Doxycycline post-exposure prophylaxis (DoxyPEP)

DoxyPEP is only available to people assigned male at birth.

• Gay and bisexual men who have sex with men.
• Transgender and non-binary people (assigned male at birth) who have sex with men including transgender women.
• Bisexual men who have sex with men and also have sexual partners with a uterus. 
• If you are living with HIV, you can use DoxyPEP.

Who should NOT take DoxyPEP?

• People with a uterus shouldn’t use it because there haven’t been any studies on them, so we don’t know if it works for them.
• Don't take it if you've had an allergic reaction to doxycycline or tetracyclines.

How to take your dose

• DoxyPEP is taken as 2 doxycycline tablets (2 x 100 mg tablets).
• Take your dose with food to reduce the chance of feeling sick (nausea).
• Swallow your doxycycline tablets with a large glass of water (100 mL) and remain upright for at least 30 minutes after taking your dose. Don't take it just before bed. Doxycycline tablets can get stuck in your throat when you swallow them and can hurt your throat if the tablets aren’t swallowed properly.
• Swallow the tablets whole. Don't crush or chew them.

Doxycycline interacts with dairy products and some other medicines

• Don't take doxycycline together with dairy products. Dairy foods such as milk, cheese and yoghurt can stop your body from absorbing doxycycline. You can have dairy products a few hours before or after your dose.
• Don't take the following within 2 hours of taking doxycycline:
  • antacids such as Mylanta and Gaviscon 
  • iron, multivitamins, zinc, magnesium or calcium preparations
  • fibre supplements.

Timing is important

• It works best when it's started within 24 hours, but it must be started within 72 hours of having oral or anal sex without a condom. The longer you wait, the greater the chance that DoxyPEP won’t work.
• DoxyPEP given more than 72 hours (3 days) after exposure is unlikely to be effective.
• If you usually have more sex at the weekend, you can take your dose on Monday morning. This helps protect you from any weekend sex (Friday, Saturday, and Sunday) while using less doxycycline.

Avoid frequent use of DoxyPEP

• DoxyPEP should not be taken more than 3 times per week. Taking it too often can increase the chance of side effects and may also lead to antibiotic resistance, making the medicine less effective over time.
• Condoms are a very effective way to prevent syphilis, chlamydia, gonorrhoea or other STIs.
• It's also important to continue to get tested for STIs every 3 months and whenever you have symptoms.
• Don't share doxycycline with other people, it may not be suitable for them.

Side effects of DoxyPEP

• Doxycycline can make your skin more sensitive to the sun. This can cause a burning, tingling feeling on your skin when you're in the sun, or you may notice redness. When you're outside, protect your skin and eyes by using a good sunscreen (at least SPF30+) and wearing sunglasses, a sunhat and clothing that protects you from the sun.
• Sore stomach or indigestion: Take DoxyPEP with a large glass of water and remain upright for half an hour after you take your dose. Don't take the medicine just before bed.    
• Allergic reaction including skin rash, itching and swelling.

• Since DoxyPEP is fairly new, not all prescribers or clinics may know about it.
• If you want to try it, you can ask your usual healthcare provider (GP or nurse practitioner). To help, there’s a letter you can take along that explains the evidence and helps guide the conversation.
• Some sexual‑health clinics already offer DoxyPEP. You can call a local clinic to check if they provide it and book an appointment if they do.
• If you’re under 30 years of age, or you're Māori or Pacific, DoxyPEP may be available free of charge at sexual‑health clinics.

Read more about who can prescribe DoxyPEP(external link).