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Herpes Medications Comparison


Price-RX provides unique comparison of herpes medications. Usual price-per-pill comparisons are generally inconclusive. That is because different medicines require different intake schedules and the length of anti-infective treatment may vairy noticeably.

Currently, there are three oral prescription medicines approved by the U.S. FDA for the treatment of herpes simplex virus (HSV) infections:

  • Acyclovir (Zovirax) is the oldest and the cheapest antiviral drug. Has been used for many years and is widely available in generic form. Main disadvantage - frequent dosing.
  • Valacyclovir (Valtrex) is an "improved" version of acyclovir. Main advantage - convenient dosing, which leads to better compliance. Main disadvantage - it is quite expensive.
  • Famciclovir (Famvir) is a prodrug of penciclovir. When taken, the body converts famciclovir to the long acting penciclovir. Main disadvantage - expensive.

All three antivirals are almost similarly effective against HSV-1, HSV-2, and herpes zoster and are equally safe.

Important notes!

  • The provided "RX dosage regimens" are recommended for otherwise healthy adults. Your dosage may be different. Follow your doctor's instructions.
  • "Price per pill" is calculated for 30- or 90-pills package. The remaining/excess medication you can use for subsequent outbreaks.

Genital Herpes: Suppressive Therapy

In persons with more than 6 recurrences of genital herpes per year, chronic antiviral therapy may be prescribed to reduce recurrences. Suppressive therapy means taking an antiviral medication daily as a preventative to keep HSV under control, reduce the number of outbreaks and, sometimes, prevent them altogether. Suppressive therapy also reduces asymptomatic shedding, and helps prevent the transmission.

Efficacy: Famciclovir appears somewhat less effective for suppression of viral shedding [1]. Valacyclovir suppressive therapy has also been proven to reduce the risk of transmission to a partner.

Cost: The following cost comparison table is completed for 1 month (30 days) course. Suppressive therapy may last for up to 1 year. Generic Valtrex (Valacyclovir), available at International supplier, seems to be an optimal choice.

U.S. Pharmacy

RX Dosage regimen Treatment course
(1 month)
Price per pill Total cost* Order
Acyclovir 400 mg 400 mg twice daily 60 pills
2 pills x 30 days
$1 $60
Acyclovir 800 mg 400 mg twice daily
(split 800 mg tablet)
30 pills
1 pill x 30 days
$1.2 $36
Valtrex® 500 mg 500 mg daily (only for patients with ≤9 outbreaks per year)
30 pills
1 pill x 30 days
$10.9 $327
Valtrex® 1000 mg 500 mg daily for patients with ≤9 outbreaks per year (split 1000 mg tablet)
15 pills
1/2 of splitted pill x 30 days
$14.9 $223.5
Valtrex® 1000 mg 1000 mg daily for patients with >9 outbreaks per year 30 pills
1 pill x 30 days
$14.9 $447
Famciclovir 250 mg
(generic Famvir)
250 mg twice daily
60 pills
2 pills x 30 days
$6.8 $408
Famciclovir 500 mg
(generic Famvir)
250 mg twice daily
(split 500 mg tablet)
30 pills
1 pill x 30 days
$10.5 $314
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* FREE Prescription and telephone consultation with U.S. licensed doctor
FREE Priority Mail shipping (delivery in 2 days)

International Pharmacy

* "RX dosage regimen" indicates the most common recommendation for otherwise healthy adults. Your doctor may prescribe a different dosage.
** "Price per pill" is calculated for 90-pills package.

RX Dosage regimen* Treatment course
(1 month)
Price per pill** Total cost Order
Acyclovir 400 mg 400 mg twice daily 60 pills
2 pills x 30 days
$0.72 $73
Acyclovir 800 mg 400 mg twice daily
(split 800 mg tablet)
30 pills
1 pill x 30 days
$1.00 $30
Valacyclovir 500 mg (generic Valtrex) 500 mg daily
30 pills
1 pill x 30 days
$1.63 $49
Valacyclovir 1000 mg (generic Valtrex) 500 mg daily (split 1000 mg tablet)
15 pills
1/2 of splitted pill x 30 days
$1.63 $25

Genital Herpes: Treatment of Recurrent Outbreak

Episodic therapy means taking the drug only during an outbreak to speed up healing. Antiviral drugs work best if they are taken promptly during the prodromal stage (tingling and pain), just before blisters or sores appear. The healing time and severity of the first herpes episode can be dramatically reduced. The recurrent outbreak can be shortened by about two days.

Efficacy: Acyclovir, famciclovir, and valacyclovir appear equally effective for episodic treatment of genital herpes [2].

RX Dosage regimen Treatment course Price per pill Total cost* Order
Acyclovir 400 mg 400 mg 3 times daily for 5 days
or alternatively
800 mg twice daily for 5 days
15 pills
3 pills x 5 days
or
20 pills
4 pills x 5 days
$1 $15
or
$20
Acyclovir 800 mg 400 mg 3 times daily for 5 days (split 800 mg tablet)
or alternatively
800 mg twice daily for 5 days
8 pills
1.5 pills x 5 days
or
10 pills
2 pills x 5 days
$1.2 $9.6
or
$12
Valtrex® 1000 mg 1000 mg daily for 5 days 5 pills
1 pill x 5 days
$14.9 $74.5
Famciclovir 500 mg
(generic Famvir)
1000 mg 2 times daily for 1 day 4 pills
4 pills x 1 day
$10.5 $42
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* FREE Prescription and telephone consultation with U.S. licensed doctor
FREE Priority Mail shipping (delivery in 2 days)


Cold Sores (Herpes Labialis): Treatment of Outbreak

Although oral acyclovir regimen is not FDA-approved for cold sores, it is widely used off-label in practice [3].

RX Dosage regimen Treatment course Price per pill Total cost Order
Acyclovir 400 mg 400 mg 5 times daily for 5 days
25 pills
5 pills x 5 days
$1 $25
Acyclovir 800 mg 400 mg 5 times daily for 5 days (split 800 mg tablet) 13 pills
2.5 pills x 5 days
$1.2 $15.6
Valtrex® 1000 mg 2 g twice daily for 1 day 4 pills
4 pills x 1 days
$14.9 $59.6
Famciclovir 500 mg
(generic Famvir)
1.5 g as a single dose for 1 day 3 pills
3 pills x 1 day
$10.5 $31.5

References:

  • 1. Wald A, Selke S, Warren T, Aoki FY, Sacks S, Diaz-Mitoma F, Corey L. Comparative efficacy of famciclovir and valacyclovir for suppression of recurrent genital herpes and viral shedding. Sex Transm Dis. 2006 Sep;33(9):529-33. PubMed
  • 2. Diseases Characterized by Genital, Anal, or Perianal Ulcers CDC
  • 3. Spruance SL, Stewart JC, Rowe NH, McKeough MB, Wenerstrom G, Freeman DJ. Treatment of recurrent herpes simplex labialis with oral acyclovir. J Infect Dis. 1990 Feb;161(2):185-90. PubMed
  • 4. Rooney JF, Straus SE, Mannix ML, et al. Oral acyclovir to suppress frequently recurrent herpes labialis. A double-blind, placebo-controlled trial. Ann Intern Med. 1993;118(4):268–272.
  • 5. Baker D, Eisen D. Valacyclovir for prevention of recurrent herpes labialis: 2 double-blind, placebo-controlled studies. Cutis. 2003 Mar;71(3):239-42.

Last Updated: December 14, 2013



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