Question
Does PEP have side effects?
5 February 2018. Related: All topics, PEP/PEPSE, 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 Is the conflicting information I am receiving due to outdated data or current data?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.
Hi Lisa,
It’s not easy to say what level of risk there might be. Individual risk is very difficult to estimate. It could depend on different factors, such as your patient’s viral load or the amount of blood on the needle.
But please talk to your doctor if you keep throwing up just after you’ve taken PEP.
I got a needle stick injury after giving an intradermal injection to an HIV positive patient. What is my risk of getting HIV? Also, I started PEP the day after I got the needlestick and I am nauseous and have diarrhoea. I threw up three days right after taking the meds and had to be put on gravol. Are my risks higher?
Hi Steve,
If you’re feeling like this, please see a doctor.
i’m on the 2nd week of pep and last night i started having burning sensation in my arms and legs and chest. i’m really scared as it’s not the usual side effects of pep.
Hi Cholan,
Everything would be fine. There shouldn’t be anything to worry about.
What happens if you take PEP when you are not HIV exposed
Hi Thabi,
Side effects of PEP are usually mild. So it’s important to see your doctor about your serious vaginal pain. Apart from PEP, you are taking other meds, and some of these are antibiotics.
So please see your doctor to discuss these symptoms.
I started a PEP treatment last night and the whole night im suffering from vaginal pain, cramps, even my bums are sore and cramping, a bit of a diarhea these vaginal pain can’t be tolerated they are extremely painful. My drugs are as follows
ANAEROBYL
Austell-Azithromycin
ESCAPELLE
TENEMINE
ALUVIA
Hi Omondi,
It’s a good idea to see the doctor about these symptoms. That’s because if side effects do occur, they are usually mild. So if you think you’re having a serious reaction, you can ask if there are other PEP meds that would be easier for you to take.
I’ve been on PEP medication for five days and it’s like I have experienced every side effect of the medication. Diarrhoea, nausea, headache, bloating, loss of appetite, stomach pain, insomnia, fever, and fatigue. I’m starting to get worried now.