5 days Valtrex prior to sex

[Westover820]

Hello

Previously, you have stated that prior to having sex, you should be on Valtrex five days in order for it to “reach its maximum efficiency“.

Sorry to bother you with this, but I was wondering if you could point me to where this information was first discovered.

If it’s a study, I will check it out. If it’s an educated conclusion based upon indirect information, I was wondering if you could explain that supporting information to me.

For example: does it relate to reaching steady state plasma levels? Because peak plasma concentrations are reached after just a few hours.

But peak plasma concentrations don’t really relate to any existing viral activity that would require some additional time to tackle and fully suppress.

Thanks for any insights.

[Westover820]

Forgot to add: why is the recommendation 5 days just to quell possible subclinical activity, but the recommendation to resolve a full-blown outbreak is 3 days? (Granted that’s 1,000mg but still…)

[Terri Warren]

Goodness, I don’t have a reference for that information – we’ve known about it for so very long, I would be hard pressed to find the reference this far into the information about antivirals. Sorry about that!
Terri

[Westover820]

Thank you. Could you humor me on the mechanics/logic behind it then at least?

I have some background in biology and health so I find this stuff fascinating. Hopefully you can nerd-out with me for a moment on this:

There are steady state levels and there are peak plasma concentrations. But none of this really matters if youre trying to treat current viral activity. So while peak plasma concentrations occur within several hours, that doesn’t necessarily mean that the rumblings going on of the virus in the nerves and potentially towards the skin, have been “resolved“.

So how exactly do you remember them coming to this conclusion?

I have to admit that five days seems like a really long time for it to be effective. Especially if you’re in a phase already where you’re not exactly mid-outbreak. If you’re just relaxing in an asymptomatic time period, I honestly feel like you could probably take it for a day or two and be “good“ as far as transmitting. It’s always bothered me that people say five days because it is so excessively long .

Why do I care so much about this topic?

Because I get severe depression from Valtrex. neuropsychiatric symptoms which apparently have been acknowledged on the Mayo website, but not many other places. Lethargy, lack of motivation, depression, unexplained sadness, etc. It’s absolutely debilitating.

It I know that I’m going to be having sex soon, I don’t want to spend the entire week feeling completely horrible first.

[Terri Warren]

I honestly don’t recall how they came to this decision. If you have side effects from this medicine, what about the possibility of using condoms instead of antiviral medicine? Condoms reduce transmission by 96% from men to women and likely a similar number from men to men with anal sex. I don’t know what gender your partners are but either way, condoms are a very useful tool in reducing the transmission of HSV. And in your case, since you report negative side effects with this medicine, it sounds like a good alternative. Also, I don’t know how long you tried taking Valtrex but in my experience, for people who have side effects, they often resolve after 2 to 3 weeks on the medicine. Also, sometimes starting with a lower dose and building to the normal dose is useful.
Terri

[Westover820]

Condoms are a nice idea but I have a lot of irritation and itching in the scrotum area, and a very suspect set of stinging little red dots a couple months ago for the first time as well.

I’m at one year and three months though so I’m sure things are still settling down and five years from now it won’t be as much of a concern.

I guess I just find it really hard to believe that you need five solid days of treatment for it to be optimally effective, and I guess since there’s no actual data and everyone quoting this number doesn’t know why, maybe I’ll just do two days in advance. And then also make sure to dose it 1.5 hours before the actual act. For that peak plasma benefit.

[Terri Warren]

Sorry that I couldn’t be of more help with the source of that information but it sounds like you have a reasonable plan in place for yourself.

Terri

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