The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Cold sores usually heal on their own within 7-20 days. Medications for the treatment of cold sores do not cure or rid the body of the virus. They are intended to reduce the number of days an outbreak may last and to reduce the discomfort of the outbreak.

Prescription Medications

Antiviral Agents

  • Acyclovir (Zovirax)
  • Famciclovir (Famvir)
  • Penciclovir (Denavir)
  • Valacyclovir (Valtrex)

Over-the-Counter Medications

Antiviral Agents

  • Docosanol cream (Abreva)

Pain Relievers

  • Acetaminophen (Aceta, Apacet, Feverall, Panadol, Tylenol)
  • Ibuprofen (Advil, Dolgesic, Genpril, Ibuprin, Motrin, Nuprin, Rufen)

Cold Sore Creams

  • Herpecil-L

Antibiotic Ointments

  • Neosporin
  • Polysporin

Anesthetic Ointments

  • Benzocaine (Americaine Topical Anesthetic, Lagol)

Prescription Medications

Antiviral Agents

Common names include:

Antivirals slow the growth and spread of the virus so that the body can fight it more effectively. They work best if started before the sore breaks out, when there is a tingling or burning sensation in the skin.

Acyclovir may be given for the first or later outbreak of cold sores. It is available as a pill and ointment (for later outbreaks). The ointment form may not work as well for cold sores, but may be helpful for genital herpes . The oral form may help to shorten outbreaks, but newer medications may work better.

Famciclovir and valacyclovir are the newer versions of acyclovir and do not have to be taken in as large doses or as frequently.

Penciclovir is an ointment that helps reduce the discomfort and length of an outbreak. The cream is applied to the area as soon as the first signs of an outbreak appear. It is used only on the face and lips—not the inside of the mouth and nose or around the eyes.

Side effects are rare, but may include:

  • Allergic reaction (rash, swelling of the face, difficulty breathing)
  • Decreased urine production
  • Unusual bleeding or bruising
  • Upset stomach, decreased appetite
  • Headache
  • Local numbness or tingling in area of application

Over-the-Counter Medications

Antiviral Agents

Common names include:

  • Docosanol (Abreva)

Docosanol is an ointment that helps reduce the discomfort and number of days of an outbreak. It is similar in its action to the prescription antiviral cream, but it is sold over-the-counter. The cream is applied to the area as soon as the first signs of an outbreak appear. It is used only on the face and lips—not the inside of the mouth and nose or around the eyes.

Possible side effects include:

  • Headaches
  • Allergic reaction (rash, swelling of the face, difficulty breathing)

Pain Relievers

Common names include:

  • Acetaminophen (Aceta, Apacet, Feverall, Panadol, Tylenol)
  • Ibuprofen (Advil, Dolgesic, Genpril, Ibuprin, Motrin, Nuprin, Rufen)

Pain relievers will help relieve the pain that accompanies a cold sore outbreak. They are taken as-needed basis. The dose depends on the amount of pain you are having. For severe pain and inflammation, ibuprofen is available in higher doses by prescription. Ibuprofen should be taken with food or a full glass of water.

Possible side effects include:

  • Headache
  • Upset stomach

Cold Sore Creams

Common brand names include:

  • Herpecil-L

Cold sore creams and ointments can help protect the lips and reduce the discomfort of a cold sore outbreak. These medications usually contain sunscreen. Other ingredients may include: lysine (an amino acid that may help reduce the length of cold sore outbreaks), vitamins, and some type of soothing balm as a base. They can be applied every hour, especially while outdoors. These products can be found in most drugstores.

Antibiotic Ointments

Common brand names include:

  • Neosporin
  • Polysporin

Antibiotic ointments contain one or a combination of antibiotics that are sometimes effective in fighting bacterial skin infections. Cold sores are caused by a virus, not a bacteria, but these ointments may be used to help treat a secondary bacterial infection. They are applied, with clean hands, directly to the cold sore. They should not be used inside the mouth or too near the eyes. Use only as directed. Possible side effects include skin irritation or allergy.

Anesthetic Ointments

Common names include:

  • Benzocaine (Americaine Topical Anesthetic, Lagol)

Anesthetic ointments work by numbing the area of the cold sore. This helps relieve the pain. Dry the area well before applying the ointment, and apply no more than four times per day. Side effects rarely occur.

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Know what the results and side effects. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.