docosanol
Regulatory sources consulted
Approved indications
- Treatment of recurrent cold-sore episodes from the prodrome or erythema stage in immunocompetent adults and adolescents aged 12 years and older.
Contraindications
Absolute
- Hypersensitivity to docosanol or any excipient.
Clinical warnings
- Avoid contact with the eyes. Not recommended in immunocompromised people or once a blister or ulcer has formed. — CIMA/AEMPS, ficha técnica 79372
- Propylene glycol in the formulation may cause skin irritation. — CIMA/AEMPS, ficha técnica 79372
Drug interactions
- LowOther skin products on the same area
Mechanism: Simultaneous use on the same area has not been studied.
Recommendation: Do not apply other medicines or cosmetics to the lesion at the same time.
CIMA/AEMPS, ficha técnica 79372https://cima.aemps.es/cima/dochtml/ft/79372/FT_79372.html
Adverse events
Common (≥1%)
Headache · Application-site dryness or rash
Pregnancy and lactation
It may be used during pregnancy and breastfeeding.
Recent literature (PubMed)
Herpes Simplex Virus (HSV) infections, caused primarily by HSV-1 and HSV-2, are among the most prevalent viral diseases worldwide, with recurrent manifestations that significantly affect quality of life. Therapeutic strategies include both topical and systemic interventions, each with distinct goals. This systematic review was conducted according to PRISMA guidelines. A comprehensive search of PubMed, Scopus, and Web of Science (2005-2025) identified studies evaluating topical or systemic treatments for HSV. Eligible studies included randomized controlled trials and observational studies reporting validated clinical outcomes. Topical treatments, including acyclovir cream, docosanol, and newer formulations, primarily reduce lesion duration and alleviate local symptoms when applied early. These interventions have limited systemic absorption and generally do not influence recurrence frequency. Novel delivery methods and combination strategies, such as acyclovir-hydrocortisone formulations or photodynamic therapy, may enhance local efficacy and symptom control. Systemic Therapies: Systemic antivirals, such as acyclovir, valacyclovir, and famciclovir, target both lesion resolution and recurrence prevention. Evidence from randomized trials supports their use for episodic and suppressive therapy, including short-course, high-dose regimens that improve adherence while controlling symptoms. Systemic therapy is particularly indicated for recurrent, disseminated, or high-risk infections. Topical and systemic therapies serve complementary roles in HSV management. Topical agents are useful for localized or initial episodes, while systemic therapy addresses broader clinical objectives, including recurrence reduction. Future research should focus on mechanism-based therapies, novel delivery systems, and standardized outcome measures to guide personalized treatment strategies. Emerging therapies targeting viral latency, immune modulation, and gene-editing technologies hold promise
This review article describes the current knowledge about the use of antiviral chemotherapeutics in avian species, such as farm poultry and companion birds. Specific therapeutics are described in alphabetical order including classic antiviral drugs, such as acyclovir, abacavir, adefovir, amantadine, didanosine, entecavir, ganciclovir, interferon, lamivudine, penciclovir, famciclovir, oseltamivir, ribavirin, and zidovudine, repurposed drugs, such as ivermectin and nitazoxanide, which were originally used as antiparasitic drugs, and some others substances showing antiviral activity, such as ampligen, azo derivates, docosanol, fluoroarabinosylpyrimidine nucleosides, and novel peptides. Most of them have only been used for research purposes and are not widely used in clinical practice because of a lack of essential pharmacokinetic and safety data. Suggested future research directions are also highlighted.