Should another anti-influenza agent be urgently indicated, it must be individually considered whether continuing breastfeeding is acceptable.In industrialized countries, breastfeeding is generally discouraged in the presence of a maternal HIV infection to avoid postnatal transmission. Docosanol (n-docosanol or behenyl alcohol; Abreva) is a saturated 22-carbon aliphatic alcohol that is inhibitory for a broad range of lipid-enveloped viruses, including HSV-1 and HSV-2, at millimolar concentrations in vitro. Oral herpes treatments differ from genital herpes and are therefore distinguished below. Docosanol (Abreva®) Manufacturer: SmithKline Beecham FDA indication: Treatment of herpes labialis Cost (AWP): $11.14 per tube Dosing: 10% cream applied topically 5× per day (apply as early as possible during prodromal stage) Pharmacology: Mechanism of action: Docosanol inhibits fusion between the plasma membrane and the viral envelope, preventing entry of the virus into the cell. Chronic suppressive therapy increased the number of Health professionals should discontinue chronic suppressive antiviral therapy once a year to determine whether continuation is necessary. Katz DH, Marcelletti JF, Khalil MH, Pope LE, Katz LR (December 1991). The presumed mechanism of action in docosanol is by inhibiting the fusion of the human host cell with the The drug was licensed as an oral herpes medicine after clinical trials by the FDA in July 2000.Marketed by Avanir Pharmaceuticals, Abreva was the first One of the most common side effects that has been reported from docosanol is Skin irritation may also occur at the site of application. "Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: A multicenter, randomized, placebo-controlled trial". Usually, skin irritation is mild to moderate and does not need any further treatment. Topical antivirals have only modest benefit.The typical duration of treatment is 7–10 days. Only in regions in which poor water hygiene when reconstituting infant formula, would pose a greater risk for the infant than the risk of infection via the mother’s milk, is breastfeeding specifically recommended (There is no known curative therapy for HSC infection. Chloroform (1.5 ml) containing 10.0 mg l+ represents amino acids detected by each methodology; − represents amino acids not detected by each methodology.After the use of topical herpes medications, an adverse effect to the breastfed infant seems unlikely because of poor absorption. Docosanol has a distinct mechanism of action and inhibits fusion between the plasma membrane and the herpes simplex virus envelope, thereby preventing viral entry into cells and subsequent viral activity and replication. Abreva is a docosanol 10% cream for the topical treatment of recurrent oral-facial herpes simplex episodes (cold sores or fever blisters). for 7 days, 5–10 mg/kg IV every 8 h for 5–7 daysAcyclovir: 800 mg t.i.d. To increase effectiveness, commence treatment within 24 hours of prodromal symptoms (pain, tingling, paresthesia). The presumed mechanism of action in docosanol is by inhibiting the fusion of the human host cell with the viral envelope of the herpes virus, thus preventing its replication.This mechanism has neither been directly observed nor proven, however. Topical antiviral medications (e.g., penciclovir, Therapeutic Areas II: Cancer, Infectious Diseases, Inflammation & Immunology and Dermatology). The most important adverse reactions are deposition of drug crystals in the renal tubules of patients with inadequate hydration or impaired renal function. It is potentially nephrotoxic.Intravenous acyclovir is indicated in the treatment of severe primary HSV, and in initial and recurrent infections in severely immunocompromised patients. No side-effects for the infant via mother’s milk would be expected with local therapy using With external and systemic administration of acyclovir or valacyclovir, breastfeeding is permitted. Therefore, people who are taking other drugs are recommended to first consult their physician and then start the therapy.This topical has not been yet tested if it is safe to be used by pregnant women. By continuing you agree to the Copyright © 2020 Elsevier B.V. or its licensors or contributors. Just based on the mechanism of action of the drug I feel it could be quite dangerous. To optimize the effectiveness of episodic therapy, it is important that patients maintain medication supply on-hand so that treatment can commence within 24 hours of the onset of prodromal symptoms (paresthesia, tingling, pain, redness).Chronic suppressive therapy.