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 Pihl, no you are not at risk. Even though you had missed a dose, the initial double dose still provides a higher level of drug in the body than normal.
You then had 2 further doses of PrEP before having sex. As long as you continue to take the following 2 doses after PrEP will remain effective.
I’ve been taking PrEP since January. However, I stopped taking it for almost a week. On Wednesday at 10 p.m., I took 2 doses of PrEP in order to restart, the next day (Thursday) I forgot to take the 2nd dose. On Friday about 11 p.m. I took one dose. On Saturday I also took a dose (8:00 p.m.) and I had unprotected sex (as bottom, although there was no semen, but I imagine there was precum by him) around 11 p.m. As I don’t know the status of the person I had sex with, two hours (1 a.m.) after sex, I took another dose of PrEP.
In Summary:
Wed. 2 pills at 10 p.m.
Thur. forgot dose.
Fri. 1 pill about 11:00 p.m.
Sat. 1 pill at 8 p.m. – Had sex about 11 p.m. – another pill about 1:00 a.m.
Do you think there could have been a risk of infection? Or do the doses I had taken protect me in any way?
Hi Jay, on-demand PrEP starts with a double dose. This doubles how much PrEP is in your body than normal. The higher level of PrEP can account for the 3-hour delay on the last day.
You do not need PEP. You can finish PrEP and the course will remain effective.
Hi,
I started on an event based prep (2-1-1). But my last dose was 3 hours late. I am a bit worried if i ask for PEP prescription.
I really need an information on this.
Wednesday 6 pm: 2 pills
Wednesday 9 pm had sex
Thursday 11 am had sex
Thursday 5 pm 1 pill
Friday 8:50 pm 1 pill.
I am so worried. Please i need a consultation on this.
Best,
Jay
Hi Matt , as you had started with a double dose of PrEP there is likely enough PrEP in your body to account for the missed dose on Sunday.
Was this a high risk exposure e.g, prolonged duration of sex, other infections, use of drugs etc…?
Some PrEP will always be better than no PrEP.
Hello!
I initiated PrEP on 2-1-1 scheme, but I forgot about the last pill, and took double dose almost 20 hours later, I still have a couple of hours to access PEP, would you recommend to do so?
Timeline is as follows
Friday around 23:00 took 2 pills
Saturday around 22:00 took 1 pill
Monday around 17:00 took 2 pills
Hi John, on-demand dosing starts with a double dose. The double dose causes a higher level of PrEP in your body than normal.
Though you had forgotten to take PrEP Thursday, you did remember within 12 hours. Due to the double dose initially and the timing of the last dose you are still protected. You are not required to take PEP.
Hi
I forgot 1 pill of prep on demand after sex. Should I be concerned?
Tue 11pm had 2 pills
Wed 8pm had anal sex
Wed 1030pm had 1 pill
Thurs I forgot to eat 1 pill
Fri 8am realized quickly ate 2 pills.
Hi Pete, as you have taken 2 doses of PrEP after sex at a similar time you started your double dose you have taken on-demand PrEP correctly.
You do not need to take any further PrEP pills. You are protected.
Hi
Can I ask a question
I took 2 pills on a Saturday night and had anal sex on Sunday ( I’m active ) I took another prep when I got home at 7 pm and another on Monday but forgot to take a 3rd pill on Tuesday. In summary
Sat. 2 pills
Sunday had sex
Sun 1 pill
Mon 1 pill.
Am I at risk. I’ve only just remembered and it’s now Thursday ( I’ve panicked and just taken two pills)