are taking other medications or supplements


Acyclovir is a generic prescription version of the brand name drug Zovirax. It is used to manage symptoms of recurring (repeat episodes) oral or genital herpes.

Acyclovir is also the active ingredient of the brand name drug Sitavig.

Sitavig comes as buccal tablets you place in your upper gum area to dissolve. It is used to manage symptoms of recurrent oral herpes.

Keep in mind, when you have active sores or blisters, you can still pass the infection to someone while taking acyclovir. The drug doesn’t cure your herpes simplex infection.

A doctor or pharmacist will discuss the right dosage of Zovirax or Sitavig for you.

Docosanol (Abreva)

Docosanol is a topical antiviral cream that’s available over the counter to treat recurring oral herpes infection of the face or lips. A 2010 review of studies of docosanol found the topical cream is safe and effective for treating fever blisters and cold sores from HSV.

Most people don’t experience side effects from using docosanol but in rare cases some people have an allergic reaction to the drug. If you experience a rash, face swelling, dizziness, trouble breathing or other serious reaction to docosanol, get medical help right away.

Wash hands before and after you use the cream. Remember, docosanol doesn’t cure oral herpes and you can still spread the virus if you have a sore or blister.

Famciclovir (Famvir)

Famcliclovir is a generic version of the brand name drug Famvir. It comes as a tablet you’ll swallow.

It is used to treat repeat episodes of oral herpes and genital herpes in adults. Famciclovir is also used to prevent repeat episodes of genital herpes in people who have frequent herpes symptoms.

A doctor can provide more information about famciclovir, its dosage, and its effectiveness for your condition.

Penciclovir (Denavir)

Penciclovir is active ingredient of the brand name Denavir. It is a prescription drug. It comes as a topical cream that is applied to oral herpes blisters or sores.

Some people experience rare allergic reaction to penciclovir cream. Tell your doctor if you have any allergies or have had a past reaction to penciclovir. If you experience a rash, trouble breathing, dizziness or other serious symptoms, get medical help immediately.

Valacyclovir (Valtrex)

Valacyclovir is the generic version of the brand name drug Valtrex. It is a prescription medication that comes as tablets you’ll swallow. It is used to treat both oral and genital herpes symptoms.

Valacyclovir is used to treat first episode of oral and genital herpes. The drug is also used for repeat episodes of genital herpes and to prevent the risk of future genital herpes outbreaks in adults at risk for multiple episodes. Valacyclovir is also used in some cases to lower the risk of spreading genital herpes.

Your doctor can provide more information on the best use for valacyclovir for your condition, the dosage and effectiveness.

The most common antiviral medications used to manage herpes simplex symptoms are available by prescription. If you have symptoms such as a cold sore or genital herpes, call your doctor’s office. They will first diagnose if you have herpes simplex. Then they will prescribe an appropriate medication to manage your symptoms.

Only docosanol (Abreva) is an antiviral medication available over the counter as a cream to manage oral symptoms such as cold sores or fever blisters.

If you have mild symptoms from a recurring oral herpes infection, you may be able to use nonprescription methods or some home remedies to manage your symptoms.

Examples include:

  • pain relievers such ibuprofen or acetaminophen to help with pain
  • cold compress or ice to soothe burning or itching
  • zinc oxide topical cream, which may help soothe itching or burning

Before trying over the counter medications or supplements, be sure to talk with your doctor or pharmacist about your symptoms.

It’s important to first talk with your doctor before using over-the-counter (OTC) products like docosanol or other home remedies.

If this is the first time you have symptoms of HSV with blisters or sores, your doctor will first diagnose if you have HSV, the type (HSV-1 or HSV-2) and discuss options to manage your condition. They will tell you about prescription and nonprescription alternatives to treat your HSV infection.

Tell your doctor if you have any serious health conditions including if you have a weakened immune system.

Your doctor will also tell you what you can expect with an HSV infection, how long it may last, and what do to prevent spreading HSV to others while you have an active infection.

Here are answers to a few commonly asked questions about herpes simplex virus.

Is herpes curable?

No, herpes simplex is not curable. But antiviral medications and OTC products are effective at managing symptoms of the condition such as lesions and sores.

After your first episode, the virus becomes dormant and may reappear at any time. Stress, hormonal changes, illness, or sun exposure can trigger an outbreak. Talk with your doctor about steps you can take to minimize outbreaks of herpes simplex.

Can I buy herpes medication over the counter?

Most of the approved antiviral medications to treat HSV symptoms are available by prescription. But there are OTC options for repeat episodes of oral herpes. Docosanol (Abreva) is an OTC option to manage herpes cold sores. Be sure to check with your doctor before taking an OTC medication.

How effective are medications for herpes?

Prescription antiviral medications have proven effectiveness in managing HSV symptoms.

A 2017 study comparing the antiviral medications acyclovir, famciclovir, penciclovir and valacyclovir to treat herpes simplex labialis (oral herpes) found all antiviral medications were effective to shorten healing time for lesions and reducing pain. The comparison study found valacyclovir had the fastest healing time and pain reduction.

Can you spread herpes while on medication?

Yes, even while taking an antiviral medication, you can infect close direct contacts with herpes simplex (oral or genital contact) while you have sores or blisters. Take steps to avoid sharing personal hygiene products (lip balm, towels, etc.) and oral and genital contact while you have an active infection.

Herpes simplex virus is a common viral infection. According to the World Health Organization (WHO), in 2016 there were 3.7 billion HSV-1 infections globally affecting people under age 50. And while HSV-2 is less common, in 2016 there were around 491 million HSV-2 infections worldwide affecting people aged 15 to 49 years.

Many people don’t have symptoms (sores or blisters) from HSV infection but can still transmit the virus with close direct contact (oral or genital).

There is no cure for HSV, but antiviral medications can help reduce painful symptoms. Most people have mild symptoms that resolve in a few days. Your risk for more serious symptoms is higher if you have a weakened immune system.

A healthcare professional can tell you more about the types of HSV infection, and all your treatment options.