docosanol


docosanol

 [do-ko´sah-nol] an antiviral agent effective against activity viruses with a lipid envelope, including herpes simplex virus; used topically in the treatment of recurrent herpes labialis.

docosanol

(doe-koe-sa-nole) docosanol,

Abreva

(trade name)

Classification

Therapeutic: antivirals
Pregnancy Category: B

Indications

Treatment of recurrent oral-facial herpes simplex (cold sores, fever blisters).

Action

Prevents herpes simplex virus from entering cells by preventing viral particles from fusing with cell membranes.

Therapeutic effects

Reduced healing time.Decreased duration of symptoms (pain, burning, itching, tingling).

Pharmacokinetics

Absorption: Unknown.Distribution: Unknown.Metabolism and Excretion: Unknown.Half-life: Unknown.

Time/action profile

ROUTEONSETPEAKDURATION
Topicalunknownunknownunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity to docosanol or any other components of the formulation (benzyl alcohol, mineral oil, propylene glycol, or sucrose).Use Cautiously in: Children <12 yr (safety not established);Pregnancy (use only if clearly needed).

Adverse Reactions/Side Effects

All local reactions occured at site of application

Local

  • acne
  • skin
  • itching
  • rash

Interactions

Drug-Drug interaction

None significant.

Route/Dosage

Topical (Adults and Children ≥12 yr) Apply small amount 5 times daily to sores on lips or face until healed.

Availability

Cream: 10% cream in 2 g tubesOTC

Nursing implications

Nursing assessment

  • Assess skin lesions prior to and periodically throughout therapy.

Potential Nursing Diagnoses

Impaired skin integrity, impaired (Indications)
Risk for infection, high risk for (Indications)
Deficient knowledge, related to disease process and medication regimen (Patient/Family Teaching)

Implementation

  • Topical: Cream should be applied to lesions 5 times daily starting at the first sign of a sore or blister.

Patient/Family Teaching

  • Instruct patient on correct technique for application of docosanol. Cream should only be applied to lips and face. Avoid application in or near eyes. Emphasize handwashing following application, or touching lesions to prevent spread to others or to other areas of the body.
  • Advise patient to begin application of docosanol at the first sign of a sore or blister, even during prodromal stage (feeling of burning, itching, tingling, or numbness).
  • Inform patient that docosanol reduces duration of herpes simplex virus episodes but does not cure virus. Viral reactivation may be triggered by ultraviolet radiation or sun exposure, stress, fatigue, chilling, and windburn. Other possible triggers include fever, injury, menstruation, dental work, and infectious diseases (cold, flu).
  • Advise patient to notify health care professional if lesions do not heal in 14 days or if fever, rash, or swollen lymph nodes occur.

Evaluation/Desired Outcomes

  • Reduction in duration of symptoms (pain, burning, itching, tingling) of herpes simplex virus episodes.