Cold Sore Medicines: A Guide to Over-the-Counter (OTC) and Prescription Treatments
Bothersome cold sores can be treated with over-the-counter and prescription medications. Learn how to treat cold sores and which medicines may work best for you.
docosanol
Used for Cold Sores
Used for Cold Sores
Docosanol (Abreva) is an antiviral cream used to treat cold sores (also known as fever blisters) on your lips or face. It works best when you start using it as soon as you notice symptoms. You apply it to the affected area 5 times a day until the cold sore heals. It's available over the counter (OTC) for people 12 years and older. Most people don't have many side effects from this cold sore treatment, but it might cause some mild stinging where you apply it.
What is Docosanol (Abreva)?
What is Docosanol (Abreva) used for?
- Cold sores (fever blisters) on the face or lips
- Shorten the healing time and reduce symptoms of cold sores like tingling, pain, burning, and itching
How Docosanol (Abreva) works
Docosanol (Abreva) is an antiviral, specifically called a herpes virus nucleoside analogue. It works by stopping the herpes simplex virus from entering healthy cells and making copies of itself. This helps slow the spread of the virus and allows your body to heal.
When does Docosanol (Abreva) start working?Time passed since treatment started:
Drug facts
| Common Brands | Abreva |
|---|---|
| Drug Class | Antiviral |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Over-the-counter |
More on Docosanol (Abreva) essentials
Side effects of Docosanol (Abreva)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Less Common Side Effects
- Rash
- Itching
Docosanol (Abreva) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reactions: hives, rash, facial swelling, wheezing, difficulty breathing
When do Docosanol (Abreva) possible side effects begin and end?
Time passed since treatment started:
M
H
D
W
M
Mild stinging
The following Docosanol (Abreva) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Headache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Docosanol (Abreva)
Pros
- Can shorten healing time and reduce symptoms of cold sores
- Available over the counter
- Can continue to use makeup
- Side effects are usually mild
Cons
- Must be applied 5 times a day
- Works best only if started at the first sign
- Can only be used on the face or lips
- Not a cure and won’t prevent future cold sores
Pharmacist tips for Docosanol (Abreva)
- Use docosanol (Abreva) at the first sign of a cold sore, such as tingling or itching. Starting early helps it work best.
- Don't put docosanol (Abreva) inside your mouth or in or around your eyes. If you accidentally swallow it, call Poison Control at 1-800-222-1222 right away.
- Stop using docosanol (Abreva) and get medical help right away if you have signs of an allergic reaction. These include hives, swelling of the face, trouble breathing, severe rash, or feeling faint.
- Don't share docosanol (Abreva) with anyone since sharing can spread the infection.
- Cold sores are contagious until they are fully healed, which can take up to 3 weeks. Even while using docosanol (Abreva), avoid close contact like kissing when you have a sore.
- When using docosanol (Abreva), consider wearing a lip balm with SPF 30 or higher. Sunlight can trigger cold sores, so daily sun protection might help prevent outbreaks.
- Tell your primary care provider if your cold sore gets worse or isn't healed within 10 days of starting docosanol (Abreva).
- Store docosanol (Abreva) at room temperature. Don't freeze it or let it get hotter than 77°F.
How to apply:
- Wash your hands before using docosanol (Abreva) and remove any makeup from the area.
- Put a small amount of docosanol (Abreva) on the area of your lips or face where you feel tingling, itching, or see a sore.
- Gently rub it in with your fingertip or a cotton swab until it's fully covered. Wash your hands again after applying.
Risks and warnings for Docosanol (Abreva)
Docosanol (Abreva) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Allergic reaction
In rare cases, docosanol (Abreva) can cause an allergic reaction. Stop using it and contact your primary care provider right away if you have swelling of your face, hives, wheezing, trouble breathing, or a severe rash. These can be signs of a serious allergic reaction, and you might need a different treatment for your cold sore.
Docosanol (Abreva) dosage
The average cost for 1 tube of 2g of 10% of Docosanol (Abreva) is $14.91 with a free GoodRx coupon. This is 30.16% off the average retail price of $21.35.
Typical dosage for Docosanol (Abreva)
- People 12 years and older: Apply to the affected area on the face or lips at the first sign of a cold sore 5 times daily until healed.
- Children under 12 years old: Ask your child’s pediatrician.
Interactions between Docosanol (Abreva) and other drugs
Docosanol (Abreva) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Docosanol (Abreva). Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Docosanol (Abreva) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
What are alternatives to Docosanol (Abreva)?
There are a number of medications that your doctor can prescribe in place of Docosanol (Abreva). Compare a few possible alternatives below.
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