Q and A

Question

Does PEP have side effects?

Hello,

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 Is the conflicting information I am receiving due to outdated data or current data?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.

Answer

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.

226 comments

  1. Lisa Thorley

    Hi Iachi,

    The itching could be due to the PEP. This is something that you’ll need to discuss with a doctor.

  2. lachi

    hi doc been on pep on my 2nd week and my skin is dry and am itching all over is this because of pep??

  3. Lisa Thorley

    Hi Courage,

    Being short of breath isn’t a known side effect of PEP. If you’re feeling like this, then you should talk to a doctor.

  4. Courage

    Hi doc

    I have been taking pep for about a week now and i started having shortness of breath. Could this be a side effect or its more than that

  5. Roy Trevelion

    Hi Kenneth,

    It’s a good idea to see the doctor about your symptoms.

    If this is due to seroconversion the doctor would expect you to have other symptoms – and a viral load test now would be positive.

    Dolutegravir seems to have fewer side effects than most other HIV drugs. This is the main drug in your PEP.

    You can read more about dolutegravir here.

  6. Kenneth

    I’m on my 15th day of using pep(dolutegravir, lamivudine and tenofovir) , 3 days ago i experience severe muscle ache until now I’m still feeling weak and fatigue, could it be side effects or seroconversion?

  7. Lisa Thorley

    Hi Risper,

    Its possible that this could be a side effect, please see a doctor about this.

  8. risper

    Hey Doc.
    AV been taking for two weeks now&woke up today only to find out my whole body is swollen up,might it be among the pep side effects?? please help

  9. Roy Trevelion

    Hi April,

    Yes, it sounds like the clinic are giving good advice. Being on PEP can protect you from new HIV risks.

  10. April

    Hi doc

    On the 26th December I had unprotected sex with a man I found out is h.I.v. positive,within 48 hours I started the pep treatment. I have been taking it everyday without fail on time and the one time we had sex while on the treatment the condom broke. Enquired at the clinic what are my chances and was advised that since I’m still on the treatment I’m safe. How true is this,I’m finishing the treatment In a day

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