How to start and stop oral PrEP
Starting
Everyone now has the option to start oral PrEP using a double dose (two pills) for the first dose BEFORE sex.
This gives protection within two hours.
Continuing
Daily dosing then involves continuing with a single pill every day at roughly the same time.
For daily PrEP, current guidelines recommend at least six daily doses a week. Although studies suggest fewer weekly doses might be okay, it is not yet clear if this will be included in the 2024 guidelines update.
But if you stop PrEP for a week, please restart using a double dose and take seven daily post-sex doses that week.
Stopping
If you are using event-based dosing, continue daily dosing for either another two days (2:1:1 dosing) or seven days (2:7 dosing).
Before stopping daily dosing, please continue for either two or seven days after you last had sex. This depends on how you are dosing PrEP. Please see:
Dosing with TAF vs TD
TAF/FTC can be dosed the same way as TD/FTC.
Even though there is less evidence for vaginal and neovaginal sex, this should still be okay.
This is because PrEP efficacy is no longer thought to be linked to drug levels in different tissues, but to drug levels in cells called PBMCs.
Last updated: 1 February 2024.