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 Theo and thanks for the question.
The guidelines recommend that you start PEP for protection after sex (within 72 hours).
Please read more here: https://i-base.info/pep-and-prep/
Hello, I took 2 pills of prep 1 hour after sex. Would that still be okay?
Hi Adam, the double dose is very good at providing extra cover in case the doses after sex are a little late.
Please see this guide for info on PrEP dosing:
https://i-base.info/uk-guide-to-prep-february-2024/
Please notes that we are not doctors and speaking to a doctor is recommended if you are worried :)
Hi Josh, May you help me with my concerns:
I’m taking the on-demand PrEP,
• First 2 dose at 11PM – without sex
• Another 1 dose at 11 PM on the 2nd day – without sex
• on the 3rd day, I had unprotected sex and forgot to taking the pill at the scheduled time as 11PM, when I realized it’s already 8 hours late, but I had took the pill right away.
Therefore, could you please advise what should I do further? Starting PEP, or just continue taking another pill on the 4th day at the right planned schedule?
Hi Simon, you need to take PrEP asap if you want it to have a chance or working. It definitely can’t work if you haven’t taken it yet,.
PrEP can also give you some cover until you start PEP if this was a high risk. Please talk to a doctor about PEP and see this info here:
https://i-base.info/qa/factsheets/pep-faq
I just had sex, but no prep, can I take it in next hour and still be safe?
Hi Hugo, you are easily covered. Please do not be worried. PrEP is very effective and the double dose at the start rapidly gets you good drugs levels to cover you if you are a bit earlier or later with the following doses. It is easy to take daily PrEP as you need it until you are past the two days since the last time you had sex.
This flexibility would have happened in the IPERGAY research study that proved 2:1:1 dosing was so effective – and no-one using this dose became HIV positive.
Hi PrEp experts,
I got a question about on-demand dose usage, does the following two pills must be taken exact the 24h and 48h?
I am asking is because I do not know whether i was protected. I had sex on the 21st of August around evening time and took 2 pills before, but the follwing days I took the following pills in the morning time, 1 pill pre day, since I knew I might have sex again over the weekend, so I kept taking prep every day, I had sex on Sunday afternoon and Monday the 26th morning, and I took prep every day until Thursday(29th).
Since I did not strictly take prep at the exact time, but definitely took it every day, am I still protected?
I am super worried and I appreciate your help!
Hi Mark yes you are right. You only need to continue for 2 further days after the last exposure.
There is no difference in stopping treatment between on-demand and daily dosing when you have had sex.
Hi
Im just looking for advice, i appreciate the topic is a touch different but i started with a double dose a week ago, had sex that night, took my next 2 doses normal 24hrs apart, but continued to take a daily dose 24hrs apart give or take an hour , just incase sex occurred as i have been active, im now on day 10 of daily dosing, if i wanted to stop do i take two doses for 48 hours after my last activity as i would with on demand dosing? Or do i need to extend the stopping period now?