Constant neuralgia

I have had HSV 2 for at least 15 years.
I have maybe one or two outbreaks a year not on the site of origin but on my upper buttock.
These outbreaks are usually preceded and followed by nerve pain.
With a new sexual partner I decided to go on Valtrex (500mg once daily)
For two months now I have not had any outbreaks.
However for two months without relief I have had nerve pain in the areas where I have had outbreaks.
Everyday all day all the time.
Am I shedding?
Is it the Valtrex?
Is it something else?

[gracefromHHP]

At this point I'd stop the valtrex for a few weeks and see what happens. If the pain goes away, try acyclovir or famvir and see if you tolerate either of those better.  there are some folks who get neuralgia from valtrex especially and trial and error is the only way to figure it out. If you still have the pains after a week off valtrex, it's probably not related to your herpes or the valtrex so you'll need to follow up on it with your doctor.

grace

[minjy]

thanks for the speedy reply.
The pain is tolerable if the Valtrex is doing what it's supposed to be doing.
Do you think the nerve pain is a sign that the Valtrex is not effectively suppressing the virus?

[gracefromHHP]

They haven't really studied this at all to see if the virus is active in the small % of folks who get neuralgia from the antivirals to see if it's just nerve irritation or the virus not being suppressed. It doesn't happen in a large enough % of folks to really study.  

grace

[mystupidex]

Grace,
Does neuralgia mean tingling?  It sounds like the same sort of question I have on my string of questions too.  Does that mean that occassional tingling could be just the Valtrex or nerve irritation.  

[minjy]

It might be safe to say that the Valtrex was suppressing the virus as almost immediately upon not taking it did I experience an outbreak in the usual spot.

Also the nerve pain substantially subsided(back to normal I'd say).
By the way, the first month I took the generic version and the second month the named brand Valtrex, both had the same effectiveness and amount of nerve pain.
15 yrs ago I used to take acyclovir so maybe I will try that again or go back to taking nothing as my outbreaks are usually quite infrequent.

So now the question to you is can one experience outbreaks in multiple areas at the same time?
The one on my upper butt cheek is easy to identify in terms of prodromal symptoms and whatnot but in my genital area I can't always be so sure.

[gracefromHHP]

Typically recurrences consist of just symptoms in one area of a time.

Why not give the acyclovir 400mg 2x/day a try to suppress the virus, reduce ob's and help reduce transmission to a partner?  I personally get neuralgia from valtrex but not from acylovir myself.

grace

[minjy]

Hi this is for anyone whose been following this thread.
After being off Valtrex for a week
I began taking 400mg 2x/day of acyclovir and the extreme neuralgia experienced while on Valtrex is gone.
My doctor still didn't really believe me and reluctantly gave me the acyclovir script.
She thought I was confusing the neuralgia with the yeast infection I had at the time????!!!!

[gracefromHHP]

It's hard to tell but there is a small percentage of folks who don't tolerate valtrex because of the symptoms you described.

acyclovir is cheaper anyways :)

grace