Lip Sores: Medication Guidance for Effective Treatment

Medication Inquiry

I have been experiencing recurrent blisters and itching on my lips for a month.
Two days ago, it started to ooze pus, so I went to see a doctor.
The doctor said it was lip inflammation, but I later mentioned that it initially looked like a cold sore (though I'm not entirely sure it is a cold sore since it hasn't crusted over like before).
The doctor said they would prescribe medication for cold sores, as both conditions can occur together and are difficult to differentiate.
The doctor prescribed Acyclovir 400 mg, to be taken three times a day, with two tablets per meal, totaling 800 mg per meal.
However, I have previously seen other doctors who prescribed this medication, and I only took one tablet per meal.
I would like to ask if I should follow the current prescription (I am still on the first day of treatment and have been taking one tablet per meal).

Ya Ya, 20~29 year old female. Ask Date: 2022/09/04

Dr. Wu Yuxin reply Dermatology

The dosage of medication is determined based on the disease itself and the patient's weight; you should consult your attending physician for guidance.

Reply Date: 2022/09/04

More Info

When dealing with lip sores, particularly those that may be caused by herpes simplex virus (commonly known as cold sores), it is essential to understand the nature of the condition and the appropriate medication prescribed for treatment. Based on your description, it seems you are experiencing inflammation and possibly a secondary bacterial infection, which can occur alongside viral infections like herpes.

The medication you mentioned, Acyclovir (often referred to by its brand name, Zovirax), is an antiviral drug commonly used to treat infections caused by certain types of viruses, including the herpes simplex virus. The standard dosage for Acyclovir can vary depending on the severity of the infection and the specific circumstances of the patient. In your case, the doctor prescribed 400 mg three times a day, which is a common regimen for treating an active herpes outbreak.

Understanding the Dosage
1. Dosage Explanation: The prescribed dosage of 400 mg three times a day (totaling 1200 mg per day) is typically recommended for treating herpes simplex infections. This higher dosage is often necessary to effectively combat the viral replication during an active outbreak. The confusion regarding the dosage you received from previous doctors may stem from variations in treatment protocols or the specific circumstances of your previous infections.

2. Importance of Adhering to Prescriptions: It is crucial to follow your current doctor's prescription unless you have a compelling reason to question it. The prescribed dosage is likely based on your current condition, the severity of your symptoms, and your medical history. If you are unsure or uncomfortable with the dosage, it is best to consult your doctor for clarification rather than adjusting the dosage on your own.

Potential Side Effects
While Acyclovir is generally well-tolerated, some patients may experience side effects. Common side effects include:
- Nausea
- Diarrhea
- Headaches
- Dizziness
- Fatigue
In rare cases, more severe side effects can occur, such as kidney problems or neurological effects, especially if the medication is not taken as directed. If you experience any unusual symptoms or side effects, it is essential to contact your healthcare provider immediately.

Additional Considerations
1. Hydration: Ensure you stay well-hydrated while taking Acyclovir, as it can help prevent potential kidney issues associated with the medication.

2. Topical Treatments: In addition to oral antiviral medications, topical treatments may also be beneficial for managing symptoms. Over-the-counter creams containing docosanol or prescription topical antivirals can help alleviate discomfort and speed up healing.

3. Preventive Measures: If you frequently experience outbreaks, discuss preventive measures with your doctor. Long-term suppressive therapy with Acyclovir or other antiviral medications may be an option to reduce the frequency of outbreaks.

4. Consultation: If you have any doubts about the treatment plan, including the dosage or the necessity of the medication, do not hesitate to reach out to your healthcare provider. They can provide personalized advice based on your medical history and current condition.

In conclusion, while it is understandable to have questions about your treatment, adhering to your doctor's prescribed dosage of Acyclovir is advisable unless you receive further guidance. Effective management of lip sores often requires a combination of antiviral medication, proper hydration, and possibly topical treatments, along with ongoing communication with your healthcare provider.

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