Valtrex alternatives: find the right antiviral for your shingles or cold sore

Valtrex (valacyclovir) is a go-to antiviral for cold sores, genital herpes, and shingles. If it’s not working for you, causing side effects, or you want a cheaper option, there are solid alternatives. Below I’ll explain the most common choices, how they differ, and quick tips for picking one that fits your situation.

Prescription alternatives that actually work

Acyclovir (brand name Zovirax) is the oldest option. It’s less expensive, widely available as a generic, and effective for the same infections as valacyclovir. The downside: you usually take it more often because its bioavailability is lower, so dosing can be less convenient.

Famciclovir (Famvir) is another oral choice. It works similarly to valacyclovir but sometimes helps when valacyclovir gives stomach upset. For shingles and recurrent genital herpes, famciclovir may be prescribed in shorter, simpler dosing schedules.

For cold sores, topical antivirals like acyclovir cream or penciclovir (Denavir) can reduce healing time if you apply them at the first tingle. Over-the-counter docosanol (Abreva) is an option for lip herpes that’s available without a prescription; it can shorten an outbreak by about a day when used early.

If a standard antiviral fails or the virus is resistant, hospitals use IV drugs like foscarnet or cidofovir. These aren’t for home use and require specialist care because of serious side effects.

How to choose and use an alternative

Start treatment early. For best results, begin antivirals within 24–48 hours of symptoms. That timing matters more than which drug you pick for most people.

Think about convenience and cost. If pill burden matters, famciclovir or valacyclovir may be easier than acyclovir’s multiple daily doses. If price is the priority, generic acyclovir often costs less.

Check kidney function and other meds. Antivirals are cleared by the kidneys, so older adults or people on diuretics need dose checks. Some drugs raise levels when used with probenecid or nephrotoxic meds — your prescriber can sort this out.

Special situations: pregnancy, breastfeeding, or weakened immune systems change choices. Acyclovir has the most pregnancy data, so clinicians often prefer it, but your doctor will pick the safest option for you.

Simple self-care helps. Stay hydrated, use pain relievers, apply cool compresses, and avoid touching lesions. For frequent recurrences, ask about daily suppressive therapy — it can cut outbreaks and reduce transmission risk.

Typical treatment length varies: cold sores are usually treated for 3–5 days, shingles often for about a week, and suppressive therapy is daily for months if recurrences are frequent. Your doctor will pick duration based on severity and your health. If symptoms get worse while on treatment, or you develop fever or spreading rash, seek medical care quickly—those signs can mean complications that need stronger or different treatment.

Want cheaper meds? Compare generic options and reputable online pharmacies, but always confirm the site requires a prescription for prescription drugs. Talk to your clinician before switching. If you need help comparing options or understanding dosing, our guides and reviews on MyOTCStore.com can point you in the right direction.

Ask questions freely.