Question
Late with the after sex on-demand PrEP dose.
5 March 2022. Related: Adherence, All topics, PrEP.
Hello for all. I started 2-1-1 prep, took 2 pills 3 hours before sex. Then I took second pill after 24 hours after sex, not 24 hours after the first 2 pills – I have delayed the second pill by 3 hours. I’m still continuing taking PrEP every day because I have sex but I am just worrying is it ok to delay the second dose by 3 hours? Thank you for reply.
Answer
Hi, how are you doing?
Being 3 hours late on the second dose is not likely to cause a problem. The initial double dose will have increased the drug levels within your body more than a single dose anyway. These drugs tend to remain at the required drug level within the body for more than 24 hours.
While it is best to take the medication as routinely as you can, being late by 3 hours is unlikely to cause you any problem. As you have now continued with daily dosing, PrEP will have remained at effective level within your body.
There is no reason to be concerned after this event,
Josh.
Hi Preston, this would not have been a reason to have been prescribed PEP in the UK even if you hadn’t taken any PrEP. Some PrEP is always better than none, even if the doses are not quite on time. Please see this link for more info of PEP:
https://i-base.info/qa/factsheets/pep-faq
The booklet mentioned at this link has info on oral sex:
https://i-base.info/qa/11844
Hi I hope this thread is still active? Because I am in distraught and need advice.
So I intended to do the on demand/event based PrEP 2:1:1 but missed second dose by many hours (43 hours)
Saturday 4pm :initial Double dose
Sunday 6am : ONLY Oral sex (guy ejaculated in my mouth ) but I didn’t swallow and had quickly spit it out ( I didn’t have any cuts in my mouth or any abrasions ). I also immediately mouth washed with chlorhexidine. But, Also some sperm got into my eye and turned red for a brief moment but I saline irrigated the eye and woke up being cleared.
Monday 11 am : double dose (as I only remembered about my prep this time and panicked and took two doses – in distraught – second dose missed for 43 hours / oral & eye post exposure )
I’m planning to take another dose daily every 4 pm now from when I took the first initial double dose. Or should I take it at 11 am daily now?
I didn’t have penetrative / condomless sex. Is oral sex as dangerous ? But also sperm got into my eyes ? what’s the risk of eyes and oral in HIV transmission.
I also don’t know the guys HIV status.
It’s too late to access PEP even if I need it.
Should I keep taking PrEP for a few days ?
Sorry if my comment seems confusing as I can’t think straight
Hi Diego, so long as you took the four pills roughly at the right time this still follows 2:1:1 dosing. If you are ever worried it is easy to take a single pill for an additional day – ie 2:1:1:1.
Actually, you didn’t have unprotected sex on Saturday but maybe had sex without a condom. It was protected becasue you are on PrEP :)
Hello everyone,
I’m new taking prep-on demand and concerned because I missed the dose in the right time. so, I took my first 2 pills Friday 11 pm, I had unprotected sex Saturday 10 pm, we did it again Sunday 1 am, I took 1 pill Sunday 2 am, and last dose Sunday 10 pm.
Thank you
Hi Nac, please see this page on event-based dosing:
https://i-base.info/guides/prep/on-demand
The latest PrEP guide has justed been updated and includes new nfo on dosing:
https://i-base.info/htb/47180
As you used a condom, PrEP isn’t really needed in this case.
Hi, I need your consultation.
I took prep on demand 2:1:1
Thursday 5pm: 2 pills (didn’t have sex)
Friday 5pm: 1 pill (didn’t have sex)
I had sex with condom on Saturday at 11AM but I took my Prep 1.5 hour late (at 6:30pm instead of 5pm)
Is there any risk of that? And I do I need to continue taking prep on just Sunday or til Monday?
Hi Tony, you do not need to be worried and you do not need to access PEP.
Starting on a double dose means there is a higher concentration of PrEP in your body than normal. This higher concentration remains at an active level for more than 24 hours and can account for you being late with your second dose.
Your course of PrEP will still be effective.
Hi there,
Bit concerned about my PREP on demand protocol.
Just started PREP on demand so there is not four days build up in the body.
I am an uncircumsized man.
Time line:
Thursday 10AM: Took two pills
Thursday evening: 10PM: Unprotected anal sex as insertive partner
Friday: Forgot to take second pill
Saturday morning 9AM: Took two pills
Sunday morning: 8:30AM Took two pills
HIV status of male partner is unknown.
ONLY HAVE A FEW HOURS LEFT TO ACCESS PEP IF NEEDED
Hi The M, you have taken PrEP correctly. You only need to take PrEP twice after having sex which you have done.
Having sex between the first double dose and the second means you have timed PrEP correctly. It does not matter that you were ‘late’ with this third dose as it was not required.
Hello
I need your urgent consultation!
I took prep (2pills) Friday afternoon at 3pm
I had sex Saturday morning
(I took a pill on Saturday at 3pm)
(Another pill on Sunday at 3pm)
And the last one was supposed to be taken today (Monday) at 3. I took it at 6 (3 H late)
Please advise if I’m still safe