Dosing:   Topical. Apply to cold sore lesions 5 times per day until healed (maximum 10 days), starting within 2 hours of the first sign or symptom.  Must be taken at the first sign or symptom of a cold sore before visible symptoms, for the drug to work.  Preferably should be taken in the first hours after a tingle.

Efficacy:
       Duration: Reduces duration of outbreaks by about half a day, from about 5 days to about 4.5 days.

 

       Severity of outbreaks: Does not reduce severity of an outbreak.
 

       Prevention: ABREVA is not approved for prevention of outbreaks.
 

      

Mechanism of Action: Docosanol works by inhibiting fusion between the human cell plasma membrane and the herpes simplex virus (HSV) envelope, thereby preventing viral entry into cells and subsequent viral replication.

 

Side Effects:  May cause dryness at the application site.

 

References:

Drugbank online. https://go.drugbank.com/drugs/DB00632

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Drugs.com docosanol monograph https://www.drugs.com/monograph/docosanol.html

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Sacks SL, Thisted RA, Jones TM, Barbarash RA, Mikolich DJ, Ruoff GE, Jorizzo JL, Gunnill LB, Katz DH, Khalil MH, Morrow PR, Yakatan GJ, Pope LE, Berg JE; Docosanol 10% Cream Study Group. Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: A multicenter, randomized, placebo-controlled trial. J Am Acad Dermatol. 2001 Aug;45(2):222-30. doi: 10.1067/mjd.2001.116215. PMID: 11464183. https://pubmed.ncbi.nlm.nih.gov/11464183/