1-Docosanol, also known as behenyl alcohol, is a saturatedfatty alcohol containing 22 carbon atoms, used traditionally as an emollient, emulsifier, and thickener in cosmetics.[6]
One of the most common side effects that has been reported from docosanol is headache. Headaches caused by the medication tend to be mild and can occur in any region of the head.[10] In clinical trials, headache occurred in 10.4% of people treated with docosanol cream and 10.7% of people treated with placebo.[8]
Docosanol is thought to work by interfering with and stabilizing the host cell's surface phospholipids, preventing the fusion of the herpes virus's viral envelope with the human host cell. This disrupted ability of the virus to fuse with the host cell membrane prevents entry and subsequent replication.[12][8][13]
The drug was approved as a cream for oral herpes after clinical trials by the FDA in July 2000.[4][14]
It was shown to shorten the healing by 17.5 hours on average (95% confidence interval: 2 to 22 hours) in a placebo-controlled trial.[15] Another trial showed no effect when treating the infected backs of guinea pigs.[16]
Two experiments with 1-docosanol cream failed to show statistically significant differences by any parameter between 1-docosanol cream and vehicle control–treated sites or between 1-docosanol and untreated infection sites.[16]
In March 2007, it was the subject of a US nationwide class-action suit against Avanir and GlaxoSmithKline as the claim that it cut recovery times in half was found to have been misleading in a California court, but the case was eventually settled and the "cuts healing time in half" claim had not been used in product advertising for some years, instead stating "clinically proven to speed healing".[17]
^ abcd"Docosan-1-ol (CHEBI:31000)". Chemical Entities of Biological Interest (ChEBI). UK: European Bioinformatics Institute. Archived from the original on 4 August 2014. Retrieved 26 July 2011.
^"Side Effects". Drugs.com. Archived from the original on 11 May 2008. Retrieved 20 May 2010.
^Sadowski LA, Upadhyay R, Greeley ZW, Margulies BJ (June 2021). "Current Drugs to Treat Infections with Herpes Simplex Viruses-1 and -2". Viruses. 13 (7): 1228. doi:10.3390/v13071228. PMC8310346. PMID34202050. n-Docosanol is a long-chain, 22-carbon, primary alcohol offered over the counter. It likely inhibits a broad range of enveloped viruses that uncoat at the plasma membrane of target cells. The drug appears to prevent binding and entry of HSVs by interfering directly with the cell surface phospholipids, which are required by the viruses for entry, and stabilizing them. This activity tends to work well against ACV-resistant HSVs and can even act synergistically with other anti-HSV drugs.
