Valtrex alternatives: what works when valacyclovir isn’t an option

Valtrex (valacyclovir) is a common go-to for cold sores, genital herpes, and shingles. But it’s not the only choice. If you can’t take it, want a cheaper option, or need a different dosing schedule, several practical alternatives exist — prescription and over-the-counter. Here’s a clear look at those options and how to pick between them.

Prescription antiviral alternatives

Acyclovir (brand name Zovirax) is the oldest and most proven alternative. It’s the same active agent once valacyclovir converts in your body, but acyclovir usually needs more frequent dosing. That can matter if you prefer fewer pills per day or have trouble sticking to a schedule.

Famciclovir (Famvir) is another prescription choice. It’s effective for herpes simplex and shingles and sometimes used when people tolerate it better than other drugs. Some people get relief with shorter courses or different dosing, but a prescriber will pick the right regimen for your condition.

If you have frequent outbreaks, your doctor might suggest daily suppressive therapy with one of these drugs to reduce recurrences. In rare cases of antiviral resistance — usually in people with weak immune systems — doctors may use intravenous antivirals or consult an infectious-disease specialist.

Non-prescription and supportive options

Topical treatments can help for cold sores. Docosanol (Abreva) is an OTC cream that can shorten a cold sore if used at the first tingle. Prescription topical antivirals like penciclovir also exist for early lesions. Topicals don’t work as well for genital herpes or shingles, which usually need oral meds.

Supportive care matters: OTC pain relievers (ibuprofen or acetaminophen), cold compresses, and keeping the area clean reduce discomfort. For mouth or lip sores, topical anesthetics can help you eat and drink more comfortably. Stay hydrated and avoid picking at sores to prevent spread and scarring.

Start treatment early. Antivirals work best if begun within the first 48–72 hours of symptoms — or at the first warning signs like tingling for a cold sore. If you can’t start immediately, still contact your provider; they’ll advise whether a different drug or a longer course makes sense.

Talk to your prescriber about kidney function and drug interactions. A doctor will adjust doses if you have kidney problems or take interacting medicines. Also check if you’re pregnant, breastfeeding, or immunocompromised — those situations change the safest choices and may require specialist input.

When to see a doctor: severe or spreading infections, eye involvement, fever with sores, infections in newborns, or if outbreaks are frequent and affecting your life. If cost is the issue, ask about generic options — acyclovir generics are often much cheaper than branded valacyclovir.

If you want help weighing options for your specific situation, talk to a clinician or pharmacist. They can match the right antiviral, dosing, and follow-up plan to your health needs and lifestyle.