Guide: antivirals
Suppressive vs Episodic Herpes Therapy: How Antiviral Medicine Is Used
Suppressive vs episodic herpes therapy are the two ways prescription antivirals are used. Episodic therapy means taking acyclovir, valacyclovir or famciclovir when an outbreak starts. Suppressive therapy means taking one every day. CDC says daily use reduces recurrences and lowers the chance of passing the virus on. Reviralis is a supplement, not an antiviral, and a clinician picks the plan.
Written by the Goreviralis label deskUpdated
The medicines01
What is a herpes antiviral medicine?
A herpes antiviral is a prescription drug that slows the virus down while it copies itself. Three are in common use: acyclovir, valacyclovir and famciclovir.
CDC's treatment guidelines list all three for genital herpes, in pills, and Mayo Clinic describes antiviral pills and creams for cold sores (CDC, STI Treatment Guidelines: Herpes) (Mayo Clinic, Cold Sore Symptoms and Causes). WHO says the same thing in plainer terms: there is no cure, and antivirals reduce how severe and how frequent symptoms are (WHO, Herpes Simplex Virus Fact Sheet).
Valacyclovir is a form your body converts to acyclovir, which is one reason it can be taken less often. Your pharmacist can explain the differences in a minute at the counter. The virus stays in the body with all three, so none of them is a cure.
Doses are not listed here on purpose. A clinician sets the dose for the person in front of them.
Two plans02
What is the difference between episodic and suppressive therapy?
Episodic therapy is short and started at the first sign of an outbreak. Suppressive therapy is daily and long term. Both use the same three drugs.
With the episodic plan, a person keeps a supply on hand and starts a short course when the tingle or itch begins, or within about a day of a sore showing up. CDC notes that earlier starts work better (CDC, STI Treatment Guidelines: Herpes). With the suppressive plan, a person takes a daily tablet whether or not a sore is present.
| Question | Episodic | Suppressive |
|---|---|---|
| When is it taken? | For a few days, starting at the first sign | Every day, with or without symptoms |
| What does it aim for? | A shorter, milder outbreak | Fewer outbreaks over time |
| Effect on passing the virus on | Not its purpose | Lowers the chance, per CDC |
| Who is it often suggested for? | People with few outbreaks | People with frequent recurrences, or a partner who is not infected |
| Who decides? | A clinician | A clinician |
The CDC and WHO sources report that daily suppression cuts recurrences by roughly 70 to 80 percent in people who have frequent ones (CDC, About Genital Herpes) (WHO, Herpes Simplex Virus Fact Sheet). Outbreaks also tend to lessen over time, so a clinician may revisit the choice.
How it gets chosen03
How does a clinician choose between the two plans?
By looking at how often outbreaks happen, how much they bother the person, and who else is affected, such as a partner. There is no single right answer for everyone.
Someone with one or two outbreaks a year may be happy with episodic care. Someone with six, or someone whose sleep, work or relationships suffer, may prefer daily care. A person in a relationship with a partner who does not have herpes may choose daily care to lower the chance of passing it on (CDC, STI Treatment Guidelines: Herpes). People with weak immune systems, including those with HIV, use different regimens (CDC, STI Treatment Guidelines: Herpes).
Get a diagnosis first
Other conditions look like herpes, and the right test tells a clinician which virus type is present.
Say how often it happens
A simple note of dates helps. Count only what a clinician has confirmed.
Review the plan at each visit
Only the prescriber switches, pauses or restarts it.
At the counter04
What should you ask the pharmacist about an antiviral?
Ask how to take it, what to avoid and what to do after a missed dose. Pharmacists answer these every day, and the answers depend on your prescription.
- Should it be taken with food, and how much water?
- What do I do if I miss a dose?
- Does it mix with my other medicines or supplements?
- Are there kidney or pregnancy points to know about?
- What side effects mean I should call the office?
If you are pregnant or become pregnant, tell your clinician. Herpes in a newborn is serious, and the CDC and WHO both ask for early prenatal conversations (CDC, About Genital Herpes) (WHO, Herpes Simplex Virus Fact Sheet).
If a pill causes a rash or anything else unusual, call the prescriber rather than guessing. Side effects can also be reported to FDA MedWatch (FDA, MedWatch).
Reviralis: from $49 a bottle60 capsules a bottle · 2, 3 or 6 bottles · free US shipping on 3 and 6 · 60-day money-back guarantee
See packsWhere Reviralis fits05
Is Reviralis an antiviral or a replacement for one?
No. Reviralis Complete is a dietary supplement in capsules. Its label never names herpes, outbreaks or any disease, and it lists no antiviral drug.
Supplements are not approved by FDA before they are sold, and a supplement label cannot claim to treat or prevent a disease (FDA, Dietary supplements) (FDA, Structure/function claims). The sales site uses words such as "outbreak" and "flare-ups". We could find no study of Reviralis or its 40 label names showing the effects those words suggest. A Cochrane review of cold-sore prevention found no evidence that lysine or one other supplement worked (Chi 2015, Cochrane: Preventing Cold Sores).
That does not make the capsules dangerous or useless as a multivitamin-style product. It means they belong in a different drawer from the prescription. If you take both, tell the prescriber and the pharmacist. These five questions check the basics.
Do not stop, skip or swap an antiviral because you started a supplement. Talk to your prescriber first about any change. See a clinician for a diagnosis if you are unsure what a sore or rash is. Call 911 for trouble breathing, a seizure, chest pain, swelling of the face or throat, or sudden confusion with a severe headache and stiff neck.
When to call06
When should you get care for herpes symptoms?
Get care quickly for anything in the eye, any symptom in a newborn, or sores that are widespread or last more than two weeks. Mayo Clinic lists these among its reasons to call (Mayo Clinic, Cold Sore Symptoms and Causes).
- A first outbreak, or a sore you cannot nameSee a clinician. A test can tell herpes from other causes, and early antivirals work best.
- A sore in or near the eye, or eye pain or blurry visionGet care the same day. Herpes in the eye can threaten sight.
- A weak immune system, or outbreaks that are severe or slow to healTell your clinician. People with weakened immunity can have longer, deeper outbreaks and may need a different plan.
- Pregnant or about to give birthTell your obstetric clinician. HSV can pass to a newborn at birth, and your team has steps to lower that risk.
- A newborn with sores, fever or poor feedingCall the pediatrician right now. Call 911 if the baby is limp, very hard to wake or struggling to breathe.
- Call 911 nowTrouble breathing, a seizure, chest pain, swelling of the face or throat, or sudden confusion with a severe headache and stiff neck.
From CDC (CDC, About Genital Herpes), Mayo Clinic (Mayo Clinic, Cold Sore Symptoms and Causes) and WHO (WHO, Herpes Simplex Virus Fact Sheet). This list is not complete, and a supplement is never a reason to wait.
The wider picture is in the genital herpes guide, the cold sores guide and the herpes basics guide.
To see how a medicine list lines up with the Reviralis label, use the medicine check. The full label is on the supplement facts page.
FAQ07
Herpes antiviral questions
Which antiviral is best for herpes?
There is no single best one. Acyclovir, valacyclovir and famciclovir all work against the virus, and CDC lists each for episodic and suppressive use. A clinician picks based on how often outbreaks occur, your other medicines and your health.
Can you take an antiviral every day for years?
Yes, daily suppressive therapy is an accepted plan, and CDC describes it for people with frequent recurrences. A clinician reviews the plan from time to time. Do not start or stop it on your own.
Does suppressive therapy stop the virus from spreading?
It lowers the chance, but it does not remove it. CDC says suppression reduces the risk of passing the virus to a partner, and condoms reduce it further. Neither makes the risk zero.
Are antivirals a cure for herpes?
No. WHO and CDC both say there is no cure. The drugs slow the virus while it copies itself, so symptoms can be shorter, milder or less frequent.
Can a supplement replace valacyclovir or acyclovir?
No source shows that. NIH's complementary health center has not found a supplement that prevents or treats outbreaks as antivirals do. Keep taking prescribed medicine and ask your prescriber before any change.
Is Reviralis an antiviral?
No. Reviralis Complete is a dietary supplement. Its label lists vitamins, minerals and a 661 mg blend of 18 names, and it never mentions herpes. It does not list acyclovir, valacyclovir or famciclovir.
Who wrote this08
Written and reviewed by
Pages built from the label, the sales page and linked NIH, CDC, FDA, FTC, Mayo Clinic and peer-reviewed sources.
Last updated . Read our editorial standards and how we check reviews. This website is the information site for a U.S. stocking partner for Reviralis. It is not the manufacturer or the distributor named on the label. We earn money when you buy through our order links.
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