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13.10.3 Antiviral preparations

1st choiceNo treatment

Aciclovir cream 5%

(encourage OTC purchase)

Apply to lesions every 4 hours (5 times daily) for 5-10 days, starting at first sign of attack

Prescribing Notes

  • Topical antiviral preparations should not be routinely prescribed. They only reduce mean duration of an episode by less than a day and need to be initiated at the onset of symptoms before vesicles appear.
  • Topical aciclovir is available over the counter and can be used by people who find it helpful.
  • Systemic treatment is necessary for buccal or vaginal infections and for herpes zoster (shingles).
  • Consider oral antiviral treatment for people with persistent, severe or prolonged episodes of recurrent labial herpes simplex infections.