Herpes Medication Comparison: What Works Best and Why

When you’re dealing with herpes, a viral infection caused by HSV-1 or HSV-2 that leads to painful sores and recurring outbreaks. Also known as cold sores or genital herpes, it’s not just about the blisters—it’s about managing how often they come back and how badly they hurt. The good news? You have real options. Not all herpes medications are the same, and choosing the right one can cut your outbreak time in half, reduce how often you flare up, and even lower the chance you pass it to someone else.

The three main drugs used are acyclovir, the original antiviral for herpes, taken multiple times a day, often cheaper but less convenient, valacyclovir, a prodrug of acyclovir that’s absorbed better, so you take it fewer times a day, and it works faster, and famciclovir, another fast-acting option, especially useful for people who need quick relief during an outbreak. Each one targets the herpes virus the same way—by stopping it from copying itself—but how you take them, how fast they work, and how much they cost can make a big difference in your daily life.

If you get outbreaks once or twice a year, you might only need to take one of these pills when you feel the tingling start. If you’re having outbreaks every few weeks, daily suppression therapy can cut that down to once a year or less. Valacyclovir is often the go-to for suppression because you only need one pill a day. Acyclovir works too, but you’d need to take five pills a day—hard to stick with long-term. Famciclovir is a solid middle ground: less frequent dosing than acyclovir, and sometimes better for nerve pain during an outbreak.

Side effects? Most people tolerate them fine. Headache, nausea, or a little dizziness are the most common. Serious reactions are rare. But if you have kidney problems, your doctor will adjust the dose—these drugs are cleared by your kidneys, and too much can build up. Also, don’t assume generic is always cheaper. Sometimes the brand name costs the same as the generic after insurance, especially for valacyclovir.

And here’s something most people don’t realize: timing matters more than you think. Taking your first dose within 24 hours of the first tingling or redness can stop a full outbreak from forming. Waiting until the blister is open? It helps, but not as much. That’s why having a prescription on hand, even if you don’t take it every day, is smart.

There’s no one-size-fits-all herpes medication. What works best for your neighbor might not be right for you. It depends on how often you break out, your budget, your schedule, and even how your body reacts. That’s why so many people end up trying more than one before they find their sweet spot.

Below, you’ll find real comparisons between these drugs—how they stack up in speed, cost, dosing, and long-term use—based on actual patient experiences and clinical data. No fluff. Just what you need to know to make a better choice.