Doxy-PEP

What is this?

Doxy-PEP means taking an oral dose of an antibiotic called doxycycline within 72 hours (3 days) of having sex (oral,anal, or vaginal) to protect against syphilis and chlamydia. 
It does not work against viral infections such as HIV or herpes.

How do you get it?

Doxy-PEP is most likely to benefit people at higher risk of syphilis, such as gay, bisexual, and other men who have sex with men, and transgender women, especially with recent syphilis or multiple recent STIs in the last 12 months.
Doxy-PEP reduces the risk of syphilis (by 70-80%) and chlamydia (by 70-90%). Due to antibiotic resistance it is unlikely to be effective against gonorrhoea, so it is important to regularly test for STIs.

Potential benefits

• Prevent syphilis and chlamydia infection
• Reduce the spread of STIs within your sexual networks
• Provide added protection alongside condoms and STI testing.

Potential risks

• Common but non-serious side effects including nausea, vomiting and diarrhoea
• Your skin may become more sensitive to sunlight, causing a rash or sunburn
• Rare but serious reactions like allergies, oesophageal ulcers or liver damage
• If used after 18 weeks of pregnancy, can cause bone and teeth defects in your baby
• May contribute to antibiotic resistance in your body, or in the community, and reduce your future treatment options for STIs and other infections. 

Doxy-PEP is one approach among several for preventing STIs. An open conversation with your doctor can help determine if Doxy-PEP is suitable for you based on your specific needs.
 

How is it treated?

• Take two 100 mg doxycycline tablets or capsules once within 72-hours (3 days) after having sex (oral, anal, or vaginal sex)
• Take doxycycline with food and a full glass of water to prevent stomach upset. Do not lie down for at least an hour after swallowing the tablets, to avoid irritation of your food pipe.
• Do not take Doxy-PEP more than once every 3 days
  Do not take antacids, iron, calcium. zinc or fibre supplements within 2 hours of doxycycline as they may interfere with its absorption
  Apply sunscreen when out in the sun to avoid sunburn.

Safety information about doxycycline

• Do not take doxycycline if you have a known tetracycline allergy - the class of antibiotics to which doxycycline belongs
• Do not take doxycycline after the 18th week of pregnancy
• Discuss the risks and benefits of taking doxycycline while breastfeeding with your doctor. 
• Consult your doctor or pharmacist about possible interactions if you are taking any of the following:
  • Vitamin A preparations and medicines for skin problems (e.g., isotretinoin, etretinate)
  • Warfarin, a medicine used to prevent blood clotting
  • Penicillins, another group of antibiotics (e.g., amoxicillin)
  • Epilepsy medicines (e.g., phenytoin, carbamazepine, phenobarbitone)
  • Birth control pills, as doxycycline may decrease their effectiveness, requiring additional contraception.