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Adverse Reactions Dermatologic: Burning, itching, mild pain, pruritus, stinging Contraindications Hypersensitivity to acyclovir, valacyclovir, or any component Precautions For external use only to the lips and face; do not apply to eye or inside the mouth or nose. Treatment should begin with the first signs or symptoms. Use with caution in immunocompromised patients. Warnings Physical contact should be avoided when lesions are present; transmission may also occur in the absence of symptoms. Treatment should begin with the first signs or symptoms. Acyclovir ointment should not be used for prevention of recurrent HSV infections. Metabolism/Transport Effects None known. Drug Interactions (For additional information: Launch Lexi-Interact™ Drug Interactions Program ) There are no known significant interactions. Pregnancy Risk Factor B ( show table ) Pregnancy Implications Teratogenic effects were not observed in animal studies. When administered orally, acyclovir crosses the placenta. Refer to the Acyclovir, Systemic monograph for details. The amount of acyclovir available systemically following topical application of the cream or ointment is significantly less in comparison to oral doses. Mechanism of Action Inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and by incorporation into viral DNA Pharmacokinetics (Adult data unless noted) Absorption: Poorly absorbed Use of UpToDate is subject to the Subscription and License Agreement . Topic 15937 Version 24.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.6- C21.56 Licensed to: AsanBook Dig. Med. Lib. | Support Tag: [0505-217.16.9.173-D52E307D49-S244013.14]