1. About aciclovir
Aciclovir (or acyclovir) is an antiviral medicine.
It treats infections caused by the herpes virus (herpes simplex), including:
Your doctor may prescribe aciclovir to prevent you getting these infections if you have had them before or you have a weak immune system.
Aciclovir is available on prescription. It comes as tablets, a liquid that you drink and a cream.
It's sometimes given by injection, but this is usually only done in hospital.
You can buy aciclovir cold sore cream at most pharmacies and supermarkets without a prescription.
2. Key facts
- Start taking aciclovir as soon as you get the first signs of infection.
- For most infections, you should start to feel better after taking aciclovir for a few days.
- Common side effects include headaches, dizziness, and feeling or being sick.
- Wash your hands before and after using the cream.
- Brand names include Zovirax, Cymex Ultra and Virasorb.
3. Who can and cannot take aciclovir
Aciclovir can be taken by most adults and children.
Aciclovir is not suitable for some people.
To make sure aciclovir is safe for you, tell your doctor if you:
- have had an allergic reaction to aciclovir or any other medicine in the past
- have kidney problems
- are over 65 years old
- are pregnant, trying to get pregnant or breastfeeding
If your immune system is weakened (for example, if you have HIV or AIDS, or you have had a bone marrow transplant), talk to your doctor about the best type of aciclovir for you.
They may recommend tablets rather than the cream.
4. How and when to take it
It's important to start taking (or using) this medicine as soon as you get the first signs of infection.
A cold sore usually starts with a tingling, itching or burning feeling.
Aciclovir tablets and liquid
Doses will vary, depending on why you're taking aciclovir. Your doctor will tell you how much to take and how often.
A single dose is generally between 200mg and 800mg, and may be lower for children.
You'll usually take aciclovir 2 to 5 times a day. Try to space the doses evenly throughout the day.
If you take aciclovir:
- 4 times a day – you could take it first thing in the morning, at midday, in the late afternoon and at bedtime
- 5 times a day – for example, you could take it at 7am, 11am, 3pm, 7pm and 11pm
You can take aciclovir with or without food. Drink plenty of water while taking this medicine to help keep your kidneys working well.
Keep taking the medicine until it's all finished or until your doctor or pharmacist tells you to stop taking it.
For treating a viral infection, you'll usually take aciclovir for 5 to 10 days. For prevention, you may need to take it for a long time.
Tablets: swallow the tablets whole with some water. If you find tablets difficult to swallow, you can dissolve them in water. Add a tablet to a small glass of water and stir. Drink all the liquid to make sure you get the full dose.
Liquid: use the measuring spoon or plastic syringe that came with your medicine. If you do not have a measuring spoon or syringe, ask your pharmacist for one. Do not use a kitchen teaspoon as you will not get the right amount of medicine.
Cream for cold sores
Wash your hands before and after using the cream.
Put a thin layer of cream on the cold sore 5 times a day. Do this every 4 hours – for example, at 7am, 11am, 3pm, 7pm and 11pm.
Do not put aciclovir cream in your mouth, eyes or vagina.
Use the cream for at least 4 days. If the cold sore has not healed by then, you can carry on using the cream for another 6 days.
If the sore still has not healed after a total of 10 days, stop using the cream and tell your doctor.
Cream for genital herpes
Wash your hands before and after using the cream.
Put a thin layer of cream on the affected area 5 times a day. Do this every 4 hours – for example, at 7am, 11am, 3pm, 7pm and 11pm.
Use the cream for at least 5 days. If the genital herpes sore has not healed by then, you can carry on using the cream for another 5 days.
If the affected area has still not healed after a total of 10 days, stop using the cream and tell your doctor.
What if I forget a dose of aciclovir?
If you forget a dose of aciclovir, take it (or use the cream) as soon as you remember, unless it's nearly time for your next dose. In this case, just skip the missed dose and continue with your next one as normal.
Never have 2 doses at the same time. Never have an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you.
You could also ask your pharmacist for advice on other ways to remember your medicines.
What if I take or use too much?
Taking too much aciclovir by accident is unlikely to harm you, unless you take too much over several days.
Talk to your doctor or pharmacist if you're worried that you have had too much aciclovir.
5. Side effects
Like all medicines, aciclovir can cause side effects in some people, although not everyone gets them.
Many people have no side effects at all, or only minor ones.
Common side effects (tablets and liquid)
These common side effects happen in more than 1 in 10 people who take aciclovir tablets or liquid.
Keep taking the medicine, but talk to your doctor or pharmacist, if these side effects bother you or do not go away:
- feeling dizzy
- feeling or being sick (nausea or vomiting)
- skin being sensitive to sunlight
Common side effects (cream)
The cold sore cream is generally very safe and less than 1 in 100 people experience any side effects.
Keep using the medicine, but talk to your doctor or pharmacist, if these uncommon side effects bother you or do not go away:
- burning or stinging for a short time after applying the cream
- itchy, dry or flaky skin
Serious allergic reaction
In rare cases, aciclovir can cause a serious allergic reaction (anaphylaxis).
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of aciclovir.
For a full list, see the leaflet inside your medicines packet.
You can report any suspected side effect to the UK safety scheme.
6. How to cope with side effects
What to do about:
- headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Paracetamol is safe to take with aciclovir if you need a painkiller. Speak to your doctor if this does not help or your headaches are severe.
- feeling dizzy – if aciclovir makes you feel dizzy, stop what you're doing and sit or lie down until you feel better. Do not drive, ride a bike, or use tools or machinery if you feel dizzy.
- feeling or being sick (nausea or vomiting) – stick to simple meals and do not eat rich or spicy food. It might help to take your medicine after you have eaten. If you're being sick, try small, frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.
- diarrhoea – drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
- skin being sensitive to sunlight – stay out of bright sun and use a high factor sun cream (SPF 15 or above) even on cloudy days. Do not use a sun lamp or sun beds.
- burning or stinging feeling after applying the cream – this usually goes away after a short time. Ask a pharmacist or your doctor for advice if it continues to be a problem.
- itchy, dry or flaking skin – try using an unscented moisturiser. Do not apply the moisturiser at the same time as your aciclovir cream.
7. Pregnancy and breastfeeding
It's usually safe to use the cream or take aciclovir during pregnancy.
Speak to your doctor, who'll be able to explain the benefits and the risks of taking aciclovir when pregnant.
They can help you decide on the best treatment for you and your baby.
For more information about how aciclovir can affect you and your baby during pregnancy, read this leaflet on the best use of medicines in pregnancy (bumps) website.
Aciclovir and breastfeeding
It's usually safe to breastfeed while taking aciclovir.
If you're taking the tablets or liquid, some of the medicine passes into your breast milk.
This is in small amounts and is unlikely to harm your baby.
Talk to your doctor if you want to breastfeed while taking aciclovir. They can advise you on what's best for you and your baby.
Tell your pharmacist or doctor if you're trying to get pregnant, already pregnant or breastfeeding.
8. Cautions with other medicines
Some medicines can affect the way aciclovir tablets or liquid work. They can also make you more likely to get side effects.
If you're using aciclovir cream on your skin, this is less likely to react with other medicines.
It's important to tell your doctor if you take any of the following medicines before taking aciclovir:
- cimetidine, a medicine for stomach ulcers
- mycophenolate mofetil, a medicine given after organ transplants
- probenecid, a medicine for gout
- aminophylline or theophylline, medicines for asthma
Mixing aciclovir with herbal remedies and supplements
There's very little information about taking herbal remedies and supplements while taking or using aciclovir.
For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.
9. Common questions
How does it work?
Aciclovir stops the herpes virus growing and spreading.
This controls the infection and helps your body's immune system deal with it.
No medicine or treatment will remove the herpes virus from your body completely.
How long does it take to work?
You should start to feel better after taking or using aciclovir for a few days.
What can I do if the treatment is not working?
Tablets and liquid
If you're not feeling better after you finish your prescribed course of aciclovir, tell your doctor.
If your symptoms get worse at any time during your treatment, speak to your doctor.
They may want to increase your dose of aciclovir.
Cream for genital herpes
If your genital herpes sore is not better after 5 days, you can use the cream for another 5 days.
If the infection gets worse at any time or the sore still has not healed after 10 days, speak to your doctor.
Cold sore cream
If your cold sore has not healed after 4 days, you can carry on using the cold sore cream for another 5 days.
If your cold sore still has not healed after this or it gets worse at any time, stop using the cream and speak to your doctor.
Can I drive or ride a bike?
Some people feel dizzy when taking aciclovir tablets or liquid. This may make it more difficult to concentrate and react.
Do not drive or use any tools or machines if you're affected.
Can I drink alcohol with it?
Yes, you can drink alcohol while taking aciclovir.
Can I have sex while I'm taking aciclovir?
If you have been prescribed aciclovir for genital herpes, do not have sex until all your sores or blisters have healed.
It's important to always use a condom when having sex, even after your symptoms have gone.
If you or your partner have cold sores, avoid kissing and oral sex until the sores have healed.
This reduces the risk of passing the infection on to your partner.
Will aciclovir affect my contraception?
But if aciclovir makes you get sick or have severe diarrhoea (6 to 8 watery poos in 24 hours) for more than 24 hours, your contraceptive pills may not protect you from pregnancy.
Look on the pill packet to find out what to do.
Will it affect my fertility?
There's no firm evidence that aciclovir will affect fertility in either men or women.
Can lifestyle changes prevent cold sores or herpes infections?
Try to avoid or manage the things that trigger the herpes virus.
- stress – try to reduce physical and emotional stress
- being overtired – make sure you get enough sleep and eat a healthy, balanced diet
- strong sunlight and ultraviolet light – use a lip balm with SPF 15 or higher and avoid using sunbeds