Cold Sore Treatment Options Table

Please note that the following contains information on prescription treatment options for cold sore treatment only. There are over-the-counter products available, please speak to your doctor or pharmacist before starting any treatment on your own.

Prescription Topical Agents

When it is used

Acyclovir/hydrocortisone topical cream

(Xerese® - pronounced 'Zer-reece')

Used to reduce the early signs and symptoms and progression of cold sore (to ulcerative lesions).

Acyclovir topical ointment

(Zovirax® - pronounced 'Zo-vi-rax')

Used to treat herpes simplex infections of the skin surrounding the lips in immunocompromised (e.g., patients who have HIV, or undergoing cancer treatment) patients.

How it works

Acyclovir/hydrocortisone topical cream

(Xerese® - pronounced 'Zer-reece')

This medication contains 2 components.

The first component - acyclovir - works by preventing the virus from replicating and spreading to nearby cells.

The second component - hydrocortisone - works by decreasing inflammation which helps the healing.

Acyclovir topical ointment

(Zovirax® - pronounced 'Zo-vi-rax')

Prevents the virus from replicating and spreading to nearby cells.

How to use it

Acyclovir/hydrocortisone topical cream

(Xerese® - pronounced 'Zer-reece')

Applied 5 times daily during waking hours for 5 days.

Acyclovir topical ointment

(Zovirax® - pronounced 'Zo-vi-rax')

Applied 4 to 6 times daily during waking hours for up to 10 days.

Adverse Effects

Acyclovir/hydrocortisone topical cream

(Xerese® - pronounced 'Zer-reece')

Can cause drying, flaking, tingling/burning sensation, redness, swelling, bitter taste after you applied the cream and change in colour of the skin where applied.

Speak to your doctor or pharmacist if you notice symptoms of hypercortisolism (symptoms include, round/red/full face, fat deposit between the shoulder blades, weight gain, weakness, backache, acne, thirst).

Stop using the medication and seek medical help immediately if you notice signs of allergic reactions (symptoms include swelling of tissue, red/inflamed skin) or skin infections.

Acyclovir topical ointment

(Zovirax® - pronounced 'Zo-vi-rax')

Can cause discomfort, mild pain, temporary burning/stinging, itching, and rash.

Stop using the medication and seek medical help immediately if you notice signs of allergic reactions (symptoms include swelling of tissue, red/inflamed skin) and angioedema (symptoms include swelling of eyes/lips, hands/feet, and throat).

Prescription Oral Agents

When it is used

Famciclovir

(Famvir® - pronounced 'Fam-veer' and generics)

Used for treatment of recurring episodes of herpes simplex infections of the mucous membrane and skin in HIV-infected patients.

Valacyclovir

(Valtrex® - pronounced 'Val-trex' and generics)

Used for treatment of cold sores.

How it works

Famciclovir

(Famvir® - pronounced 'Fam-veer' and generics)

Prevents the virus from replicating and spreading to nearby cells.

Valacyclovir

(Valtrex® - pronounced 'Val-trex' and generics)

Prevents the virus from replicating and spreading to nearby cells. It reduces the number of painful blisters and helps them heal more quickly.

How to use it

Famciclovir

(Famvir® - pronounced 'Fam-veer' and generics)

Taken orally once or twice a day for 7 days.

Valacyclovir

(Valtrex® - pronounced 'Val-trex' and generics)

Taken orally twice a day for 1 day.

Adverse Effects

Famciclovir

(Famvir® - pronounced 'Fam-veer' and generics)

Side effects can include feeling sick, headache, confusion, dizziness, drowsiness (usually in older people), hallucinations, vomiting, yellowing of the skin and/or eyes, abnormal liver function test results, abnormal heartbeat, skin rash, itching or blistering, diarrhea, tiredness, and abdominal pain.

Stop using the medication immediately and seek medical help if you notice signs of serious skin reaction (symptoms include severe itching, blistering, swelling of tissue such as face, mouth, eyes, throat, skin, hands, and feet), unexplained bruising, reddish/purplish patches on skin, nosebleeds.

Valacyclovir

(Valtrex® - pronounced 'Val-trex' and generics)

Side effects can include nausea, vomiting, diarrhea, stomach pains, mild headache.

Stop using the medication immediately and seek medical help if you notice skin rash, pain in the side between ribs and hip or kidney area, issues with platelets (symptoms include abnormal bruising/bleeding, fever, fatigue, headache, confusion, numbness, paralysis), anemia (symptoms include bloody diarrhea, abdominal pain, dizziness, confusion, and swelling of hands and feet), or central nervous system issues (symptoms include confusion, dizziness, agitation, and hallucination). This medication can also alter liver function tests.