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.
Hello Mark and thanks for getting in touch.
I think your approach is the safest and well done to you for following the guidelines so closely.
Hi
Could i ask advice, i take prep on event based basis, took my first two pills (7pm sunday) but had no sex, so i have missed day 2 as i had not had sex, however day 3 today ive planned sex so i have taken two pills to start with again due to the gap in dose, in anticipation of sex and will continue with 1pill for 2 days post sex, am i right? Or should i have continued on today with just one dose even though i missed a dose yesterday because nothing happened.
Hello Gianni and thanks for getting in touch.
Please don’t worry. You are covered. You are not at risk.
You are taking a bit more medication than the guidelines suggest you should.
So, right now the indicated way to take PrEP is 2:1:1 (adding 1 tablet per day for more days you keep having sex and making sure you take a tablet a day for two days after you stop having sex.)
I think these examples will help you understand better how many tablets and for how many days you need to take them:
https://i-base.info/guides/prep/real-life-examples-for-on-demand-dosing
Thank you for your prompt reply Simon, I took 2:1:2 since the second after sex dose was 6 hours late.
Im going to take one more pill today because i had another sexual intercourse in the middle, so the final course would be 2:1:2:1.
Am I at risk?
Thank you again!!!
Hi Gianni, please see the info on 2:1:1 dosing in this PrEP guide:
https://i-base.info/uk-guide-to-prep/
I am not sure why you did 2:1:2.
Because you had sex on two days you need to finish by taking daily PrEP for two days after the last sex. This would be 2:1:1:1.
The differences probably won’t make much difference but it is better to follow the guide.
Hi, this is what happened with my on demand prep:
Sunday – 3pm (2 pills)
Sunday – six hours later (anal sex without a condom with no ejaculation inside)
Monday – 3pm (1 pill)
Tuesday – 1am (similar anal sex without ejaculation inside)
Tuesday – 9pm (2 pills – 6 hours later)
Am I still protected? What time should I take the next dose?
Thank You in advance!
Hi Atlas, dose time don’t need to be exact so this all sounds fine. Taking the dounble dose at least two hour before sex give really strong protection and the sex doesn’t sound like it involved any risk anyway.
Hi,
I’m a bit concerned with my 2-1-1 on demons time line and would really appreciate it if you could help me with it.
I took 2 pils on Sunday around 4pm, had a hand job and some body rubbing around 7:30pm (I was sceptical about the protection since I only took the initial does three hours before the event)
Then, second does on Monday 6pm and had oral sex around 7:30pm
Should I keep taking 1 pill per day around 4pm for the next two days? Was I still protected during the events? Since I took the first double does only three early than the event and was 2-3 hours late to my second does.
Much appreciated for your answer
Atlas
Hello Ligg and thanks for getting in touch.
If both you and your partner are negative the PrEP was the extra protection.
Well done for being on PrEP and for taking it as the guidelines suggest.
I don’t see how the sex you had can be unsafe in any way.
I took 2preps while having sex and 1after 24h and 1more after 48 does it safe if both me and my partner are tested negative ?