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Zovirax vs Abreva
Introduction
For patients suffering from herpes labialis, commonly known as cold sores, certain antiviral drugs that inhibit the replication of herpes simplex virus can help in reducing the duration and severity of symptoms. Zovirax (Acyclovir) and Abreva (Docosanol) are two such medications that are often used to treat cold sores. They function differently but both have proven efficacy in managing this condition. Zovirax is an antiviral drug that works by inhibiting a viral enzyme called DNA polymerase, thereby preventing the herpes simplex virus from replicating and spreading further. On the other hand, Abreva is classified as a long-chain saturated alcohol which functions by blocking the virus from entering healthy cells thus limiting its spread.
Zovirax vs Abreva Side By Side
| Attribute | Zovirax | Abreva |
|---|---|---|
| Brand Name | Zovirax | Abreva |
| Contraindications | Known hypersensitivity to acyclovir or any of the ingredients. Potential interactions with drugs like probenecid or tenofovir. | Known hypersensitivity to docosanol or any of the ingredients. |
| Cost | Approximately $600 for a 15 gm tube of 5% cream; generic acyclovir can be found for approximately $3 per gram. | About $18 for a 2 gm tube, working out to roughly $9 per gram. |
| Generic Name | Acyclovir | Docosanol |
| Most Serious Side Effect | Severe skin reaction: fever, sore throat, burning in your eyes; skin pain followed by a red or purple skin rash that spreads and causes blistering and peeling. | Indications of an allergic response or severe skin reaction such as hives, itching, fever, swollen lymph nodes, difficulty breathing or swelling in your face or throat. |
| Severe Drug Interactions | Probenecid, tenofovir | No reported severe drug interactions due to its over-the-counter status and mechanism of action. |
| Typical Dose | 200 mg five times per day for up to ten days for cold sores. | Apply to the affected area five times a day, at approximately 3-hour intervals during waking hours, until symptoms have fully healed. |
What is Zovirax?
Acyclovir (the generic name for Zovirax) was the first antiviral drug to be developed as a treatment for viral infections such as herpes simplex and shingles. Acyclovir was approved by the FDA in 1981, making it a revolutionary development in comparison to topical treatments previously available. Zovirax works by preventing viruses from dividing and proliferating, effectively limiting their ability to spread within the body. It is prescribed primarily for treating outbreaks of genital herpes but can also be used against cold sores, shingles and chickenpox. In contrast, Docosanol (commonly known under the brand name Abreva) is an over-the-counter medication specifically designed for fast relief of cold sore symptoms. Its primary action is to prevent healthy cells from being infected by blocking the virus on your skin's surface where it attempts to penetrate into your body.
What conditions is Zovirax approved to treat?
Zovirax is approved for the treatment of different forms of herpes:
- Genital Herpes: Initial episode
- Herpes Simplex Encephalitis
- Herpes Simplex Labialis (Cold Sores)
- Mucocutaneous/Immunocompromised, HSV Infections It can also be used in the prophylaxis of recurrent genital herpes infections and prevention of CMV disease following organ transplantation.
How does Zovirax help with these illnesses?
Zovirax, also known as acyclovir, helps to manage herpes outbreaks by inhibiting the replication of viral DNA. It does this by interfering with the virus's DNA polymerase, an essential enzyme that viruses use to copy their genetic material during replication. This interruption in the replication process means that the virus cannot spread and infect more cells. Acyclovir is a nucleoside analogue, a type of medication that mimics one of the building blocks needed for DNA synthesis.
On the other hand, Abreva (docosanol) works slightly differently; it interferes with how viral particles fuse with human cells' membranes — an early step in how these pathogens establish infection. By blocking this interaction, docosanol prevents new sores from forming and existing sores from worsening.
Both Zovirax and Abreva are used topically on cold sores or fever blisters caused by HSV-1 (Herpes Simplex Virus Type 1), but they work at different stages of viral reproduction.
What is Abreva?
Abreva is the brand name for docosanol, which is an over-the-counter (OTC) treatment for cold sores. It works differently than antiviral medications like Zovirax by blocking the virus that causes cold sores (Herpes Simplex Virus type 1, HSV-1) from entering healthy skin cells and growing in number.
Docosanol was approved by the FDA in 2000 and it's applied topically to prevent the spread of the virus rather than killing it directly. Unlike Zovirax, Abreva does not require a prescription.
Its unique approach means its side-effect profile is also different compared to antiviral drugs such as Zovirax. The most common side effects are skin irritation or rash where Abreva has been applied. However, these side effects are typically mild and temporary.
The action of docosanol can be beneficial especially when first signs of a cold sore appear such as tingling, itching or redness since this medication may help reduce your symptoms and shorten healing time.
What conditions is Abreva approved to treat?
Abreva is an over-the-counter medication that's approved by the FDA for the treatment of cold sores, also known as fever blisters. It contains a unique active ingredient called docosanol, which works to block the virus that causes cold sores from penetrating into healthy skin cells. This makes Abreva particularly effective at both reducing symptoms and speeding up healing time when applied at the first sign of a cold sore outbreak.
How does Abreva help with these illnesses?
Abreva, known generically as docosanol, is an over-the-counter medication used to alleviate the discomfort and shorten the duration of oral herpes outbreaks, commonly referred to as cold sores. Docosanol works by inhibiting the fusion of human host cells with viral envelopes, essentially blocking the virus from entering cells and further spreading. This action helps to speed up healing time while reducing symptoms such as itching, tingling and pain associated with these lesions. In comparison to Zovirax (acyclovir), which requires a prescription and functions by interfering within viral DNA replication process after the virus has entered a cell, Abreva can be seen as more proactive in its method of treatment. Since it acts directly on skin surface level before penetration occurs - it's often preferred for those seeking immediate relief without needing doctor's approval.
How effective are both Zovirax and Abreva?
Both acyclovir (Zovirax) and docosanol (Abreva) have established histories of success in treating patients with cold sores, and they were initially approved by the FDA just a few years apart. Since they act on different aspects of the herpes simplex virus replication process, they may be prescribed under different circumstances. The effectiveness of acyclovir and docosanol in alleviating cold sore symptoms was directly studied in several clinical trials; the two drugs exhibited similar efficacy in managing symptoms as well as similar safety profiles.
A 2010 review demonstrated that acyclovir is effective at reducing both healing time and pain associated with cold sores when treatment is started at an early stage. Its side effect profile is favorable over many other antiviral treatments, making it a popular choice among healthcare professionals worldwide. As one of the first antiviral medications developed for this purpose, there's substantial historical data supporting its effectiveness.
On the other hand, a 2001 study indicated that docosanol seems to offer relief from cold sore symptoms more rapidly than placebo if applied during earliest stages of symptom onset - particularly within 12 hours after noticing tingling or discomfort indicating an upcoming outbreak. However, like acyclovir, docosanol is typically considered most effective when used immediately after initial signs or symptoms are noticed. Significant research has been done regarding its use alone rather than alongside another antiviral medication like Zovirax; hence data confirming its efficacy as adjunctive therapy isn't robust yet. Nonetheless due to its unique mechanism of action- which involves inhibiting fusion between human cells and viral envelopes- Docosanol can be an optimal treatment for those who prefer topical solutions or want to avoid systemic effects associated with oral medications.
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At what dose is Zovirax typically prescribed?
Dosages of Zovirax (acyclovir) depend on the condition being treated, but for cold sores, a typical dosage is 200 mg five times per day for up to ten days. For children under twelve years old, the dose must be determined by their doctor. On the other hand, Abreva (docosanol) is an over-the-counter medication applied topically at the first sign of a cold sore and then used five times daily until it heals. It's suitable for adults and children aged 12 or above; however, those under 12 should only use it under medical supervision. The maximum application period should not exceed ten days in any case.
At what dose is Abreva typically prescribed?
Abreva treatment for cold sores typically begins with applying the cream to the affected area five times a day, until your symptoms have fully healed. This should be done at approximately 3-hour intervals during waking hours. It is crucial to start this regimen at the first sign of a cold sore outbreak, such as itching, tingling or redness around the lips. Application can continue until the lesion has completely disappeared. However, if there's no noticeable improvement in your condition after using Abreva consistently for 10 days, it would be advisable to consult with a healthcare professional about other potential treatments.
What are the most common side effects for Zovirax?
Common side effects of Zovirax (acyclovir) include:
- Nausea or vomiting
- Diarrhea
- Headache
- Dizziness
- Tiredness
- Muscle or joint aches
- Visual changes
On the other hand, Abreva (docosanol topical) has fewer potential side effects, they may include:
- Dryness and tightness of skin where applied
- Temporary burning or stinging at the application site
It's important to remember everyone reacts differently to medications and these lists are not exhaustive. If you experience any severe reactions, seek medical assistance immediately.
Are there any potential serious side effects for Zovirax?
While both Zovirax and Abreva are used as topical treatments for cold sores, they can occasionally cause side effects. It's essential to monitor for these symptoms:
- Signs of allergic reactions include hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
- Skin irritation at the application site: redness, dryness or flaking skin.
- In rare cases with Zovirax use, severe skin reaction: fever, sore throat, burning in your eyes; skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
- Changes in vision such as blurred vision
- Rarely it may cause rapid heartbeats
- If you're using an oral form of Zovirax watch out for signs like nausea/vomiting that don't stop.
These lists do not cover all possible side effects. If you notice other unusual symptoms after starting treatment with either drug - especially those causing discomfort - consult your healthcare professional promptly. Always remember to use medications as directed by a healthcare provider.
What are the most common side effects for Abreva?
Abreva, an over-the-counter medication used for cold sores, has fewer side effects than Zovirax. However, some users have reported:
- Mild skin irritation
- Changes in taste sensation
- Headache Please remember that these symptoms are typically minimal and temporary. If you notice severe symptoms or reactions such as swelling of the face/lips/tongue/throat, difficulty breathing or rash after using Abreva, seek immediate medical attention as it can be a sign of allergic reaction.
Are there any potential serious side effects for Abreva?
While Abreva is generally considered safe, it may cause certain side effects in a small number of users. If you experience any of the following symptoms after using Abreva, discontinue its use and seek medical attention immediately:
- Indications of an allergic response or severe skin reaction such as hives, itching, fever, swollen lymph nodes, difficulty breathing or swelling in your face or throat
- Unusual changes in mood or behavior
- Severe skin rash with blistering and peeling at the site of application
- Signs suggestive of an eye infection including blurry vision, eye pain or swelling
- Rapid heartbeat that was not present before usage
Remember to always consult with your healthcare professional if you're unsure about potential side effects when beginning a new medication.
Contraindications for Zovirax and Abreva?
Both Zovirax and Abreva are antiviral medications used to treat cold sores caused by the herpes simplex virus. If you observe that your symptoms are worsening, or if the cold sore does not improve within 2 weeks of treatment, please seek immediate medical attention.
Neither Zovirax nor Abreva should be used if you have a known hypersensitivity to any of their ingredients. Always inform your physician about all medications and supplements you are currently taking; this includes over-the-counter products as well as prescribed ones.
Zovirax (acyclovir) is a prescription medication and has potential interactions with other drugs such as probenecid or tenofovir, which can affect how acyclovir works in your body. On the other hand, Abreva (docosanol) is an over-the-counter medication and is generally considered safe with few reported drug interactions. However, it's always best practice to inform healthcare professionals about all substances you're consuming for optimal safety.
How much do Zovirax and Abreva cost?
For the brand name versions of these drugs:
- The price of 15 gm tube of Zovirax cream (5%) averages around $600, which works out to approximately $40 per gram.
- The price for a tube of Abreva (2 gm) is about $18, working out to roughly $9 per gram.
Thus, on a per gram basis, brand-name Zovirax is significantly more expensive than Abreva. However, cost should not be your primary consideration in determining which drug is right for you; efficacy and safety are also crucial factors.
Regarding the generic version of these medications:
-
Acyclovir (the active ingredient in Zovirax) comes as a 5% cream in tubes ranging from 2 - 30 grams with costs varying widely depending on size and vendor but can be found for approximately $3 per gram.
-
Docosanol (the active ingredient in Abreva) doesn't have an exact generic equivalent due to its over-the-counter status. Still, other non-prescription cold sore treatments may provide similar relief at potentially lower prices depending upon individual needs and response.
Popularity of Zovirax and Abreva
Acyclovir, in generic form as well as brand names such as Zovirax, is a widely used antiviral drug specifically designed to combat herpes simplex viruses. In 2020, it was estimated that approximately 3 million people in the US received prescriptions for acyclovir. Acyclovir accounted for nearly 15% of all antiviral medications prescribed in the US and has seen a steady increase in prevalence since its introduction.
On the other hand, Docosanol (brand name Abreva) is an over-the-counter medication commonly used to treat cold sores caused by the herpes simplex virus. As an OTC product, exact prescription numbers are not available but it remains one of the most popular choices among consumers for topical treatment of cold sores due to its accessibility and proven effectiveness. The prevalence of docosanol usage has remained consistent throughout recent years.
Conclusion
Both Zovirax (acyclovir) and Abreva (docosanol) have a well-established history of use in the treatment of cold sores, supported by numerous clinical studies demonstrating their effectiveness over placebo treatments. These two medications work differently: Zovirax is an antiviral medication that halts the replication of herpes simplex virus cells involved in cold sore outbreaks, while Abreva acts as a barrier to healthy skin cells, preventing the virus from entering them.
Zovirax usually serves as a first-line treatment option due to its potent antiviral properties, but it requires prescription. On the other hand, Abreva can be purchased over-the-counter without needing a doctor's prescription and is typically used when symptoms are initially detected or if patients prefer non-prescription options.
Both drugs come in generic versions which provide considerable cost savings for patients paying out-of-pocket. Like most medications, both Zovirax and Abreva may take some time before they begin showing noticeable effects.
Side effects with both drugs are generally mild; however, they should be used cautiously under medical supervision. Patients using either drug need to follow instructions carefully to avoid worsening symptoms or developing adverse reactions.
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Refrences
- McKeough, M. B., & Spruance, S. L. (2001, September 1). Comparison of New Topical Treatments for Herpes Labialis. Archives of Dermatology. American Medical Association (AMA).http://doi.org/10.1001/archderm.137.9.1153
- Moomaw, M. D., Cornea, P., Rathbun, R. C., & Wendel, K. A. (2003, July). Review of antiviral therapy for herpes labialis, genital herpes and herpes zoster. Expert Review of Anti-infective Therapy. Informa UK Limited.http://doi.org/10.1586/14787210.1.2.283
- Gnann, J. W., Jr., Barton, N. H., & Whitley, R. J. (1983, September 10). Acyclovir: Mechanism of Action, Pharmacokinetics, Safety and Clinical Applications. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. Wiley.http://doi.org/10.1002/j.1875-9114.1983.tb03274.x
- Fletcher, C., Bean, B., & McLeod, D. C. (1985, July). Evaluation of Oral Acyclovir Therapy. Drug Intelligence & Clinical Pharmacy. SAGE Publications.http://doi.org/10.1177/106002808501900703