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 Is the conflicting information I am receiving due to outdated data or current data?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 Charles, this is not a sign of HIV. As you have no other symptoms and completed a course of PEP, the likelihood of this being HIV is minimal. If these sores continue not to heal, are you able to access a health clinic? 3 weeks after PEP is too soon. For a confirmatory test, you will need to wait 6 weeks after the last dose of PEP (another 3 weeks). This will require a 4th generation antigen/antibody test.
Hello, I’m Charlie
I finished pep two weeks ago, and now on the third week I developed sores on my penis that has refused to heal for 3 days now. I also noticed a small painful lymph nodes in my groin that disappeared in three days before the sores came. I did not involved myself in any unprotected sex during my pep course and I did not miss a dose. So far I have not had any rashes, fever, headache or sore throat since I finished pep going to 3 weeks now. I only had neck pain the week after pep, that lasted for 3 to 4 days and stopped. Since then I have not had any signs or symptoms till this penis sores developed. Please I need to know if this is a sign of HIV infection, and can I get tested in my 3rd week after pep. Please I worried and scared, help me.
Hi Desmon, these are common symptoms and not specific for HIV. These symptoms can be caused by very common illnesses e.g., the flu or a cold. As you have been on PEP, your symptoms are very unlikely to be caused by PEP. PEP delays any effect HIV has on the body. Symptoms would not appear until 1-3 weeks after PEP. Even then, the symptoms that present would still more likely be caused by other common illnesses as you have completed your course.
Hi. On the 17th December 2022 I meet a lady and we sleep at the sameday and condom blust the next day we went to the hospital she was positive I tested negative they advise me to take pep emediate and while I was taking pep I was normal no pain nothing at all on last week of the treatment I feel pain in my neck and my tunsels where painting and my hole body was itching. now I finish the corse 2days ago. I start to feel tunsels pain and itching please advice.
Hi Rohit, aside from your precum touching your partners penis, was there any other contact? This alone is not a risk for HIV transmission. The symptoms you have experienced are too soon to be caused by HIV seroconversion. A sore throat is a common infection and in this case would not have been caused by HIV. The combination you are taking for PEP is a common treatment used as PEP. As you started it soon after your potential exposure it will be effective.
Hi,
I started my PrEP on Nov 13 and missed one dose in between. Nov 30 I went to massage and the guy rubbed my precum and touched his dick back and forth. I worried and went to clinic on Dec 1. They did test and it was negative. Dec 2 – after 48 hours I started taking PEP.
After taking PEP , 2nd day ( Dec 04) got sore throat, and it lasted for one week. And then got dry mouth and blisters on back of my lower lips. I m worried. I didn’t have any oral sex .
Taking daily for the past 12 days
emtricitabine/tenofovir disoproxil fumarate
Tivicay (dolutegravir)
Please advice
Hi Steve, vitamin D and C do not interact with PEP. How long have you been experiencing these symptoms? and are you still feeling them?
What is the name of the PEP you are taking? Different types can have different severities of side effects. What time of the day are you taking PEP?
Hi,
I started PEP 6 days ago now. I have been having the medication the same day as Vitamin D and C supplements. Something I think is not recommended but I wasn’t told this and only found out today. So I’m panicking about my medication not working. From my understanding I’m worried about other STI symptoms and not just HIV. That’s why I was taking the supplements just in case they stopped the other infections. I’ve not felt so sick in my life before though. I’m tired but can’t slip, my lip burns, my mouth is dry. My throat is so sore. I keep clearing my throat but this is hurting my head and throat each time I cough. I feel so sore all over. I’ve never felt so sick before. I read everywhere the side effects are mild for PEP but I honestly feel like I could die in the next couple of hours. I’ve still got 22 days before I finish this medication and another 8 days before I can get tested for some of the other stuff. I am struggling to cope, I left work early. I can’t focus. I can’t wait that long to get tested. I feel like my throat is so sore from one of the other STI’s maybe.
Hi Sello, Wednesday is too late to start PEP. For PEP to be effective it needs to be started within 72 hours of the exposure. How many days after finishing PEP did you notice these symptoms? PEP suppresses HIV and symptoms would not be expected until a few weeks after finishing. As you are experiencing flu-like symptoms, even if PEP was not effective, it still remains more likely that you have the flu rather than HIV.
I had sex with some one who is positive I only realised after we both tested and his came out positive so It happened that we had sex Saturday early morning and I only began Pep Wednesday so does it mean I took it late cos after I finished it I start experiencing flu like symptoms and sores around my nose and a bit on my tongue