Q and A


Does PEP have side effects?


I am confused with PEP treatment, specifically about the side effects.

From sexual health charities I hear that PEP treatment can cause occasional side effects which may or may not go over the 28 days treatment. Another one (THT) says that the side effects are extreme and about 1 in 5 people on PEP stop taking it as a result.

The sexual health nurse said that side effects on PEP are very common and are severe.

I’ve heard from 3 people who have had PEP and they said that they didn’t get any side effects.

What’s the official line on PEP and side effects? I thought that PEP usually uses recommended triple therapy, using drugs that are well tolerated. Is the conflicting information I am receiving due to outdated data or current data?

Thank you for any clarity you provide.


All meds have some risk of side effects, but for PEP this risk is usually low. If side effects do occur, they are usually mild.

This depends on the meds used in the PEP combination.

In the UK in 2018, the PEP combination is usually raltegravir plus a combined pill with tenofovir DF/emtricitabine, which generally causes very few side effects, if any.

Even general side effects like nausea, diarrhoea and tiredness are not experienced by most people.

If mild side effects occur, they usually get easier after the first week or two as your body adjusts.

PEP that contains a drug called efavirenz is not recommended in the UK, though is used in some countries where there is less choice for HIV drugs. Efavirenz has a higher risk of side effects including mood changes and vivid dreams.

Discontinuation rates for PEP are often not very good. Studies of health workers who are exposed with a needle-stick injury report many people stop before the full month of treatment.

Note: This answer was updated in February 2018 from a question first posted online in June 2009.


  1. Roy Trevelion

    Hello Jess,

    As Simon says on this question the PEP you are taking generally causes very few side effects, if any. But your symptoms sound severe. So please check with the clinic that you are not having a severe reaction to the treatment.

  2. Jess

    Im from the UK and Im on my first week taking PEP (Truvada+Raltegravir) and all I can say its that the side effects are terrible. Headaches, fever, sore throat, muscle pains, severe gengivitis, stomach pains, nausea, fatigue, diarrhoea, dizziness, sleeping disorders, …
    I can understand now why some people stop taking the treatment. I don’t know if Ill be able to make it through 3 full weeks more.

  3. Simon Collins

    Hi Mxolisi, please talk to your doctor about breathlessness. This can sometimes be an important symptom of other health problems. This might be more likely than being a side effect of Tribuss. Either way, your doctor needs to know.

    Also, your HIV meds are naturally flushed by your body each day. This is why you need to take a new pill each day. You need a constant minimum level of the drugs 24/7 to make sure that HIV is controlled as such a low level/

  4. Mxolisi

    Hi I’m taking tribuss and it cause me to lose my breath, how can I flush it out of my system

  5. Lisa Thorley

    Hi Drake,

    You shouldn’t really be getting yellowing of the eyes when on PEP. Therefore, unless you really need to take them, I’d stop.

  6. Drake


    Am Drake, am taking pep but one key side effect am experiencing is yellowing of the eyes. My eyes have turned pure yellow and when i consulted my doctor, he confirmed the side effect.

    How can i control this side effect? plz help


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