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 Laurel, no you do not need PEP. Your initial first dose is a double dose which can account for being a few hours late with the second. You can take your third dose 24 as you would have initially expected e.g., the time you took your first dose.
Hi there! I missed my second dosage for 2-1-1 after sex by about 6 hours. I took 2 to start 6 hours before unprotected sex. But I only took my second dosage 24 hours after the sex, so 30 hours after the initial dosage. I took 2 the second time just in case. Do I need PEP?
Hi Ray, though it is recommended that PEP is a combination of 3 drugs, a 2 combination drug like PrEP can be used when you do not have access to PEP. You can continue to take PrEP for 28 days (the regular course of PEP) or you can switch to a 3 drug combination if you can access PEP. As you took PrEP within 72 hours it is likely to have some effectiveness if you continue taking it. What was the exposure you had?
An HIV test this early would not be accurate. You need to wait at least 6 weeks from the last day of taking PrEP/PEP. You would need a 4th generation antigen/antibody test.
I took prep 24 hours after exposure and did not have access to Pep…
I continued to take Prep a few days after exposure.
I’m extremely worried for my health.
Should I take an HIV test ?
Hi Karl, yes you will still have protection. As you were 8 hours late, this course of PrEP will may not offer as much protection as if you were to be on time. Though as you have continued for an extra day and had your initial loading dose, this course of PrEP will still offer significant protection against transmission. There is no cause for you to do anything else.
Hi!
I did on demand Prep and this was how I took it and was late on the third day:
Thursday 2 pills at 10:20am had sex at 3pm
Friday 1 pill at 10:20am had sex again at 1pm
Saturday 1 pill at 18:00 late for like 8hours
Sunday will take 1 pill at 10:20am again
Am I protected noting that I was late on Saturday for 8 hours?
Thanks
Hi Jay, both the meds in PrEP reach good drugs levels that also only leave slowly. This will easily cover you if you are a couple of hours early or late. If you are worried, you can always take an extra PrEP pill the next day, but is isn’t really needed.
I sorry I’m a bit worried. I’m overthinking. What about my last dose? I was also on the on-demond prep, but I have delayed the last dosage for about 1 hour and 30 minutes. Is it still effective?
Hi Jason, no you do not need to take PEP. PrEP will still be effective as you had your followed the earlier dosing pattern. This last dose is to ensure effectiveness but there will still be a high enough level in your body to account for being a few hours late.
What about the last dose? I was also on the on-demond prep (2-1-1) but I missed the last dosage for about 3 hours and 10 minutes. Should I take PEP?