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 Is the conflicting information I am receiving due to outdated data or current data?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 Mish, these are not symptoms of HIV. It is too soon after finishing PEP to be experiencing symptoms of HIV. PEP would suppress HIV so symptoms would not present until a few weeks after the end of the course. Have you spoken to a doctor about these symptoms?
Sometimes being stressed and anxious around HIV/testing can lead to physical symptoms. Have you spoken with anyone?
Please help!
I finished taking my pep after 28 days but I’m still having side effects like nausea, headache and a sore throat. Is it normal?
Dear John, it sounds like you should not be a dentist. You are not following basic training. If your obsession with other infections continues – hepatitis, HPV, CMV, covid etc – please look for an alternative job. I would not feel safe being treated by you.
Hi doc
I’m a dentist
During work for patients, if few drops of blood enter my eyes put me at risk for HIV ?
I’m so worried
please answer me
Hi Joan, yes your medication will still work. It will still be considered that you started medication from 4 hours after exposure. What form of PEP are you taking?
I started pep within 4hours and then changed the time and took another tablet the following day in the morning, because I didn’t sleep when I took my first dose so I changed time but within the 72hours,it means l took two tablets within 24hours will my medication work
Hi John, taking this split dose is not going to affect how the medication works. If you prefer, you can move your morning Isentress dose to the evening and have one medication a day, or you can leave your medication as is – both options will work.
While you are on PEP, any test you take is not going to be accurate. For confirmation of status, the earliest test you can take is a 4th generation test. These are confirmatory from 6 weeks after PEP. For peace of mind they are 95% accurate from 4 weeks after finishing PEP – but then a second test is needed 2 weeks later.
Thank you for your answer Josh!
No actually I’m still taking in two different moments:
– 08:45AM one tablet of Isentress 600mg
– 08:45PM one tablet of Isentress 600mg+one tablet of Emicitrabine Tenofovir 200mg/245mg.
I always took the medications at the same time, today is the 12th day
Do I need to change and start to take the two tablets of isentress toghether?
I am really anxious because I’m thinking that the treatment will not do the desired effect not respecting the prescribed dose.
Then, what do you think if I take a NAT test next week?
Hi John, as you were getting the full dose within a 24 hour period there is no risk. The Isentress will work just as well as a split dose as it would have if taken together. Are you now taking the full Isentress dose together at the same time each day?
The effectiveness of PEP will not be changed by this.
Please help me!
I had an inseritive anal sex with a guy of unknown hiv status when I realized that the condom failed and my penis was completely uncovered by it. I don’t know if it was for 2sec or 5min. After 42 hours I went to the hospital and they prescribed me a PEP treatment. The nurse told me to take ONE tablet of Isentress 600mg in the morning and ONE tablet of isentress+one of emicitrabine in the evening. After more than one week I realized that on the box of Isentress and also in the leaflet is stated that the tablets of Isentress are to be taken TOGHETHER. (actually, when the nurse was telling me how to take the medication she was a bit confused) now, my questions are:
What do I need to do?
I used to take the Isentress 600mg tablets separately during the day, will it make any difference or adversely affect the treatment?
Will the PEP work anyway?
Thank you