Q and A

Question

I have been given Kocitaf for PEP?

18 December 2023. Related: All topics, Changing treatment, PEP/PEPSE, Side effects.

Hi, I had unprotected sex with a girl I dont know in a somewhat high risk country. I have started PEP around 14 hrs after.

This is 3rd time in my life on PEP. First time I was on Biktarvy. I know it’s not approved for PEP in the US or UK, but popular here where I live.

Second time Acriptega.

Neither had any side effects except for kidney pain, or maybe that was gas build up at the end of the treatment.

This time I was put on a drug called Kocitaf. I can’t find much info on it online and it’s causing serious side effects. Kidney pain from day 1, bad fatigue, headache, stomach cramps, dizzines, feeling hungry in a way when blood sugar drops.

I am on day 6 and did some blood tests because I was scared of the pain.
Tests came back all good except for white blood count, some were low, some high, but I may as well have an unrelated infection.
Kidney and liver was all good.

Anyway, I am worried and it’s hard to live with those side effects. Have you heard about this drug? Is it okay to change it to let’s say Biktarvy mid-treatment? My doctor here said – yes, but I want to confirm.

Thanks

Answer

Answer: Josh Peasegood

Hi, how are you doing?

I am sorry to hear about the side effects you have been experiencing.

Acriptega and Kocitaf are very similar drugs.

Acriptega is a generic version of tenofovir DF, lamivudine and dolutegravir.

Kocitaf is a generic version of tenofovir AF, emtricitabine and dolutegravir.

Both emtricitabine and lamviduine are largely the same medication. They have a similar chemical make up and you should not experience more side effects with one over the other. This is also true between tenofovir DF and AF.

Have you noticed any other side effects/symptoms e.g., fever, diarrhoea, vomiting or other things suggestive of an infection? and have you had any symptoms tested other than bloods e.g., blood sugar, blood pressure and urinalysis?

The white blood cell count could put this down to an infection. It is good that your liver and kidney were good.

Yes you can change treatment mid-way through the course if these are side effects, but you should check that there is not another cause for the symptoms before you do.

Please see this link for more information about PEP:
https://i-base.info/qa/factsheets/pep-faq

Josh.

4 comments

  1. Josh Peasegood •

    Hi Dave, yes you can switch to PrEP right away. This is a common recommendation and it is safe to do so.

  2. Dave •

    Hi Josh,

    Thanks for the reply. I have one follow-up question.

    Due to my risky behaviour, I now wish to take PreP.

    The question is, as soon as I finish my PeP course on day 28th, can I start PreP right away on the next day (Day 29th)?

    Appriciated your advice. Thank you.

  3. Josh Peasegood •

    Hi Dave,

    1. Yes. PEP (Kocitaf) will work like PrEP for the duration of treatment. For this to work you are required to have 2 remaining days of PEP after the last exposure.

    2. While on PEP it is still not recommended to have sex. If you do it is advised to use a condom.

    3. No you do not need to extend your course of PEP.

    4. Where did this recommendation come from? 30 tablets is commonly prescribed and only recommended for 28 days. The additional 2 tablets can be used to start PEP again if needed.

    More information about PEP can be found here:
    https://i-base.info/qa/factsheets/pep-faq

  4. Dave •

    Hi josh

    Kindly advise me on what to do. I took my first pill of Kocitaf after 3 hrs of first exposure. I am now on day 9th of pep and still have 21 days to go (out of the 30 days course). But yesterday (before my 8th dose), I have condomless sex with a new partner who doesn’t know her status.

    I have the following questions:

    1. As you mentioned: Kocitaf is a generic version of tenofovir AF, emtricitabine and dolutegravir. Does this mean Kocitaf can also work as PreP and that I should be safe from my second exposure on day 8th?

    2. If the above is true , for this particular case, untill when before I finish my course can I have unprotected sex without exposing myself to HIV or infect others?

    3. With the second exposure yesterday, should I extend my course of Kocitaf longer? If yes, for how long? Why and why not?

    4. Having learned from this website that the course of pep is 28 days, any idea why it’s 30 days for Kicitaf?

    Thank You so much