(1) I will use 500 mg or 1 g Valacyclovir daily. How does one know which dosage to use? (My doctor does not seem very knowledgeable)
In the old days, it was based on the frequency of recurrences. But we’ve looked at those two doses, comparing shedding rates, and there is little benefit for going to the higher doses.
(2) Given my circumstances, it may be an option sometimes to go off the meds for a few days or even a week. I read where you said I should be on it for 5 days before sexual activity, but there will be times when I won’t see my girlfriend for a week or even two. What are the upsides or downsides of going off the medication for some period of time and having it clear my system?
If there is only a week or so between visits, I don’t see a benefit of going of the meds at all then.
(3) Given that I’m only going to see her a few times per month, is there any argument or evidence for taking higher doses for the couple days before I see her? If yes, how high is safe?
You could – you could do 500 mg twice a day to keep drug levels more even. Not sure from a science point of view how much better that might be but no harm in giving it a try.
(4) Does going on Valacyclovir require any blood work or any other monitoring/testing before or during usage?
no
(5) My blisters aren’t on the penile shaft, but in other parts of the genital region. Does this increase risk since the condom does not cover these areas? (I’m assuming that shedding will be in the same place as the blisters, but who knows I guess)
Shedding is normally from the shaft of the penis or anus – very thin skin – regardless of the location of the blisters.
May I ask exactly how you were diagnosed with HSV 2?
One final comment: based on the studies I have read, and your comments in this forum, I’m surprised at how much the risk can be lowered with the use of Valtrex and condoms (1-2% over a year). Herpes seems like an out-of-control epidemic, so it is counter-intuitive to me that we can reduce the risk this much. I guess I should be thankful.
The reason the benefit is so high is the condom use. It reduces transmission by 96% when used with every intercourse and stays intact. The Valtrex is also useful at 48% reduction.
Terri