Question
Will PEP still work if I am not taking it strictly every 24 hours?
16 May 2022. Related: Adherence, All topics, PEP/PEPSE.
I started my 28-day PEP course 4 days ago after having oral sex with a girl and later noticed that my gum was potentially bleeding while giving the oral sex. The third day of taking PEP I was taking the pill late for 1 hour (taking it at 12:30 vs. my usual time of 11:30). The fourth day I was late for another one hour (taking it at 13:30). Today I took the pill again at 12:30 because I felt like taking it at my usual time of 11:30 would have been too soon since the last dose (13:30). Will PEP still work effectively for me? Thank you so much.
Answer
Hi, how are you doing?
Yes PEP will still work effectively for you.
PEP needs to be taken regularly every 24 hours for it to work. But PEP does remain in the body longer than 24 hours. For this reason there is some leeway for being late or early with a dose by an hour.
Though it is best to avoid this to ensure you are maintaining a suitable level of PEP within the body. Is 11.30 still suitable for you or is it better moving your regular time to 12.30? To help remember it may be suitable to set an alarm each day to prompt you to take PEP.
Josh.
Hi Mario, when using a condom there is no risk of transmission.
For more information please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
If ihave an protect sex put never release sperm to me can iget uninfected
Hi Saggy, please see here for more information about PEP: https://i-base.info/qa/factsheets/pep-faq
Hi, I started my PEP at the 17th hour after possible exposure (condom broke and lady got tested a year back). On my second day I took it 3 hours early (39th hour after exposure), on my third day I took it 2 hours early. After third day I took it within a window of 24 plus or minus 1 hour. Will I be alright? I am too scared to get tested again. Before starting PEP I did get tested and came back negative.
Hi Alex, I am sorry to hear how anxious you are feeling but there is nothing to worry about.
Even though you did not see this condom, there is no reason to think that what he said was a lie. In addition, the ‘exposure’ you have described is very low risk to none. If there was a condom there is no risk, and even if not being slow and only fo this short duration means the risk os very small. In most cases this would not be a high risk exposure that would require PEP to be started.
While in most cases, 3 drugs are used as PEP, using 2 is suitable. The recommendation for a 3rd drug is more so for completion rather than being evidence backed. a 2 drug combination has been shown to be effective at preventing transmission. You also started within 72 hours meaning PEP will be effective in your case.
You will be able to test from 6 weeks after the last dose of PEP for a conclusive result. Using a 4th generation test will mean that the result will be conclusive and you would not need to wait until 3 months after.
For more information about testing and transmission please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Worried about PEP effectiveness. (Long Post)
Slightly freaking out. (PEP) (Stealthing) 10/22/23 met up with a guy to just Jo and oral (with condom). We were messaging and he said he was visiting and if I wanted to come over. I told him I was into safe sex because I rarely mess around. I asked him if he was DDF and recently tested. He said “yes I’m clean”. So I was like cool I’ll just Jo with him and maybe oral. So we meet up that’s what we do, and then he lifts my legs up saying if I wanna try to bottom. (I’ve only done this once) I told him to go slow, he did and it hurt so he was gentle. Nothing to worry about. (For now), it went on for like 5 mins of him trying to put it in and I couldn’t really see his dick. I then told him that I didn’t want to continue because it wasn’t very comfortable he told me to turn around. As I got up I noticed his condom was off. I freaked out so bad (internally) and I got up and told him if it was off the whole time… he said “no i just took it off” all hesitant. I did not believe him. So I told him I had to go and I left. He didn’t cum in me but I felt disgusted. :( and I immediately began overthinking everything. I got super anxious and hopped on a telehealth visit to get prescribed PEP at the 24 hour mark I got prescribed my medication but then I went to the doctor and the price of tivicay and truvada at cvs was insane! I recently lost my insurance from my job and I was going to pay out of pocket. The total was coming out to about $3,000. I felt sick to my stomach.
The pharmacist told me to not worry and to transfer my prescription to Safeway where I could get it far cheaper. Unfortunately they were closed and I had to wait till 12pm the next day. I was now at the 39 hour mark. I got my generic Truvada prescription for $30 with a coupon. I unfortunately was not able to afford tivicay or the substitutes as they were over $1k. I called my doctor about the prices and he told me to not worry and to just take Truvada and I will be ok. That tivicay does offer some more effectiveness but just Truvada works too and that I’m still at the time frame to not worry. The pharmacist told me the same. I took my first dose right at the 40 hour mark. I felt a little relief but now I’m freaking out again because I keep reading it’s a combo of 3 drugs and not just Truvada. :( has anyone just taken Truvada? I honestly think I’m just overthinking everything. Only side effects I’ve had is a slight headache and some digestive side effects. But overall I feel good. I messaged the guy and he supposedly is on PREP. I really hope he is because he didn’t seem to trustworthy since he lied about the condom. Will just Truvada still be ok? I read that that’s what was initially used for PEP (& now Prep). I just want time to fly by so I can retest at the 30 day mark then 3rd month mark. :(
Hi Eve, the time difference will not affect how PEP will work. Even though in this case you should now consider the second dose as the first, you will have still started treatment within 72 hours which is the recommended time for PEP to work.
Vomiting after 55 minutes of your treatment is too soon for PEP to be absorbed. This is why this dose does not count.
The two occasions you have been late will not change how effective your treatment is. This is because PEP can remain active in the body longer than 24 hours and this can account for being late. It is good that you have reverted back to your normal time as being late regularly can risk it not working, but these 2 times will not be a problem.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi Josh. I started pep 18 hours after possible exposure, but I puked 55 minutes into taking it. I was so nauseated that I couldn’t take another pill, and took the next dose the following day at 18:55pm. Would the time difference affect how pep would work? Since I puked early into the first dose, does the first day I took it count as the first? Or should I start counting from the second day, 42 hours later?
Also, on the 9th and 11th day of treatment I was late in taking my medication. I was traveling and couldn’t take it on my usual time, and took it at 21:20pm. I have since reverted back to the usual time at 18:55pm. Would this affect how the medication works? I’m on the 22nd day of treatment and have been taking it on time since then.
Hi Timothy, being late on this occasion is unlikely to cause any. problems. It would still be recommended to take PEP for the duration of the course.
PEP will remain active in the body a little longer than 24 hours. While not recommended to do it often, because PEP can remain active in the body for a longer time, being late will not stop the treatment working.
Have you thought about setting an alarm on your phone to help remember to take PEP at the right time? Or something else that will help you remember while you are on PEP?
PEP: https://i-base.info/qa/factsheets/pep-faq
I started my pep 2 days aga at 9pm and the third day I forgot to take it till 12am , is the pep still active or should I discounting