What is DoxyPEP?

DOXY PEP (Doxycycline as Post Exposure Prophylaxis) is medication taken after condomless sex which has been shown to reduce syphilis and chlamydia infections, but is unlikely to reduce gonorrhoea infections, HIV infections or other viruses.

Who is eligible?

This service is for gay, bisexual, and other men who have sex with men, as well as transgender women, or other individuals in Lanarkshire, who may benefit from additional protection against syphilis.

DoxyPEP will be offered to eligible gay, bisexual, and other men who have sex with men, as well as transgender women, including those who:

• have had a bacterial STI in the previous 12 months (chlamydia, syphilis, or gonorrhoea)
• have had multiple sexual partners in the previous 3 months

What DoxyPEP does:

• DoxyPEP is an antibiotic that protects against bacterial STIs
• It is prescribed to protect against syphilis, but it also offers protection from chlamydia
• Studies have shown it is around 75-80% effective at reducing these infections
• It should be taken within 72 hours after sex (ideally within 24 hours)

What DoxyPEP doesn’t do:

• It’s important to note that DoxyPEP doesn’t protect you from HIV. For this, you may be interested in HIV PrEP.
• DoxyPEP also does not offer suitable protection from gonorrhea, although the Men B vaccine may be available to you. (Vaccination to help protect against gonorrhoea | NHS inform)
• Condoms are the only way to protect against all STIs. You can pick these up for free in our clinics, or other locations across Lanarkshire (C Card Centres).
• Because DoxyPEP is not 100% effective, and does not protect against all infections, regular STI testing is still encouraged.

What are the risks and side effects of taking DoxyPEP?

Common side effects of DoxyPEP include sensitivity to sunlight, feeling sick, headaches, stomach pains and heartburn. Doxycycline might increase the chance of developing yeast infections (thrush). DoxyPEP is safe to use if you are living with HIV. It can be used in combination with HIV treatment. DoxyPEP does not affect contraceptives, hormone replacement therapy, or PrEP.  If you have concerns about side effects, speak to a sexual health doctor or nurse for advice.

There is a possibility DoxyPEP could make some bacteria that cause chest and skin infections develop antibiotic resistance. This could make these infections harder to treat in the future. It is not clear what the impact will be. In people with a penicillin allergy, this may be more of a concern. We do not know how DoxyPEP might affect the balance of healthy bacteria in our bodies or how this might affect our health.

How do I get DoxyPEP? 

If you are interested in DoxyPEP and think you are eligible (see above ‘who is eligible’), then please phone to book a phone consultation to discuss. It also might be possible to discuss this at an appointment you already have. If you mention this at your appointment, the clinician will advise if there is time to discuss at that appointment, and if not then they will arrange a follow up phone consultation.

Can I take DoxyPEP if I’m using other medications?

DoxyPEP can interact with other medicines including medicines you can buy over the counter, and supplements.  Please advise the doctor or nurse if you are taking any of these.

I’m on DoxyPEP and have been a contact of an infection

If you are a contact of syphilis and have taken doxycycline within 72 hours of likely exposure, you may prefer a ‘watch-and-wait’ approach; however due to the time required to rule out infection (12 weeks), you may prefer to attend for treatment.

If you are a contact of chlamydia but have already taken doxycycline within 72 hours of likely exposure, you do not need further treatment.  Please continue to get regular sexual health screens every 3 months.

I’m running out of my DoxyPEP prescription

If you have already had a DoxyPEP start appointment in Lanarkshire Sexual Health, you can request more by:

• Attending your routine HIV PrEP review (if you use PrEP)
• Attending your routine pre booked appointment
• If you have run out before any arranged follow up, please call us and we will arrange for a phone consultation. Please advise how much medicine you have left.

For more information about DoxyPEP please visit: DoxyPEP | NHS Inform.