DOXY pep & PrEP together?

[Knobby 212]

I use PrEP when I  go to Thailand but can that be taken with PEP?

Or is it too much at the same time?

 

[Gambino 196]

I'm new to learning about this. But I've spoken to a doctor that has prescribed both, and there was never any mention of adverse interactions when taking them concurrently.

Note, though, that they are on different schedules (PrEP is once daily at the same time every day, and PEP is as-needed within 24 hours of exposure, but not within 2 hours of dairy, calcium, antacids, or multivitamins).

Good luck! 

[SAGuy 3,855]

I go to MedConsult clinic on soi 49 for all my medical requirements (vaccinations, medicine, tests) as they have farang doctors, are cheap and have a great reputation.

Just by coincidence, I received this email from them recently, which you may find to be of interest:

View in browser          The Pre-Songkran holiday sexual health series Have you heard of DOXY pep? Hey there! With the holiday season around the corner, it's time to talk about something super important: sexual health! Yep, that's right, because let's face it, holiday times can sometimes bring unexpected adventures, and it's crucial to keep your sexual health in check while you're out there having fun. First off, let's talk about safety. Whether you're with a longtime partner or meeting someone new, make sure to practice safe sex. That means using condoms or other barrier methods to protect against STIs and unintended pregnancies. It's like wearing a seatbelt for your sexual health – just a smart move all around. Doxycycline as PEP primarily focuses on its effectiveness in preventing sexually transmitted infections (STIs), particularly chlamydia and gonorrhea, rather than HIV. Studies have shown that daily or intermittent use of doxycycline can reduce the risk of acquiring these bacterial STIs among individuals at high risk. The guidelines state that a single 200mg dose of oral doxycycline taken within 72 hours after oral, anal or vaginal sex. Prevention of HIV Pre-Exposure Prophylaxis (PrEP): PrEP involves taking a daily medication (usually a combination of tenofovir and emtricitabine) to reduce the risk of acquiring HIV through sexual contact. PrEP has been shown to be highly effective when taken consistently, offering an additional layer of protection for individuals at high risk of HIV infection. PrEP on Demand" is a dosing strategy for pre-exposure prophylaxis (PrEP) that involves taking medication around the time of sexual activity, rather than on a daily basis. This approach is based on clinical research showing that PrEP can be highly effective when taken as needed, particularly for individuals who engage in infrequent or episodic sexual activity. Taking PrEP pills only when you are at risk for getting HIV is known as “on-demand” PrEP. It is also known as “intermittent,” “non-daily,” “event-driven,” or “off-label” PrEP use. The type of “on-demand” PrEP that has been studied is the “2-1-1” schedule. This means taking 2 pills 2-24 hours before sex, 1 pill 24 hours after the first dose, and 1 pill 24 hours after the second dose.           MedConsult GP Clinic Floor 3, Building 2 of The Racquet Club, Sukhumvit 49/9 Alley, Khlong Tan Nuea, Watthana, Bangkok 10110, Bangkok Thailand

[steve54 23]

My understanding is that there is no problem taking them together (I have been prescribed both for use together later in the year on my intended Thailand trip).

I believe that PREP can be taken ongoing but DoxyPEP is an antibiotic intended to be taken either after an exposure or at half dose for a max period of 28 days -  so in my case I will take DoxyPep daily during my 2-3 weeks trip.

One aspect of DoxyPep that I was advised about and quite relevant to Thailand is that when taking it the user is at a significantly higher risk to get sun burnt and as such hats/shade and sunscreen become more important.

[Knobby 212]

On 4/4/2024 at 3:52 AM, SAGuy said:

I go to MedConsult clinic on soi 49 for all my medical requirements (vaccinations, medicine, tests) as they have farang doctors, are cheap and have a great reputation.

Just by coincidence, I received this email from them recently, which you may find to be of interest:

View in browser          The Pre-Songkran holiday sexual health series Have you heard of DOXY pep? Hey there! With the holiday season around the corner, it's time to talk about something super important: sexual health! Yep, that's right, because let's face it, holiday times can sometimes bring unexpected adventures, and it's crucial to keep your sexual health in check while you're out there having fun. First off, let's talk about safety. Whether you're with a longtime partner or meeting someone new, make sure to practice safe sex. That means using condoms or other barrier methods to protect against STIs and unintended pregnancies. It's like wearing a seatbelt for your sexual health – just a smart move all around. Doxycycline as PEP primarily focuses on its effectiveness in preventing sexually transmitted infections (STIs), particularly chlamydia and gonorrhea, rather than HIV. Studies have shown that daily or intermittent use of doxycycline can reduce the risk of acquiring these bacterial STIs among individuals at high risk. The guidelines state that a single 200mg dose of oral doxycycline taken within 72 hours after oral, anal or vaginal sex. Prevention of HIV Pre-Exposure Prophylaxis (PrEP): PrEP involves taking a daily medication (usually a combination of tenofovir and emtricitabine) to reduce the risk of acquiring HIV through sexual contact. PrEP has been shown to be highly effective when taken consistently, offering an additional layer of protection for individuals at high risk of HIV infection. PrEP on Demand" is a dosing strategy for pre-exposure prophylaxis (PrEP) that involves taking medication around the time of sexual activity, rather than on a daily basis. This approach is based on clinical research showing that PrEP can be highly effective when taken as needed, particularly for individuals who engage in infrequent or episodic sexual activity. Taking PrEP pills only when you are at risk for getting HIV is known as “on-demand” PrEP. It is also known as “intermittent,” “non-daily,” “event-driven,” or “off-label” PrEP use. The type of “on-demand” PrEP that has been studied is the “2-1-1” schedule. This means taking 2 pills 2-24 hours before sex, 1 pill 24 hours after the first dose, and 1 pill 24 hours after the second dose.           MedConsult GP Clinic Floor 3, Building 2 of The Racquet Club, Sukhumvit 49/9 Alley, Khlong Tan Nuea, Watthana, Bangkok 10110, Bangkok Thailand

I got that hence creating the thread

[Knobby 212]

I was doing some quick research on Doxy and looking at the possible side effects.

Seems to me amoxicillin would do a decent job on its own and it's easier to get in nearly any pharmacy in Thailand. 

I do have an appointment at Dean St clinic in London before my next trip so while getting my usual tests done and PrEP I will see what they say about this.

[Gambino 196]

@Knobby Amoxicillin is not bacteriostatic (but doxycycline is). Doxycycline prevents the growth of the bacteria. Amoxicillin just kills bacteria directly, which could work if you actually came down with a case of an STD, but it would not be effective as a prophylaxis, which is what DoxyPEP is.

And don't worry about finding doxycycline easily; it is in any pharmacy in Thailand and it's incredibly inexpensive. 

[Knobby 212]

1 hour ago, Gambino said:

@Knobby Amoxicillin is not bacteriostatic (but doxycycline is). Doxycycline prevents the growth of the bacteria. Amoxicillin just kills bacteria directly, which could work if you actually came down with a case of an STD, but it would not be effective as a prophylaxis, which is what DoxyPEP is.

And don't worry about finding doxycycline easily; it is in any pharmacy in Thailand and it's incredibly inexpensive. 

Yes, I read the same things about both. Doxy seems to have more possible side effects and says no alcohol when taking Doxy. I am no big drinker but do like a drink or three at the weekends.  

Now while alcohol can effect any medication Doxy seems to have a few I don't like the sound of. When I get to my Dean St appointment I will ask their advice.