brand name | preparation | manufacturer | route | form | dosage^ | cost* |
Abreva | Docosanol | GlaxoSmithKline | topical | cream | 10% (2g) | $16.05 |
*Prices represent cost per unit specified, are representative of "Average Wholesale Price" (AWP).
^Dosage is indicated in mg unless otherwise noted.
Pediatric Dosing Author: George K Siberry, MD, MPH
Usual dose.
Usual dose.
Usual dose.
Usual dose.
Usual dose.
Usual dose.
None
Docosanol is a long-chain, 22-carbon primary alcohol that can interfere with a wide range of enveloped viruses. It inhibits fusion between the plasma membrane and the viral envelope phospholipids, preventing the entry of the virus into the cell.
No systemic absorption after topical administration.
N/A
N/A
N/A
N/A
N/A
Usual dose.
No data. Probably compatible since systemic absorption is negligible.
No data. Probably compatible since systemic absorption is negligible.
Comment: This article focuses on the mechanism of action of docosanol. A note is made that as a primary alcohol, it has activity against acyclovir-resistant HSV.
Comment: The study that relied upon a patient survey instrument suggested a 4d reduction in time to healing compared to a placebo.
Comment: A review of the available literature speaks to the safety of this topical compound and given the mechanism of action--little chance for the development of resistance.
Comment: The authors compared three topical treatments (penciclovir cream, acyclovir cream, and docosanol cream) in a guinea pig model of HSV infection. Penciclovir was superior to acyclovir cream in reducing the number of lesions (19% vs. 0%), area involved (38% vs. 21%) and virus titer (88% vs. 75%). The n-docosanol cream failed to show any differences compared to controls. The authors conclude that penciclovir cream is superior to the other two topical preparations in this animal model and presumably in people as well.
Comment: RCT suggests ~ 18h improvement compared to placebo regarding median time to healing. Only mild adverse reactions were seen.