Question
Can Truvada be used as PEP?
17 March 2022. Related: Access to treatment, Adherence, All topics, HIV transmission, PEP/PEPSE, PrEP.
Hello I’m writing from South America, Chile, first thing I am sorry about my English since it is not my first language. I had a risky encounter (broken condom, I was bottoming) and I started PEP 34 hours after, but they only gave me Truvada. I don’t know if this 28 day prophylaxis will be effective, any advice will be welcome.
Thanks in advance.
Answer
Hi, how are you doing?
Truvada alone is not the most effective medication to be used as PEP.
Truvada only contains two medications instead of three meds used in PEP. Are you able to speak to a doctor? Truvada does contain some of the medication of PEP, but adding a third drug (maybe raltegravir or dolutegravir) with Truvada would be better.
However this does depend on availability and other options may be available where you are.
Even if you can’t get an additional drug, there is still benefit to taking Truvada and it will reduce the risk of transmission.
Josh.
I am based in the US. My ER doctor gave me Truvada o12 hrs after exposure 100/150MG one pill and Tivocay 50MG. Once a day for both. On 3rd day, my family doctor doubled the Truvada dosage at 62hr of exposure. I don’t have kidney problems.
What are the chances of my pep being effective since I only had low Truvada dosage first 2 days?
I have posted before and my exposure was insertive unprotected anal where she confirmed positive via OraQuick?
Hi Jake, yes this is okay. You still obtained a 3-drug regimen in 72 hours. Even without a 2-drug combination such as Truvada can be suitable alone as PEP. Adding Isentress only helps to ensure it works.
More information about PEP can be found here: https://i-base.info/qa/factsheets/pep-faq
Had encounter as bottom with broken condem, Received Truvada and started at 25 hrs, but they didn’t have isentress and had to take at 52hrs, is this okay?
Hi Mikey, where are you based? In the UK the recommended dose is emtricitabine 200mg and tenofovir 245mg. Have you been given the 100/150mg as a combined tablet? and how often were you told to take it e.g., once/twice a day?
You are taking the recommended dose of Tivicay. Do you have any known problems with your kidneys? The emtrictabine/tenofovir dose is halved when someone has moderate kidney impairment and this should be started under the surveillance of a specialist.
Who prescribed this course of PEP e.g., ED doctor, GP, nurse etc…?
I male 34 years old who had an unprotected anal intercourse with a Trans and I was the Top. We had anal sex 3 times unprotected within 2 hours. The first 2 times, I did not insert my penis fully, however, the third time I did and there was some blood. I am circumcized. She did OraQuick home test after and it was positive. I went to urgent care and did my medical work and got PEP which consisted off Emtricitabine/Tenofovir 100MG-150MG + Tivicay 50MG.
Is there a reason why I was only prescribed 100MG-150MG of Emtricitabine/Tenofovir? will this be effective at all considering low dosage?
I am on day 2 of the meds and will be consulting my family doctor soon.
Any help would be appreciated to give me a piece of mind. Thank you
Hi Oz, are you taking this as PEP?
Yes you can add this third drug even though it is 12 days in.
Truvada alone can be enough for PEP and it is good that you were able to start it so soon after exposure. Adding this third drug can only help increase how effective PEP is. There is no problem in adding it now. What is the name of this third drug you have been given?
I started Truvada at 12 hrs after exposure. Can I start taking the other 3rd Medication even if it’s 12 days later?
Hi WorriedOne, there is still benefit to completing your course of PEP. PEP can be effective when started within 72 hours.
PEP is recommended to be a combination of 3 drugs but this does not have a strong evidence base. It is recommended more on the basis of completion rather than studies. For this reason 2 drugs would be suitable which is why starting Truvada at hour 60 will be okay. As you have added Tivicay this will help to improve how effective your course of treatment is.
Hi, I really appreciate you all for maintaining this site and answering so many questions from nervous people!
I’ve had a possible exposure with a partner of unknown status – receptive anal where the partner was supposed to use condom but did not use it the whole time. (No internal ejac.) Because was traveling I had trouble obtaining and starting PEP. I was able to start Truvada at hour 60 but the third drug Tivicay wasn’t available until hour 80. I’ve read that recent (2020) animal studies indicate a 2-drug PEP regime, and really any PEP regime started after 48 hours is unlikely to provide any benefit. But I’ve also read here on this site that there may be some benefit to continuing the medications even in my situation. Either way, PEP delays testing reliably and so extends the period of anxiety. If there is truly no benefit to continuing the medication because of when I started it or because of the lack of Tivicay until hour 80, I’d rather discontinue it and get a reliable test result sooner.
What are your thoughts on Truvada at 60 hrs + Tivicay at 80 hrs?
Hi Leo, please see here for more information: https://i-base.info/qa/factsheets/hiv-transmission-and-testing