Docosanol
Encyclopedia
Docosanol, also known as behenyl alcohol, is a saturated
fatty alcohol
used traditionally as an emollient, emulsifier, and thickener in cosmetics, nutritional supplement (as an individual entity and also as a constituent of polyicosanol), and more recently, in a Food and Drug Administration
(FDA) approved pharmaceutical, Abreva, approved as an antiviral agent for reducing the duration of cold sores caused by the herpes simplex virus
.
of the herpes virus, thus preventing its replication
. This mechanism has neither been directly observed nor proven, however.
The drug was licensed as an oral herpes medicine after clinical trials by the FDA in July 2000.
It was shown to shorten the healing by 17.5 hours on average (95% confidence interval
: 2 to 22 hours) in a placebo-controlled trial. Three other trials showed negative results, but these were not published.
Marketed by Avanir Pharmaceuticals, Abreva was the first over-the-counter antiviral drug
approved for sale in the United States
and Canada
. In Europe, it is marketed by Healthcare Brands under the name Erazaban. In March 2007 it was the subject of a US nationwide class-action suit against Avanir and GlaxoSmithKline as the claim that it cut recovery times in half was found to have been misleading in a California court, but the case was eventually settled and the "cuts healing time in half" claim had not been used in product advertising for some years.
from the drug, if they occur, may go away during treatment as the body adjusts to it, otherwise a physician should be consulted.
One of the most common side effects that has been reported from docosanol is headache
. Headaches caused by the drug tend to be mild and can occur in any region of the head. The intensity of the pain can, in some cases, interfere with the ability of remaining focused when working or when at school. If headaches develop while using the ointment, one is recommended to take an over-the-counter medication such as paracetamol
to alleviate the pain
.
Skin irritation may also occur at the site of application. Usually, skin irritation is mild to moderate and does not need any further treatment. It may also diminish after prolonged use of docosanol.
The most serious side effects, although rare, are allergic reactions. Some of the patients experienced the symptoms of allergic reactions, including difficulty breathing, confusion
, facial swelling
, fainting, dizziness
, hives or chest pain
. Allergic reactions are medical emergencies and individuals who experience them are recommended to seek immediate medical care in order to prevent further complications.
Other side effects may include:
People who are allergic to one of the ingredients of Abreva are recommended to avoid taking this medication. Also, it is not to be used by individuals who suffer from different medical conditions before consulting their health care provider. Interactions with docosanol may occur although there are no known specific interactions at this moment. 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. Also, people who are taking other over-the-counter drugs, supplements
or herbal preparations are recommended to consult their doctor prior to starting therapy. Nursing mothers are advised to avoid using this topical as it is not established if the active ingredients in the medicine pass into the breast milk
. People who are allergic to docosanol or any other ingredient of the product are strongly advised not to use it.
Cosmetic
products are recommended to be avoided while using docosanol mainly because they are likely to spread the unhealed infection
and not because they interact with the topical. Lipstick
is not contraindicated but it is recommended to be applied by using a different applicator to prevent spreading of the infection and recurrence. Cosmetics must be removed before applying the ointment. Also, it is important to know that herpes is highly contagious during outbreaks and patients are advised to avoid physical contact with other people as well as sharing the medicine.
Docosanol has not been specifically approved for treatment of children under 12 but is not expected to produce different side effects or problems than it does in adults. This topical is only intended for external, oral-facial use and should not be administered with the purpose of curing genital herpes or shingles.
Saturation (chemistry)
In chemistry, saturation has six different meanings, all based on reaching a maximum capacity...
fatty alcohol
Fatty alcohol
Fatty alcohols are aliphatic alcohols consisting of a chain of 8 to 22 carbon atoms. Fatty alcohols usually have even number of carbon atoms and a single alcohol group attached to the terminal carbon. Some are unsaturated and some are branched...
used traditionally as an emollient, emulsifier, and thickener in cosmetics, nutritional supplement (as an individual entity and also as a constituent of polyicosanol), and more recently, in a Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
(FDA) approved pharmaceutical, Abreva, approved as an antiviral agent for reducing the duration of cold sores caused by the herpes simplex virus
Herpes simplex virus
Herpes simplex virus 1 and 2 , also known as Human herpes virus 1 and 2 , are two members of the herpes virus family, Herpesviridae, that infect humans. Both HSV-1 and HSV-2 are ubiquitous and contagious...
.
Mechanism and history of antiviral drug usage
The presumed mechanism of action in docosanol is by inhibiting the fusion of the human host cell with the viral envelopeViral envelope
Many viruses have viral envelopes covering their protein capsids. The envelopes typically are derived from portions of the host cell membranes , but include some viral glycoproteins. Functionally, viral envelopes are used to help viruses enter host cells...
of the herpes virus, thus preventing its replication
Viral replication
Viral replication is the term used by virologists to describe the formation of biological viruses during the infection process in the target host cells. Viruses must first get into the cell before viral replication can occur. From the perspective of the virus, the purpose of viral replication is...
. This mechanism has neither been directly observed nor proven, however.
The drug was licensed as an oral herpes medicine after clinical trials by the FDA in July 2000.
It was shown to shorten the healing by 17.5 hours on average (95% confidence interval
Confidence interval
In statistics, a confidence interval is a particular kind of interval estimate of a population parameter and is used to indicate the reliability of an estimate. It is an observed interval , in principle different from sample to sample, that frequently includes the parameter of interest, if the...
: 2 to 22 hours) in a placebo-controlled trial. Three other trials showed negative results, but these were not published.
Marketed by Avanir Pharmaceuticals, Abreva was the first over-the-counter antiviral drug
Antiviral drug
Antiviral drugs are a class of medication used specifically for treating viral infections. Like antibiotics for bacteria, specific antivirals are used for specific viruses...
approved for sale in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
and Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
. In Europe, it is marketed by Healthcare Brands under the name Erazaban. In March 2007 it was the subject of a US nationwide class-action suit against Avanir and GlaxoSmithKline as the claim that it cut recovery times in half was found to have been misleading in a California court, but the case was eventually settled and the "cuts healing time in half" claim had not been used in product advertising for some years.
Side effects
Side effectsSide Effects
Side Effects is an anthology of 17 comical short stories written by Woody Allen between 1975 and 1980, all but one of which were previously published in, variously, The New Republic, The New York Times, The New Yorker, and The Kenyon Review. It includes Allen's 1978 O...
from the drug, if they occur, may go away during treatment as the body adjusts to it, otherwise a physician should be consulted.
One of the most common side effects that has been reported from docosanol is headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...
. Headaches caused by the drug tend to be mild and can occur in any region of the head. The intensity of the pain can, in some cases, interfere with the ability of remaining focused when working or when at school. If headaches develop while using the ointment, one is recommended to take an over-the-counter medication such as paracetamol
Paracetamol
Paracetamol INN , or acetaminophen USAN , is a widely used over-the-counter analgesic and antipyretic . It is commonly used for the relief of headaches and other minor aches and pains and is a major ingredient in numerous cold and flu remedies...
to alleviate the pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
.
Skin irritation may also occur at the site of application. Usually, skin irritation is mild to moderate and does not need any further treatment. It may also diminish after prolonged use of docosanol.
The most serious side effects, although rare, are allergic reactions. Some of the patients experienced the symptoms of allergic reactions, including difficulty breathing, confusion
ConFusion
ConFusion is an annual science fiction convention organized by the Stilyagi Air Corps and its parent organization, the Ann Arbor Science Fiction Association. Commonly, it is held the third weekend of January. It is the oldest science fiction convention in Michigan, a regional, general SF con...
, facial swelling
Swelling (medical)
In medical parlance, swelling is the transient enlargement or protuberance in the body and may include tumors. According to cause, it may be congenital, traumatic, inflammatory, neoplastic or miscellaneous....
, fainting, dizziness
Dizziness
Dizziness refers to an impairment in spatial perception and stability. The term is somewhat imprecise. It can be used to mean vertigo, presyncope, disequilibrium, or a non-specific feeling such as giddiness or foolishness....
, hives or chest pain
Chest pain
Chest pain may be a symptom of a number of serious conditions and is generally considered a medical emergency. Even though it may be determined that the pain is non-cardiac in origin, this is often a diagnosis of exclusion made after ruling out more serious causes of the pain.-Differential...
. Allergic reactions are medical emergencies and individuals who experience them are recommended to seek immediate medical care in order to prevent further complications.
Other side effects may include:
- AcneAcneAcne is a general term used for acneiform eruptions. It is usually used as a synonym for acne vulgaris, but may also refer to:*Acne aestivalis*Acne conglobata*Acne cosmetica*Acne fulminans*Acne keloidalis nuchae*Acne mechanica...
- Burning
- Dryness
- Itching
- RashRashA rash is a change of the skin which affects its color, appearance or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful. The causes, and...
- Redness
- Acute diarrheaDiarrheaDiarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
- Soreness
- Swelling
Contraindications
As soon as side effects develop, individuals must interrupt therapy and consult their medical care provider.People who are allergic to one of the ingredients of Abreva are recommended to avoid taking this medication. Also, it is not to be used by individuals who suffer from different medical conditions before consulting their health care provider. Interactions with docosanol may occur although there are no known specific interactions at this moment. 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. Also, people who are taking other over-the-counter drugs, supplements
Dietary supplement
A dietary supplement, also known as food supplement or nutritional supplement, is a preparation intended to supplement the diet and provide nutrients, such as vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may not be consumed in sufficient quantities in a person's diet...
or herbal preparations are recommended to consult their doctor prior to starting therapy. Nursing mothers are advised to avoid using this topical as it is not established if the active ingredients in the medicine pass into the breast milk
Breast milk
Breast milk, more specifically human milk, is the milk produced by the breasts of a human female for her infant offspring...
. People who are allergic to docosanol or any other ingredient of the product are strongly advised not to use it.
Cosmetic
Cosmetics
Cosmetics are substances used to enhance the appearance or odor of the human body. Cosmetics include skin-care creams, lotions, powders, perfumes, lipsticks, fingernail and toe nail polish, eye and facial makeup, towelettes, permanent waves, colored contact lenses, hair colors, hair sprays and...
products are recommended to be avoided while using docosanol mainly because they are likely to spread the unhealed infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
and not because they interact with the topical. Lipstick
Lipstick
Lipstick is a cosmetic product containing pigments, oils, waxes, and emollients that applies color, texture, and protection to the lips. Many varieties of lipstick are known. As with most other types of makeup, lipstick is typically, but not exclusively, worn by women...
is not contraindicated but it is recommended to be applied by using a different applicator to prevent spreading of the infection and recurrence. Cosmetics must be removed before applying the ointment. Also, it is important to know that herpes is highly contagious during outbreaks and patients are advised to avoid physical contact with other people as well as sharing the medicine.
Docosanol has not been specifically approved for treatment of children under 12 but is not expected to produce different side effects or problems than it does in adults. This topical is only intended for external, oral-facial use and should not be administered with the purpose of curing genital herpes or shingles.