HIV and AIDS
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My recommendation would be to not take PEP.
Oral sex is fairly low risk overall- while I would not say the risk is zero, it is quite low if all you had was oral sex. The benefit of PEP is fairly low in these situations, so that most would not advise it to be necessary.
Truvada is in fact fairly safe. It is well tolerated. There are some side effects we see with long term use ( affects on bones, or kidneys) but for a 4 week PEP course, these risks are minimal. Nonetheless, I doubt it would help you.
I assume you have been tested for HIV at baseline, to make sure you are negative before this episode- If you are already positive, as well, then Truvada by itself can lead to resistance ( usually we treat with at least 3 medications to someone who is infected).
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If you are on the fence- there is nothing wrong about starting it, until you decide one way or another. There is nothing wrong with taking PEP here. I just meant to say the benefit is likely very low with a low risk exposure. Given the already low risk of oral sex, I still generally do not use PEP in situations like you describe.
The estimated risk of infection while performing oral sex , with a KNOWN infected partner is about 1 in 10 000 per the CDC. That's if we know he is infected. Now, if he is not infected, then the risk is zero for HIV.
Then if you think that the risk reduction from PEP is about 80%, the statistics just make this is an intervention where one would be treating a huge number of people to have any benefit at all... The risk is just quite low.
As for what you can do with Truvada if you don't take it- That is harder. Yes all HIV meds are quite pricey. And hopefully you will not have use for them in the future.
Once a bottle is dispensed , the pharmacy will not take it make for safety reasons. In my office I sometimes do take samples from patients who no longer need them to potentially give to patients with insurance issues, or those who need immediate access and have some other financial probelms. You may want to talk to your doctor- but his policy may be not to accept it, again out of theoretical safety concerns, since he cannot know that pills were not tampered with ( that's the reality of our world...).