Q and A

Question

Does PEP have side effects?

Hello,

I am confused with PEP treatment, specifically about the side effects.

From sexual health charities I hear that PEP treatment can cause occasional side effects which may or may not go over the 28 days treatment. Another one (THT) says that the side effects are extreme and about 1 in 5 people on PEP stop taking it as a result.

The sexual health nurse said that side effects on PEP are very common and are severe.

I’ve heard from 3 people who have had PEP and they said that they didn’t get any side effects.

What’s the official line on PEP and side effects? I thought that PEP usually uses recommended triple therapy, using drugs that are well tolerated. Is the conflicting information I am receiving due to outdated data or current data?

Thank you for any clarity you provide.

Answer

All meds have some risk of side effects, but for PEP this risk is usually low. If side effects do occur, they are usually mild.

This depends on the meds used in the PEP combination.

In the UK in 2018, the PEP combination is usually raltegravir plus a combined pill with tenofovir DF/emtricitabine, which generally causes very few side effects, if any.

Even general side effects like nausea, diarrhoea and tiredness are not experienced by most people.

If mild side effects occur, they usually get easier after the first week or two as your body adjusts.

PEP that contains a drug called efavirenz is not recommended in the UK, though is used in some countries where there is less choice for HIV drugs. Efavirenz has a higher risk of side effects including mood changes and vivid dreams.

Discontinuation rates for PEP are often not very good. Studies of health workers who are exposed with a needle-stick injury report many people stop before the full month of treatment.

Note: This answer was updated in February 2018 from a question first posted online in June 2009.

226 comments

  1. Roy Trevelion

    Hi Billy,

    Please see the info about PEP at this link.

    For PEP, you need to have a rapid HIV test which gives the result within 30 minutes. This test only tells you whether you were HIV positive three months ago. It tells you nothing about the recent risk.

    After a course of PEP you need to wait 28 days before testing for HIV. This is because PEP can delay infection.

  2. billy

    hi,
    I had unprotected sex with a girl who later to me i should visit the doctor, and am now taking PEP, I was asking what are the results when maybe you were infected? and also what are the results while taking PEP when you dont have any infection?

  3. Roy Trevelion

    Hi Mark,

    It’s good that you finished the PEP now. I hope you’re feeling better. But if you have extreme side effects like this it’s important to see the doctor about them. There might have been different PEP meds you could take.

  4. Mark

    I had extreme side effects from taking PEP – had a really tough 28 days and am definitely going to avoid any situation in my life that would mean I have to take this again. It was horrible! Diarrohea all the time, headaches, tiredness, intestine spasms, back pain, vomiting, bloody stools, temperature, flu symptoms, mouth ulcers and many more! Was a nightmare!!!

  5. Roy Trevelion

    Hi !art chari,

    Yes, you have a routine 4th generation test for HIV every 3 – 4 months, if you are on PrEP.

  6. !art chari

    Naomba kuuliza once umeanza prep.utakuwa ukichukuwa prep unapimwa tena

  7. Roy Trevelion

    Hi Simon,

    Here’s more info about PEP and PrEP. After your course of PEP, you might think about asking for PrEP. Is this available where you live?

    Taking PrEP before you have sex can help stop you worrying about HIV risk.

  8. Simon

    I had sex with a person whom I don’t know his status, I was tested negative but Iam worried of HIV and Iam on PEP
    Iam I not going to get the side effect

  9. Roy Trevelion

    Hi Kit,

    All meds have some risk of side effects, but for PEP this risk is usually low. If side effects do occur, they are usually mild. So please see your doctor about the headache.

  10. Kit

    I felt having headache after completing 28 days course.

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